Study of MiniMed™ 640G Insulin Pump With SmartGuard™ in Prevention of Low Glucose Events in Adults With Type 1 Diabetes (SMILE)
A premarket, international multicenter, prospective, open label, adaptive, randomized controlled study.
The aim is to evaluate the efficacy of sensor augmented pump therapy with MiniMed™640G and SmartGuard™in preventing hypoglycemic events in comparison with continuous subcutaneous insulin infusion therapy in type 1 diabetes adults with an increased risk of hypoglycemia. The primary objective is to demonstrate a reduction in the mean number of hypoglycemic events when using the MiniMed™640G system with SmartGuard™ and the secondary objectives will aim at evaluating the difference in glycemic parameters and HbA1c.
研究概览
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Bergamo、意大利
- Ospedale Papa Giovanni Xxiii
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Milan、意大利
- Ospedale S. Raffaele
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Olbia、意大利
- Ospedale S. Gionanni di Dio
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Besançon、法国
- CHU de Besançon
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Grenoble、法国
- Chu Grenoble
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Marseille、法国
- APHM - La Conception
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Montpellier、法国
- CHU Montpellier - Hôpital Lapeyronie
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London、英国、SE5 9NU
- King's College London
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Manchester、英国
- Manchester Diabetes Center
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N. Yorkshire
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Harrogate、N. Yorkshire、英国、HG2 7SX
- Harrogate District Hospital
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Gouda、荷兰
- Groene Hart Ziekenhuis
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Rotterdam、荷兰
- Maasstad ziekenhuis
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Utrecht、荷兰
- UMC Utrecht
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Zwolle、荷兰
- Isala
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Age 24-75 years old at time of screening.
- Diagnosed with Type 1 diabetes ≥10 years prior to screening.
- On pump therapy for ≥ 6 months prior to screening.
- Not on Real Time continuous glucose monitoring for ≥ 3 months prior to screening.
- HbA1c value ≥5.8% and ≤10.0% as assessed by local lab ≤ 15 days prior to screening or performed at screening.
- A documented Severe Hypoglycemia event ≤ 12 months prior to screening, OR Clarke score ≥4 assessed at time of screening, OR
- Gold score ≥4 assessed at time of screening.
- Subject is willing to sign and date informed consent, comply with all study procedures and wear all study devices as required during the study.
Exclusion Criteria:
- Untreated Addison's disease, thyroid disorder, growth hormone deficiency, hypopituitarism or definite gastroparesis, per investigator judgment.
- Subject is using Pramlintide (Symlin) SGLT2 inhibitor, GLP agonist at time of screening.
- Renal failure defined by creatinine clearance <30 ml/min, as assessed by local lab test ≤ 3 months before screening or performed at screening at local lab.
- Hearing or vision impairment hindering perception of glucose display and alarms, or otherwise incapable of using the study devices, per investigator judgment.
- Current pregnancy or intention to conceive.
- Any unresolved adverse skin condition in the area of sensor placement (e.g. psoriasis, rash, Staphylococcus infection).
- Alcohol or drug abuse, other than nicotine, per investigator judgment.
- Any other disease or condition that may preclude the patient from participating in the study, per investigator judgment.
- Legally incompetent, illiterate or vulnerable person.
Randomization Criteria:
If subjects meet the above criteria, as well as all of the following criteria assessed at the end of the run-in period, they may continue to participate in the treatment period of the study:
- Subject has worn two weeks the sensor with transmitter during the run-in period.
- Subject has shown acceptable tolerance of sensor wear, per investigator judgment.
- Subject performed ≥ 4 finger stick blood glucose measurements daily, as determined by CareLink™ Clinical data upload as the mean number of SMBG/day over the past 14 days (SMBG number / day ≥ 3.5 rounds up to 4).
- Subject showed ability to comprehend the pump training and study procedures, per investigator judgment.
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的：Treatment
MiniMed™640G and Suspend before Low feature of SmartGuard™ turned on.
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All enrolled subjects will start a run in phase, receive training and start pump therapy with the MiniMed™640G insulin pump and usage of blinded Continuous Glucose Monitoring. Eligible subjects that meet the randomization criteria assessed after the running phase will be randomized into the treatment or control arm. Treatment Arm: training and start of Sensor Augmented Pump therapy with Suspend before Low feature of SmartGuard turned ON. Control Arm: continuation of pump therapy alone with blinded continuous glucose monitoring for a total of 6 weeks during the treatment phase.
其他名称：
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有源比较器：Control
MiniMed™640G alone
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Control Arm: continuation of pump therapy alone with blinded continuous glucose monitoring for a total of 6 weeks.
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研究衡量的是什么？
主要结果指标
结果测量 |
大体时间 |
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Mean Number of Sensor Glucose Hypoglycaemic Events Below or Equal to 55 mg/dL Per Patient/Week.
大体时间：6 months
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6 months
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次要结果测量
结果测量 |
大体时间 |
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Mean Time Spent of Sensor Glucose Values Below or Equal 55 mg/dL.
大体时间：6 months
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6 months
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Mean Time Spent of Sensor Glucose Values Within Range and Including 70-180 mg/dL.
大体时间：6 months
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6 months
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合作者和调查者
出版物和有用的链接
一般刊物
- Habteab A, Castaneda J, de Valk H, Choudhary P, Bosi E, Lablanche S, de Portu S, Da Silva J, Vorrink-de Groot L, Shin J, Cohen O. Predicting Factors Associated with Hypoglycemia Reduction with Automated Predictive Insulin Suspension in Patients at High Risk of Severe Hypoglycemia: An Analysis from the SMILE Randomized Trial. Diabetes Technol Ther. 2020 Sep;22(9):681-685. doi: 10.1089/dia.2019.0495.
- Bosi E, Choudhary P, de Valk HW, Lablanche S, Castaneda J, de Portu S, Da Silva J, Re R, Vorrink-de Groot L, Shin J, Kaufman FR, Cohen O; SMILE Study Group. Efficacy and safety of suspend-before-low insulin pump technology in hypoglycaemia-prone adults with type 1 diabetes (SMILE): an open-label randomised controlled trial. Lancet Diabetes Endocrinol. 2019 Jun;7(6):462-472. doi: 10.1016/S2213-8587(19)30150-0. Epub 2019 Apr 29.
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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