Early Feasibility Study of Zone-MPC and HMS With DiAs in the Outpatient Setting

NCT ID: NCT02463682

Last Updated: 2016-04-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

9 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-05-31

Study Completion Date

2015-10-31

Brief Summary

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This is a feasibility study of an artificial pancreas (AP) system with our previously validated Zone-MPC and Health Monitoring System (HMS) algorithms (ClinicalTraisl.gov: NCT01929798) integrated into the Diabetes Assistant (DiAs) system.

Detailed Description

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This is a feasibility study of an artificial pancreas (AP) system with our previously validated Zone-MPC and Health Monitoring System (HMS) algorithms (ClinicalTraisl.gov: NCT01929798) integrated into the Diabetes Assistant (DiAs) system. The system will be evaluated on 2-3 subjects per site (n=6-9 subjects) for 2 weeks at 3 different sites (William Sansum Diabetes Center, University of Virginia, and Mayo Clinic, Rochester, MN). Basal rates will be adjusted in a run-to-run manner by study physicians prior to the closed-loop phase for a maximum of 3 weeks. Subjects will then complete 2 weeks at home use of the Zone-MPC/HMS system using the DIAs platform for a closed-loop feasibility trial. The purpose of this pilot study is to establish that safe day-and-night use of the Zone-MPC/HMS system integrated into the DiAs is achievable in the home environment, to analyze and learn to improve upon the run-to- run optimization process, and to collect efficacy data to inform a future larger study.

Conditions

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Diabetes Mellitus, Type 1

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Sensor-Augmented Pump Open-Loop Care (Week 1)

The subjects Sensor-Augmented Pump Open-Loop Care for the first week of the study before any adjustments to pump settings.

Group Type ACTIVE_COMPARATOR

CGM and Insulin Pump

Intervention Type DEVICE

Dexcom G4 Platinum CGM with Share AP Receiver Roche Accu-Chek insulin pump

Closed-Loop Control System with Zone MPC and HMS

The artificial pancreas system will be allowed to employ its Model Predictive Control algorithm to make decisions about insulin delivery based on measured glucose levels. The Health Monitoring System algorithm uses the same CGM data as the MPC control algorithm but utilizes a separate algorithm for trending and predictions of future glucose values. Using a redundant and independent algorithm is an important safety feature of the overall AP device.

Group Type EXPERIMENTAL

Closed-Loop Control System

Intervention Type DEVICE

The devices that will be used in the Closed-Loop Control System include the following components:

DiAs - a smart-phone medical platform; Dexcom Dexcom G4 Platinum connected to DiAs via Bluetooth CGM receiver; Roche Accu-Chek insulin pump connected to DiAs via wireless Bluetooth; Remote Monitoring Server connected to DiAs via 3G or local Wi-Fi network, and Zone-MPC and HMS algorithms running on DiAs (MPC and HMS)

Interventions

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CGM and Insulin Pump

Dexcom G4 Platinum CGM with Share AP Receiver Roche Accu-Chek insulin pump

Intervention Type DEVICE

Closed-Loop Control System

The devices that will be used in the Closed-Loop Control System include the following components:

DiAs - a smart-phone medical platform; Dexcom Dexcom G4 Platinum connected to DiAs via Bluetooth CGM receiver; Roche Accu-Chek insulin pump connected to DiAs via wireless Bluetooth; Remote Monitoring Server connected to DiAs via 3G or local Wi-Fi network, and Zone-MPC and HMS algorithms running on DiAs (MPC and HMS)

