The Pediatric Artificial Pancreas Automated Initialization Trial (PEDAP-AI): A Pilot Study of AI Advisor-Driven Pump Initiation and Parameter Adaptation in Young Children With Type 1 Diabetes
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 33
- 试验地点
- 6
- 主要终点
- Safety Endpoint (Tested for Non-inferiority Compared to Baseline) CGM Measured (a)
研究概览
简要总结
The goal of this clinical trial is to obtain safety data and exploratory glycemic control data from use of an at-home closed loop control (CLC) system (t:slim X2 with Control-IQ Technology) with periodic parameter adjustments driven by an AI-based Advisor system in young children with Type 1 Diabetes. The main endpoints this study aims to answer is the safety and efficacy of the use of the AI-driven pump parameters. Participants will use the study system (pump and Continuous Glucose Monitor) in closed-loop mode for eight weeks.
详细描述
In this single-arm pilot study of an AI Advisor-driven closed loop system initiation and parameter adaptation in youth age 2 to <6 years old, participants will use the Tandem t:slim X2 with Control-IQ and t:connect mobile application and Dexcom G6 or G7 system, connected to the University of Virginia (UVA) cloud-based Physician Dashboard for eight weeks at home.The key safety outcomes are adverse events related to hypoglycemia and hyperglycemia, CGM-measured time spent below 54mg/dL, and CGM-measured time spent above 250 mg/dL. CGM-measured endpoints will be tested against baseline for non-inferiority.Glycemic outcomes including time in target range 70-180 mg/dL (TIR) and various other CGM measures of hypo- and hyperglycemia will be assessed and tested for superiority against baseline and a matched historical control population from the prior PEDAP study that did not involve the use of any AI-driven pump parameters. Up to 45 screened participants with the goal of at least 30 participants completing the study pump use period.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 2 Years 至 5 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Clinical diagnosis, based on investigator assessment, of type 1 diabetes for at least 1 month
- •Familiarity and use of a carbohydrate ratio for meal boluses
- •Age ≥2 and <6 years old
- •Using a Dexcom CGM at the time of enrollment, with use on at least 21 out of the prior 28 days
- •Living with one or more parent/legal guardian knowledgeable about emergency procedures for severe hypoglycemia and able to contact emergency services and study staff
- •Parent/guardian has a phone that can run the Tandem t:connect Mobile App (typically Android 10 or above or iPhone Operating System (iOS) 15 or above)
- •Willingness to use the t:connect Mobile App as needed during the study and ensure connectivity for a data upload at least once per day
- •Investigator has confidence that the parent can successfully operate all study devices and is capable of adhering to the protocol
- •Willingness to switch to lispro (Humalog) or aspart (Novolog) if not using already, and to use no other insulin besides lispro (Humalog) or aspart (Novolog) during the study for participants using a study162 provided Tandem pump during the study
- •Total daily insulin dose (TDD) at least 5 Units/day
- •Body weight at least 20 pounds (lbs)
- •Willingness not to start any new non-insulin glucose-lowering agent during the course of the trial
- •Participant and parent(s)/guardian(s) willingness to participate in all training sessions as directed by study staff
- •Parent/guardian proficient in reading and writing English
- •Live in the United States, with no plans to move outside the United States during the study period
排除标准
- •Concurrent use of any non-insulin glucose-lowering agent (including GLP-1 agonists, Symlin, DPP-4 inhibitors, SGLT-2 inhibitors, sulfonylureas)
- •Hemophilia or any other bleeding disorder
- •History of >1 severe hypoglycemic event with seizure or loss of consciousness in the last 3 months
- •History of >1 diabetic ketoacidosis (DKA) event in the last 6 months not related to illness, infusion set failure, or initial diagnosis
- •History of chronic renal disease or currently on hemodialysis
- •History of adrenal insufficiency
- •Hypothyroidism that is not adequately treated in the opinion of the investigator
- •Use of oral or injectable steroids within the last 8 weeks
- •Known, ongoing adhesive intolerance
- •Plans to receive blood transfusions or erythropoietin injections during the course of the study
- •A condition, which in the opinion of the investigator or designee, would put the participant or study at risk
- •Participation in another pharmaceutical or device trial at the time of enrollment or during the study
- •Having immediate family members employed by Tandem Diabetes Care, Inc. or Dexcom, Inc., or having a direct supervisor at place of employment who is also directly involved in conducting the clinical trial (as a study investigator, coordinator, etc.); or having a first-degree relative who is directly involved in conducting the clinical trial
结局指标
主要结局
Safety Endpoint (Tested for Non-inferiority Compared to Baseline) CGM Measured (a)
时间窗: Baseline and Weeks 1-8
% of time below 54 mg/dL
Safety Endpoint (Tested for Non-inferiority Compared to Baseline) CGM Measured (b)
时间窗: Baseline and Weeks 1-8
% of time above 250 mg/dL
Hierarchical Efficacy Endpoints (Tested for Superiority Compared With Baseline) CGM Measured (a)
时间窗: Baseline and Weeks 1-8
% of time in range 70-180 mg/dL
Hierarchical Efficacy Endpoints (Tested for Superiority Compared With Baseline) CGM Measured (b)
时间窗: Baseline and Weeks 1-8
Mean glucose
Hierarchical Efficacy Endpoints (Tested for Superiority Compared With Baseline) CGM Measured (c)
时间窗: Baseline and Weeks 1-8
% of time \>250 mg/dL
Hierarchical Efficacy Endpoints (Tested for Superiority Compared With Baseline) CGM Measured (d)
时间窗: Baseline and Weeks 1-8
% of time \<70 mg/dL
Hierarchical Efficacy Endpoints (Tested for Superiority Compared With Baseline) CGM Measured (e)
时间窗: Baseline and Weeks 1-8
% of time \<54 mg/dL
次要结局
- CGM Measured (d)(Baseline and Weeks 1-8)
- CGM Measured (e)(Baseline and Weeks 1-8)
- CGM Measured Time in Range(Baseline and Weeks 1-8)
- CGM Measured (a)(Baseline and Weeks 1-8)
- CGM Measured (b)(Baseline and Weeks 1-8)
- CGM Measured (c)(Baseline and Weeks 1-8)
- CGM Measured (f)(Baseline and Weeks 1-8)
- CGM Measured (g)(Baseline and Weeks 1-8)
- CGM Measured (h)(Baseline and Weeks 1-8)
- CGM Measured (i)(Baseline and Weeks 1-8)
- Binary Outcome 1(Baseline and Weeks 1-8)
- Binary Outcome 2(Baseline and Weeks 1-8)
- Binary Outcome 3(Baseline and Weeks 1-8)
- Total Daily Insulin(Baseline and Weeks 1-8)
- Basal Insulin(Baseline and Weeks 1-8)
研究者
Marc Breton
Principal Investigator
University of Virginia