Percent of Time With Sensed Glucose < 70 mg/dl
| Group | Value (percentage 4 hrs post exercise on Day 1) |
|---|---|
| Dual Hormone Closed-loop Arm | 0 |
| Single Hormone Closed-loop Arm | 8.3 |
| Predictive Low Glucose Suspend Arm | 4.2 |
Trial · Interventional
CompletedPhase 1Results postedRegistry dataUnited States
1 trial · 1 completed · 1 with posted results
Text and fields below are the sponsor's entries at ClinicalTrials.gov, shown as posted.
Closed-loop systems are an emerging technology that automate hormone delivery. They are quickly paving the way to revolutionize the treatment of type 1 diabetes. Several categories have emerged: dual-hormone (insulin and glucagon) closed-loop systems and closed-loop systems with insulin only, one variety of which is the low glucose suspend safety feature now available from Medtronic (MiniMed640G with SmartGuard). The study described within this protocol is designed to test the efficacy of a new closed-loop algorithm for managing blood glucose in people with type 1 diabetes before and after exercise. The new algorithm will have 3 modes: a single hormone insulin only mode, a dual-hormone insulin and glucagon mode and an insulin only mode with predictive low glucose suspend, all with an exercise detection algorithm. The purpose of this study is to determine whether a dual hormone AP using a stable investigational glucagon with an exercise detection algorithm outperforms both single hormone AP and a low glucose suspend algorithm.
Experimental
Dual Hormone Closed-loop Arm
Subjects will undergo a 76 hour study with 9 hours inpatient and 67 hours outpatient using the closed-loop artificial pancreas controller in dual hormone mode and XeriSol glucagon to manage blood sugar that includes an exercise detection component that includes a reduction in insulin delivery and an increase in glucagon delivery upon detection.
Experimental
Single Hormone Closed-loop Arm
Subjects will undergo a 76 hour study with 9 hours inpatient and 67 hours outpatient using the closed-loop artificial pancreas controller in single hormone mode to manage blood sugar that includes an exercise detection component that includes a reduction in insulin delivery upon detection.
Experimental
Predictive Low Glucose Suspend Arm
Subjects will undergo a 76 hour study with 9 hours inpatient and 67 hours outpatient using the closed-loop artificial pancreas controller in predictive low glucose suspend mode. The system will run through the closed-loop system but will utilize the patient's optimized basal rates, correction factors and carb ratios as they would normally run on their own insulin pump. But the mode will have the additional safety net of the pump suspending insulin when it predicts a hypoglycemic event.
Outcomes the sponsor listed as primary.
Percent of Time With Sensed Glucose < 70 mg/dl
Time frame · 4 hours post exercise on Day 1
Assess the percent of time that the Dexcom G5 or G6 reported sensor glucose values less than 70 mg/dl using Dexcom sensor across all three arms.
Percent of Time With Sensed Glucose Between 70-180 mg/dl
Time frame · entire 76 hour study
Assess the percent of time that the Dexcom G5 or G6 reported sensor glucose values between 70-180 mg/dl using Dexcom sensor across all three arms.
Number of Carbohydrate Treatments
Time frame · 24 hours
Assess the number of rescue carbohydrate treatments across all three arms per day.
Percent of Time With Sensed Glucose < 54 mg/dl
Time frame · entire 76 hour study
Assess the percent of time that the Dexcom G5 or G6 reported sensor glucose values less than 54 mg/dl using Dexcom sensor across all three arms.
Percent of Time With Sensed Glucose > 180 mg/dl
Time frame · entire 76 hour study
Assess the percent of time that the Dexcom G5 or G6 reported sensor glucose values greater than 180 mg/dl using Dexcom sensor across all three arms.
Mean Amount of Insulin Delivered in One Day
Time frame · 24 hours
Assess the mean amount of insulin delivered in units/kg as documented through the artificial pancreas controller across all three arms.
Mean Amount of Glucagon Delivered in One Day
Time frame · 24 hours
Assess the mean amount of XeriSol glucagon delivered in mcg/kg as documented through the artificial pancreas controller in dual hormone arm.