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis, based on investigator assessment, of type 1 diabetes for at least one year and using insulin for at least 1 year and an insulin pump for at least 6 months
* Willing to wear the study CGM device for the duration of the study
* Age ≥21 to \<65 years
* HbA1c \<10.0%; if HbA1c \<6.0% then total daily insulin must be ≥0.5 U/kg
* For females, not currently known to be pregnant If female and sexually active, must agree to use a form of contraception to prevent pregnancy while a participant in the study. A negative urine pregnancy test will be required for all premenopausal women who are not surgically sterile. Subjects who become pregnant will be discontinued from the study.
* Demonstration of proper mental status and cognition for the study
* Currently using insulin-to-carbohydrate ratio to calculate meal bolus sizes
* Hypoglycemia awareness as demonstrated by a Clarke Hypoglycemia Unawareness score of 2 or lower
* Access to internet and cell phone service at home, and a computer for downloading device data
* Availability of care partner committed to participating in training activities, knowledgeable at all times of the participant's location, and being present and available to provide assistance when system is being used at night
* Commitment to maintaining uninterrupted availability via cell phone and avoiding any overnight travel for the duration the period using the closed-loop system
* An understanding of and willingness to follow the protocol and sign the informed consent

Exclusion Criteria

* Admission for diabetic ketoacidosis in the 12 months prior to enrollment
* Severe hypoglycemia resulting in seizure or loss of consciousness in the 12 months prior to enrollment
* History of a seizure disorder (except hypoglycemic seizure), unless written clearance is received from a neurologist
* Coronary artery disease or heart failure, unless written clearance is received from a cardiologist
* History of cardiac arrhythmia (except for benign premature atrial contractions and benign premature ventricular contractions which are permitted)
* Cystic fibrosis
* A known medical condition that in the judgment of the investigator might interfere with the completion of the protocol such as the following examples:

* Inpatient psychiatric treatment in the past 6 months for either the subject or the subject's primary care giver (i.e., parent or guardian)
* Presence of a known adrenal disorder
* Abnormal liver function test results (Transaminase \>2 times the upper limit of normal); testing required for subjects taking medications known to affect liver function or with diseases known to affect liver function
* Abnormal renal function test results (calculated GFR \<60 mL/min/1.73m2); testing required for subjects with diabetes duration of greater than 5 years post onset of puberty
* Active gastroparesis
* If on antihypertensive, thyroid, anti-depressant or lipid lowering medication, lack of stability on the medication for the past 2 months prior to enrollment in the study
* Uncontrolled thyroid disease (TSH undetectable or \>10 mlU/L); testing required within three months prior to admission for subjects with a goiter or who are on thyroid hormone replacement, and within one year otherwise
* Abuse of alcohol or recreational drugs
* Infectious process not anticipated to resolve prior to study procedures (e.g. meningitis, pneumonia, osteomyelitis)
* 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 protocol
* Current use of the following drugs and supplements:

* Acetaminophen
* Any medication being taken to lower blood glucose, such as Pramlintide, Metformin,GLP-1 Analogs such as Liraglutide, and nutraceuticals intended to lower blood glucose
* Beta blockers
* Oral or injectable glucocorticoids
* Any other medication that the investigator believes is a contraindication to the subject's participation
Minimum Eligible Age

21 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of California, Santa Barbara

OTHER

Sponsor Role collaborator

Mayo Clinic

OTHER

Sponsor Role collaborator

University of Virginia

OTHER

Sponsor Role collaborator

University of Padova

OTHER

Sponsor Role collaborator

Sansum Diabetes Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Francis J Doyle III, PhD

Role: PRINCIPAL_INVESTIGATOR

University of California, Santa Barbara/William Sansum Diabetes Center

Eyal Dassau, PhD

Role: PRINCIPAL_INVESTIGATOR

University of California, Santa Barbara/William Sansum Diabetes Center

Jordan E Pinsker, MD

Role: PRINCIPAL_INVESTIGATOR

Sansum Diabetes Research Institute

Ananda Basu, MD

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic, Rochester, MN

Yogish Kudva, MD

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic, Rochester, MN

Boris Kovatchev, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Virginia

Sue Brown, MD

Role: PRINCIPAL_INVESTIGATOR

University of Virginia

Stephen Patek, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Virginia

Claudio Cobelli, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Padova

Locations

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William Sansum Diabetes Center

Santa Barbara, California, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

University of Virginia

Charlottesville, Virginia, United States

Site Status

Countries

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United States

Other Identifiers

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99796-JPIN

Identifier Type: -

Identifier Source: org_study_id

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