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Reduction of Nocturnal Hypoglycemia and Hyperglycemia in the Home Using Predictive Algorithms
Not Recruiting
Trial ID: NCT02438189
Purpose
Objective: to gain experience with in-home use of a modified algorithm that will dose insulin
to minimize projected hyperglycemia overnight in addition to suspending the pump if
hypoglycemia is projected overnight and to obtain feasibility, safety, and initial efficacy
data.
Study Design: randomized controlled trial, with randomization on a night level within
subject.
Major Eligibility Criteria: clinical diagnosis of type 1 diabetes, daily insulin therapy for
at least one year and an insulin infusion pump for at least 6 months; 15.0 to <46.0 years of
age; HbA1c < 10.0%; no DKA in last 6 months; no hypoglycemic seizure or loss of consciousness
in last 6 months; Living with a significant other or family member ("companion") committed to
participating in all study activities, and being present and available to provide assistance
when the system is being used at night.
Sample Size: 30 subjects.
Study Duration and Visit Schedule: duration approximately 3 months, with preliminary run-in
activities followed by up to 90 days spent in clinical trial phase of study; clinic visits at
enrollment, following CGM and system assessment run-in phases, at start of clinical trial
phase, at 21-day point of clinical trial phase, and after 42 nights of successful system use.
Major Efficacy Outcomes:
- Primary: time in range (70-180 mg/dl, 3.9-10.0 mmol/L) overnight.
- Secondary: time spent in hypoglycemia (≤70 mg/dl, 3.9 mmol/L) and time spent in
hyperglycemia (>180 mg/dl, 10.0 mmol/L) overnight.
Major Safety Outcomes: CGM measures of hypo- and hyperglycemia, including morning blood
glucose and mean overnight sensor glucose; adverse events including severe hypoglycemia and
diabetic ketoacidosis.
Official Title
Reduction of Nocturnal Hypoglycemia and Hyperglycemia in the Home Using Predictive Algorithms, Pump Suspension, and Insulin Dosing
Stanford Investigator(s)
Bruce Buckingham
Professor of Pediatrics (Endocrinology) at the Lucile Salter Packard Children's Hospital, Emeritus
Eligibility
Inclusion Criteria:
- Clinical diagnosis of type 1 diabetes and using daily insulin therapy for at least one
year and an insulin infusion pump for at least 6 months The diagnosis of type 1
diabetes is based on the investigator's judgment; C peptide level and antibody
determinations are not required.
- Age 15.0 to <46.0 years
- HbA1c <10.0%
- Measured with DCA2000 or equivalent device for assessing eligibility
- HbA1c measurements performed as part of usual clinical care within 2 weeks prior
to obtaining informed consent for participation in the trial may be used.
- Uninterrupted internet access while study system is being used overnight and for
upload of study data in the morning
- Living with a significant other or family member ("companion") committed to
participating in all study activities, and being present and available to provide
assistance when the system is being used at night
- An understanding of and willingness to follow the protocol and sign the informed
consent
Exclusion Criteria:
- Diabetic ketoacidosis in the past 3 months
- Hypoglycemic seizure or loss of consciousness in the past 6 months
- History of seizure disorder (except for hypoglycemic seizure)
- History of any heart disease including coronary artery disease, heart failure, or
arrhythmias
- Cystic fibrosis
- Current use of oral/inhaled glucocorticoids, beta-blockers or other medications, which
in the judgment of the investigator would be a contraindication to participation in
the study.
- History of ongoing renal disease (other than microalbuminuria). Creatinine level must
have been obtained within the last year if subject has diabetes of >10 years duration.
If creatinine is >1.5 mg/dL (132 µmol/L), the subject is excluded.
- Medical or psychiatric condition that in the judgment of the investigator might
interfere with the completion of the protocol such as:
- Inpatient psychiatric treatment in the past 6 months
- Uncontrolled adrenal disorder
- Abuse of alcohol
- Pregnancy Negative urine pregnancy test required for females who have experienced
menarche as well as agreement from subject and parent/guardian to use a form of
contraception to prevent pregnancy while participant is in the study. Subjects who
become pregnant will be discontinued from the study.
- Liver disease as defined by an ALT greater than 3 times the upper limit of normal
Intervention(s):
device: Hyperglycemia Minimization Algorithm
Not Recruiting
Contact Information
Stanford University
School of Medicine
300 Pasteur Drive
Stanford,
CA
94305