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Efficacy of Closed-loop Insulin Therapy in Prepubertal Child in Free-life (FREELIFE-KID)

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ClinicalTrials.gov Identifier: NCT03739099
Recruitment Status : Recruiting
First Posted : November 12, 2018
Last Update Posted : November 29, 2018
Sponsor:
Information provided by (Responsible Party):
University Hospital, Montpellier

Brief Summary:
The study is a randomized trial preceded by a run-in period and followed by a non-randomized study extension. After 3 weeks of outpatient use of study pump (1 week) and study pump+CGM (2weeks) as run-in period, patient and parents will be admitted for 4-hour training to closed-loop (AP) mode. Following randomization (1:1), patient will be allocated to '24-hour' use of AP or 'dinner and overnight AP mode/day time pump and CGM use' for the next 18-week period. At 18-week visit, a study extension for a further 18-week period will be initiated. AP mode that will be prescribed to all patients will depend from an independent DSMB decision based upon study safety data collected after 6 and 12 weeks from the first 30 included patients. Visits will occur at week 27 (safety follow-up) and 36 (final visit).

Condition or disease Intervention/treatment Phase
Type 1 Diabetes Mellitus in Prepubertal Children Device: Closed-loop insulin infusion driven by continuous glucose monitoring through an algorithm, in free-life conditions Not Applicable

Detailed Description:
The study is a randomized trial preceded by a run-in period and followed by a non-randomized study extension. After 3 weeks of outpatient use of study pump (1 week) and study pump+CGM (2weeks) as run-in period, patient and parents will be admitted for 4-hour training to closed-loop (AP) mode. Following randomization (1:1), patient will be allocated to '24-hour' use of AP or 'dinner and overnight AP mode/day time pump and CGM use' for the next 18-week period. A hotline phone number will be given to the patient and parents so that they can contact the study staff as needed. A logbook will be provided to collect details about hypoglycemic and hyperglycemic episodes, physical activity and noticeable events. Phone calls will be scheduled between investigator and patient+parents 48 hours, 1 week and 2 weeks after AP mode initiation. Potential misbehaviors will be corrected and all questions answered. If needed, AP parameters may be revised and reconfigured. Hospital visits will be scheduled 6, 12 and 18 weeks after AP mode initiation for the same purposes, plus HbA1c measurement at week 12 and 18. At 18-week visit, a study extension for a further 18-week period will be initiated. AP mode that will be prescribed to all patients will depend from an independent DSMB decision based upon study safety data collected after 6 and 12 weeks from the first 30 included patients. Visits will occur at week 27 (safety follow-up) and 36 (final visit).

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 120 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Assessment of the Efficacy of Closed-loop Insulin Therapy (Artificial Pancreas) on the Control of Type 1 Diabetes in Prepubertal Child in Free-life: Comparison Between Nocturnal and 24-hour Use on 18 Weeks, Followed by an Extension on 18 Weeks
Actual Study Start Date : November 5, 2018
Estimated Primary Completion Date : September 5, 2020
Estimated Study Completion Date : September 5, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Diabetes Type 1

Arm Intervention/treatment
Active Comparator: Closed-loop insulin delivery 24/7, day and night
Closed-loop subcutaneous insulin infusion driven by continuous glucose monitoring through an algorithm
Device: Closed-loop insulin infusion driven by continuous glucose monitoring through an algorithm, in free-life conditions
Continuous subcutaneous insulin infusion according to an automated algorithm from continuous glucose monitoring data
Other Name: Artificial pancreas

Closed-loop insulin delivery 7/7, dinner and night
Closed-loop subcutaneous insulin infusion driven by continuous glucose monitoring through an algorithm
Device: Closed-loop insulin infusion driven by continuous glucose monitoring through an algorithm, in free-life conditions
Continuous subcutaneous insulin infusion according to an automated algorithm from continuous glucose monitoring data
Other Name: Artificial pancreas




