Inpatient Evaluation of the MD-Logic Artificial Pancreas System in Patients With Type 1 Diabetes (MD-Logic- Cont)
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Purpose
The purpose of this feasibility study is to evaluate the MDLAP (MD-Logic artificial pancreas system)automated insulin management system using continuous glucose monitoring (CGM) and subcutaneous insulin pump infusion in individuals with type 1 diabetes. The study will include 3 inpatient admissions (12-24 hr), which will include overnight sleep, over-bolus meal, under-bolus meal and exercise.
| Condition | Intervention | Phase |
|---|---|---|
|
Diabetes Type 1 |
Device: MD-logic artificial pancreas system |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Inpatient Evaluation of the MD-Logic Artificial Pancreas System in Patients |
- Percent of glucose values 71-180 mg/dL of combined day and night readings during the first admission visit [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- Percent of subjects with blood glucose reading of 71-180 mg/dL 4 hours following the breakfast with a missed meal bolus [ Time Frame: Day 1 ] [ Designated as safety issue: No ]Success is defined as >=40% subjects with a blood glucose in the 71-180 mg/dL range.
- Percent of subjects with blood glucose reading of 71-180 mg/dL 5 hours following the breakfast with a meal bolus 30% more than the recommended bolus amount [ Time Frame: Day 2 ] [ Designated as safety issue: No ]Success is defined as >=50% subjects with a blood glucose in the 71-180 mg/dL range.
- Percent of subjects with a blood glucose nadir <=60 mg/dL following exercise [ Time Frame: Day 3 ] [ Designated as safety issue: Yes ]Success is defined as less than 25% of subjects with a blood glucose nadir <=60 mg/dL.
- Overall frequency of hypoglycemia [ Time Frame: day 3 ] [ Designated as safety issue: Yes ]Success defined as no subjects with severe hypoglycemia with a low blood glucose resulting in seizure, unconsciousness or the inability to treat oneself.
- Overall frequency of hyperglycemia [ Time Frame: Day 3 ] [ Designated as safety issue: Yes ]Success defined as no subjects with diabetic ketoacidosis (DKA).
- Percent of subjects with a peak blood glucose >400 mg/dL following the breakfast with a meal bolus 30% more than the recommended bolus amount [ Time Frame: day 2 ] [ Designated as safety issue: Yes ]Success is defined as less than 5% of subjects have a peak blood glucose >400 mg/dL
- Percent of blood glucose values 71-180 mg/dL during the day (9:00AM-11:00PM) of the first admission visit [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- Percent of blood glucose values 70-180 mg/dL during the night (11:00PM-8:00AM) of the first admission visit [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
- Percent of blood glucose values >400 mg/dL during the first admission visit [ Time Frame: Day 1 ] [ Designated as safety issue: Yes ]Individual success is defined as no blood glucose values >400 mg/dL.
- Percent of blood glucose values <=60 mg/dL during the first admission visit [ Time Frame: Day 1 ] [ Designated as safety issue: Yes ]No more than 33% of visits with blood glucose <=60 mg/dL
- Percent of subjects with a peak blood glucose >400 mg/dL following the breakfast with a missed meal bolus [ Time Frame: Day 1 ] [ Designated as safety issue: Yes ]Success is defined as less than 5% of subjects have a peak blood glucose >400 mg/dL
- Percent of subjects with a nadir blood glucose <=60 mg/dL following the breakfast with a missed meal bolus [ Time Frame: Day 1 ] [ Designated as safety issue: Yes ]Success is defined as less than 15% of subjects have a nadir blood glucose <=60 mg/dL
- Percent of subjects with a nadir blood glucose <=60 mg/dL following the breakfast with a meal bolus 30% more than the recommended bolus amount [ Time Frame: Day 2 ] [ Designated as safety issue: Yes ]Success is defined as less than 25% of subjects have a nadir blood glucose <=60 mg/dL
| Estimated Enrollment: | 25 |
| Study Start Date: | October 2013 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Closed Loop Control- MD-Logic
The MD-Logic artificial pancreas system will be used in conjunction with continuous glucose monitoring and insulin pump delivery to manage the subject's blood glucose.
|
Device: MD-logic artificial pancreas system
The MD-logic artificial pancreas system is a closed loop control system using continuous glucose monitoring (CGM)and subcutaneous insulin pump infusion to mange glucose control in individuals with type 1 diabetes
|
Detailed Description:
The purpose of this feasibility study is to evaluate the MDLAP (MD-Logic artificial pancreas system)automated insulin management system using continuous glucose monitoring (CGM) and subcutaneous insulin pump infusion in individuals with type 1 diabetes. The study will include 3 inpatient admissions (12-24 hr), which will include overnight sleep, over-bolus meal, under-bolus meal and exercise. During the the visits, meal boluses will be semi-automated, with manual meal announcement by the physician/nurse, automated bolus recommendation by the system, and automated delivery of the bolus following confirmation of the recommendation. Between-meal insulin dosing will be fully automated. Bolus confirmation by the physician/nurse will be requested by the closed loop controller only when it determines that carbohydrates may be necessary to avoid hypoglycemia following the bolus.
Eligibility| Ages Eligible for Study: | 12 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Clinical diagnosis of type 1 diabetes for at least one year and using an insulin pump for at least 6 months
- Age 12 to 65 years
- Hemoglobin A1c (HbA1c) between 5.0% and 10.5%, as measured with DCA2000 or equivalent device
- For females, not currently known to be pregnant
- Demonstration of proper mental status and cognition for the study
- An understanding of and willingness to follow the protocol and sign the informed consent or assent
Exclusion Criteria:
- Diabetic ketoacidosis in the past 6 months
- Severe hypoglycemia resulting in seizure or loss of consciousness in the 12 months prior to enrollment
- History of a seizure disorder (except hypoglycemic seizure).
- Coronary artery disease or heart failure.
- Cystic fibrosis
- Active infection
- A known medical condition that in the judgment of the investigator might interfere with the completion of the protocol
- A recent injury to body or limb, muscular disorder, use of any medication, any carcinogenic disease, or other significant medical disorder if that injury, medication or disease in the judgment of the investigator will affect the completion of the exercise protocol
- Current use of a beta blocker medication
- Hematocrit <30%
- Use of pseudoephedrine 48 hours prior to Clinical Research Center (CRC) admission
Contacts and Locations| Contact: Moshe Phillip, Prof | 972-3-9253778 | mosheph@clalit.org.il |
| Israel | |
| Schneider children's Medical center | Not yet recruiting |
| Petah-tikva, Israel, 49202 | |
| Sub-Investigator: Revital Nimri, MD | |
| Sub-Investigator: Eran Atlas, Eng | |
| Sub-Investigator: Tal Oron, MD | |
| Principal Investigator: | Moshe Phillip, Prof | Rabin Medical Center |
More Information
No publications provided
| Responsible Party: | Rabin Medical Center |
| ClinicalTrials.gov Identifier: | NCT01501032 History of Changes |
| Other Study ID Numbers: | rmc006385ctil |
| Study First Received: | December 14, 2011 |
| Last Updated: | March 5, 2013 |
| Health Authority: | Israel: Ministry of Health |
Keywords provided by Rabin Medical Center:
|
Diabetes Type 1 Artificial Pancreas |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 1 Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Autoimmune Diseases |
Immune System Diseases Pancreatin Pancrelipase Gastrointestinal Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 13, 2013