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Multi-center Trial in Adult and Pediatric Patients With Type 1 Diabetes Using Hybrid Closed Loop System and Control at Home

Not Applicable
Completed
Conditions
Type 1 Diabetes
Registration Number
NCT02748018
Lead Sponsor
Medtronic Diabetes
Brief Summary

The purpose of this study is to evaluate the safety and effectiveness of the Hybrid Closed Loop system (HCL) in adult and pediatric patients with type 1 diabetes in the home setting. A diverse population of patients with type 1 diabetes will be studied. The study population will have a large range for duration of diabetes and glycemic control, as measured by glycosylated hemoglobin (A1C). They will be enrolled in the study regardless of their prior diabetes regimen, including using Multiple Daily Injections (MDI), Continuous Subcutaneous Insulin Infusion (CSII) or Sensor-Augmented Pump therapy (SAP)

Detailed Description

This is a 6 month, multi-center, randomized, parallel, adaptive study in type 1 diabetes with a 6 month continuation period. The study will have three periods, per Cohort:

1. Run-in Period: The run-in period can be up to 60 days during which time a blinded CGM sensor will be worn for two weeks.

2. Study Period: There will be a 6 month randomized study period with two arms: The HCL system and Control. The primary and secondary endpoints will be evaluated during this period only.

3. Continuation Period: There will be a 6 month continuation period during which time all subjects will use the HCL system with Auto Mode. Only the safety endpoint will be evaluated during this period.

Up to 1500 subjects will be enrolled in order to have 1000 subjects complete the study. Up to 70 investigational Centers in the US, Europe, Canada, Australia and New Zealand will be enrolled.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
959
Inclusion Criteria

Not provided

Exclusion Criteria
  1. Subject participated in any Closed Loop study in the past.
  2. Subject is unable to tolerate tape adhesive in the area of sensor placement
  3. Subject has any unresolved adverse skin condition in the area of sensor placement (e.g., psoriasis, rash, Staphylococcus infection) or area of infusion set placement
  4. Women of child-bearing potential who have a positive pregnancy test at screening or plan to become pregnant during the course of the study
  5. Subject is being treated for hyperthyroidism at time of screening
  6. Subject has an abnormality (out of reference range) in thyroid-stimulating hormone (TSH) at time of screening visit. TSH is not required for subjects 2-13 years of age.
  7. Subject has taken any oral, injectable, or IV glucocorticoids within 8 weeks from time of screening visit, or plans to take any oral, injectable, or IV glucocorticoids during the course of the study.
  8. Subject is actively participating in an investigational study (drug or device) wherein he/she has received treatment from an investigational study drug or investigational study device in the last 2 weeks
  9. Subject is currently abusing illicit drugs or marijuana
  10. Subject is currently abusing prescription drugs
  11. Subject is currently abusing alcohol
  12. Subject is using pramlintide (Symlin), SGLT2 inhibitors, GLP agonists, biguanides, DPP-4 inhibitors or sulfonylureas at time of screening
  13. Subject is using hydroxyurea at the time of screening or plans to use it during the study
  14. Subject has a history of visual impairment which would not allow subject to participate in the study and perform all study procedures safely, as determined by the investigator
  15. Subject has a sickle cell disease, hemoglobinopathy; or has received red blood cell transfusion or erythropoietin within 3 months prior to time of screening
  16. Subject plans to receive red blood cell transfusion or erythropoietin over the course of study participation
  17. Subject diagnosed with current moderate to severe eating disorder such as anorexia or bulimia
  18. Subject has been diagnosed with chronic kidney disease requiring dialysis or resulting in chronic anemia
  19. Subjects who are currently being actively treated for cancer.
  20. Subject who is designated as a research staff member for this study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
CSII Cohort: Baseline A1C > 8%: Change in A1C (∆A1C)Baseline and end of 6-month study period

CSII Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit, for subjects with baseline A1C \> 8%

CSII Cohort: Baseline A1C ≤ 8%: Time in Hypoglycemic Range6 months study period

CSII Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period, for subjects with baseline A1c ≤ 8%

MDI Cohort: Baseline A1C > 8%: Change of A1C (∆A1C)Baseline and end of 6-month study period

MDI Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit, for subjects with baseline A1c \> 8%

MDI Cohort: Baseline A1C ≤ 8%: Time in Hypoglycemic Range6 months study period

MDI Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period, for subjects with baseline A1c ≤ 8%