Primary Outcome Measures :
  1. Percent of time spent in the 70-180 mg/dl glucose range assessed on daily CGM data [ Time Frame: 18 weeks ]
    % time blood glucose in 70-180 mg/dl range


Secondary Outcome Measures :
  1. Percent of time spent with glucose level < 70, 60 and 50 mg/dl, assessed on daily CGM data [ Time Frame: 18 and 36 weeks ]
    Percent time while blood glucose is kept in safe 70-180 mg/dl range

  2. Percent of time spent with glucose level > 180 and 300 mg/dl, assessed on daily CGM data [ Time Frame: 18 and 36 weeks ]
    Percent time while blood glucose is kept in safe 70-180 mg/dl range

  3. Percent of time spent in the 70-140 mg/dl glucose range assessed on daily CGM data [ Time Frame: 18 and 36 weeks ]
    Percent time while blood glucose is kept in safe 70-180 mg/dl range

  4. Mean glucose level assessed on daily CGM data [ Time Frame: 18 and 36 weeks ]
    CGM data will be used to calculate daily glucose mean to assess the efficacy of the algorithm on glucose control.

  5. HbA1c level measured at week 12, 18, 27 and 36 [ Time Frame: 12,18, 27 and 36 weeks ]
    Levels of glycated hemoglobin will be measured at different time intervals to assess the clinical impact of the use of the algorithm on patient diabetes.

  6. Number of needed interventions by the patients or care providers to treat hypoglycemia [ Time Frame: 18 and 36 weeks ]
    A logbook will be used all along the study by patients to record carbs intake in case of hypoglycemia. If patient required further assistance, care provider who will record third parties intervention.

  7. Percent of time with AP functional, discriminating between each component failure modes [ Time Frame: 18 and 36 weeks ]
    Percent time while blood glucose is kept in safe 70-180 mg/dl range

  8. Score of the Artificial Pancreas Acceptance Questionnaire [ Time Frame: 18 and 36 weeks ]
    This questionnaire consists of 15 affirmations about the use of AP and patient can answer in a scale from 0 (do not agree) to 6 (totally agree). The global score is calculated by the sum of all answers. A high score means a good acceptation of the system. There is no subscale.



Information from the National Library of Medicine

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Ages Eligible for Study:   6 Years to 12 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Treatment of diabetes by insulin pump since > 6 months
  • HbA1c level < 10%

Exclusion Criteria:

  • Unwillingness of one parent or the legally responsible party to participate in insulin treatment
  • Any associated chronic disease or therapy (except insulin) affecting glucose metabolism

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03739099


Contacts
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Contact: Eric M RENARD, MD, PhD +33 467 338 382 e-renard@chu-montpellier.fr
Contact: Jerome M PLACE, MSc +33 467 457 310 jerome.place@umontpellier.fr

Locations
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France
Montpellier University Hospital Recruiting
Montpellier, France, 34295
Contact: Sylvine PLAGNOL, Research Assistant    +33467339832    s-plagnol@chu-montpellier.fr   
Contact: Lucie CHARRIER, Research Assistant    +3367333050    l-charrier@chu-montpellier.fr   
Principal Investigator: Eric M RENARD, MD, PhD         
Sponsors and Collaborators
University Hospital, Montpellier
Investigators
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Principal Investigator: Eric M RENARD, MD, PhD Montpellier University Hospital

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Responsible Party: University Hospital, Montpellier
ClinicalTrials.gov Identifier: NCT03739099     History of Changes
Other Study ID Numbers: UF 7580
First Posted: November 12, 2018    Key Record Dates
Last Update Posted: November 29, 2018
Last Verified: November 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by University Hospital, Montpellier:
Type 1 diabetes
Prepubertal children
Closed-loop insulin infusion
Additional relevant MeSH terms:
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Diabetes Mellitus, Type 1
Diabetes Mellitus
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Autoimmune Diseases
Immune System Diseases
Insulin
Insulin, Globin Zinc
Pancrelipase
Pancreatin
Hypoglycemic Agents
Physiological Effects of Drugs
Gastrointestinal Agents