Values are shown as posted at ClinicalTrials.gov, with their units. PepBank has not converted, pooled or compared them.
| Group | Value (percentage 4 hrs post exercise on Day 1) |
|---|---|
| Dual Hormone Closed-loop Arm | 0 |
| Single Hormone Closed-loop Arm | 8.3 |
| Predictive Low Glucose Suspend Arm | 4.2 |
| Group | Value (percentage of 76 hours) | Spread |
|---|---|---|
| Dual Hormone Closed-loop Arm | 71.0 | 9.2 |
| Single Hormone Closed-loop Arm | 72.6 | 9.2 |
| Predictive Low Glucose Suspend Arm | 63.4 | 16.6 |
| Group | Value (number of carbohydrate treatments/day) | Spread |
|---|---|---|
| Dual Hormone Closed-loop Arm | 0.6 | 0.9 |
| Single Hormone Closed-loop Arm | 1.7 | 2.0 |
| Predictive Low Glucose Suspend Arm | 1.4 | 1.3 |
| Group | Value (percentage of 76 hours) |
|---|---|
| Dual Hormone Closed-loop Arm | 0 |
| Single Hormone Closed-loop Arm | 0.2 |
| Predictive Low Glucose Suspend Arm | 0.1 |
| Group | Value (percentage of 76 hours) | Spread |
|---|---|---|
| Dual Hormone Closed-loop Arm | 28.2 | 9.4 |
| Single Hormone Closed-loop Arm | 25.1 | 9.0 |
| Predictive Low Glucose Suspend Arm | 34.7 | 16.7 |
| Group | Value (units/kg/day) | Spread |
|---|---|---|
| Dual Hormone Closed-loop Arm | 42.3 | 16.9 |
| Single Hormone Closed-loop Arm | 41.1 | 16.4 |
| Predictive Low Glucose Suspend Arm | 44.0 | 15.3 |
| Group | Value (mcg/kg/day) | Spread |
|---|---|---|
| Dual Hormone Closed Loop | 4.5 | 1.9 |
| Group | Deaths | Serious events | Other events |
|---|---|---|---|
| Dual Hormone Closed-loop ArmSubjects will undergo a 76 hour study with 9 hours inpatient and 67 hours outpatient. Artificial Pancreas Controller in Dual Hormone Mode: The artificial pancreas controller contains an algorithm for managing blood glucose in people with type 1 diabetes which includes an exercise detection component. XeriSol glucagon: XeriSol glucagon is an investigational drug that is a stable, soluble liquid glucagon formulation that can be injected or administered through an insulin pump. XeriSol glucagon will be used to fill the Omnipod to deliver glucagon for the Artificial Pancreas Controller in Dual Hormone mode. | 0 / 22 | 0 / 22 | 7 / 22 |
| Single Hormone Closed-loop ArmSubjects will undergo a 76 hour study with 9 hours inpatient and 67 hours outpatient. Artificial Pancreas Controller in Single Hormone Mode: The artificial pancreas controller contains an algorithm for managing blood glucose in people with type 1 diabetes which includes an exercise detection component. | 0 / 21 | 0 / 21 | 3 / 21 |
| Predictive Low Glucose Suspend ArmSubjects will undergo a 76 hour study with 9 hours inpatient and 67 hours outpatient. The system will utilize the patient's optimized basal rates, correction factors and carb ratios as they would normally run but the mode will have the additional safety net of the pump suspending insulin when it predicts a hypoglycemic event. Artificial Pancreas Controller in Predictive Low Glucose Suspend Mode: The artificial pancreas controller contains an algorithm for managing blood glucose in people with type 1 diabetes which includes an exercise detection component. | 0 / 20 | 0 / 20 | 3 / 20 |
| Dexcom Training Period ArmSubjects used the Dexcom G6 CGM along with the APC app. Subjects attended a training visit on using the Dexcom G6. Subjects used the G6 at home over the next 7 days. | 0 / 23 | 0 / 23 | 0 / 23 |
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