SAP Cohort: Baseline A1C > 8%: Change of A1C (∆A1C)Baseline and end of 6-month study period

SAP Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit, for subjects with baseline A1c \> 8%

SAP Cohort: Baseline A1C ≤ 8%: Time in Hypoglycemic Range6 months study period

SAP Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period, for subjects with baseline A1c ≤ 8%

Secondary Outcome Measures
NameTimeMethod
CSII Cohort: Baseline A1C > 8%: Time in Hypoglycemic Range6 months study period

CSII Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period, for subjects with baseline A1c \> 8%

CSII Cohort: Baseline A1C ≤ 8%: Change in A1C (∆A1C)Baseline and end of 6-month study period

CSII Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit, for subjects with baseline A1c ≤ 8%

CSII Cohort: Time in Hypoglycemic Range During Night for All Subjects6 months study period

CSII Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Night for all subjects

CSII Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) During Night for All Subjects6 months study period

CSII Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Night for all subjects

CSII Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) During Day and Night for All Subjects6 months study period

CSII Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Day and Night for all subjects

CSII Cohort: Time in Hypoglycemic Range During Day and Night for All Subjects6 months study period

CSII Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Day and Night for all subjects

CSII Cohort: Change in A1C for All SubjectsBaseline and end of 6-month study period

CSII Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit for all subjects

MDI Cohort: Time in Hypoglycemic Range During Night for All Subjects6 months study period

MDI Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Night for all subjects

MDI Cohort: Baseline A1C > 8%: Time in Hypoglycemic Range6 months study period

MDI Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period, for subjects with baseline A1c \> 8%

MDI Cohort: Baseline A1C ≤ 8%: Change in A1C (∆A1C)Baseline and end of 6-month study period

MDI Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit, for subjects with baseline A1c ≤ 8%

MDI Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) During Night for All Subjects6 months study period

MDI Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Night for all subjects

MDI Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) During Day and Night for All Subjects6 months study period

MDI Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Day and Night for all subjects

MDI Cohort: Time in Hypoglycemic Range During Day and Night for All Subjects6 months study period

MDI Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Day and Night for all subjects

MDI Cohort: Change in A1C for All SubjectsBaseline and end of 6-month study period

MDI Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit for all subjects

SAP Cohort: Baseline A1C > 8%: Time in Hypoglycemic Range6 months study period

SAP Cohort: Time with sensor glucose (SG) below 70 mg/dL (3.9mmol/L) during the six-month study period, for subjects with baseline A1c \> 8%

SAP Cohort: Baseline A1C ≤ 8%: Change in A1C (∆A1C)Baseline and end of 6-month study period

SAP Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit, for subjects with baseline A1c ≤ 8%

SAP Cohort: Time in Hypoglycemic Range During Night for All Subjects6 months study period

SAP Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Night for all subjects

SAP Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) During Night for All Subjects6 months study period

SAP Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Night for all subjects

SAP Cohort: Time in Target Range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) During Day and Night for All Subjects6 months study period

SAP Cohort: Time in target range measures the time with SG in target range 70mg/dL (3.9mmol/L) - 180 mg/dL (10.0mmol/L) during Day and Night for all subjects

SAP Cohort: Time in Hypoglycemic Range During Day and Night for All Subjects6 months study period

SAP Cohort: Time with SG below 70 mg/dL (3.9mmol/L) during Day and Night for all subjects

SAP Cohort: Change in A1C for All SubjectsBaseline and end of 6-month study period

SAP Cohort: Change in A1C from baseline to the end of the six-month treatment period, defined as A1C measured at the six-month treatment visit minus A1C measured at the randomization visit for all subjects

Trial Locations

Locations (36)

Scripps Health System

🇺🇸

La Jolla, California, United States

Stanford University

🇺🇸

Palo Alto, California, United States

Center of Excellence in Diabetes & Endocrinology

🇺🇸

Sacramento, California, United States

Sansum Diabetes Research Institute

🇺🇸

Santa Barbara, California, United States

SoCal Diabetes

🇺🇸

Torrance, California, United States

Diablo Clinical Research

🇺🇸

Walnut Creek, California, United States

Barbara Davis Center

🇺🇸

Aurora, Colorado, United States

University of South Florida Diabetes Center

🇺🇸

Tampa, Florida, United States

Atlanta Diabetes Associates

🇺🇸

Atlanta, Georgia, United States

Endocrine Research Solutions

🇺🇸

Roswell, Georgia, United States

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Scripps Health System
🇺🇸La Jolla, California, United States

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