Post Bariatric Closed Loop Glucagon Trial

NCT ID: NCT02966275

Last Updated: 2018-12-13

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-30

Study Completion Date

2017-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

This study is to test our automated hypoglycemia prevention and treatment device (glucagon-only bionic pancreas) in subjects that have undergone post-bariatric surgery that are experiencing symptoms of hypoglycemia.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Hypoglycemia

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

glucagon continuous glucose monitorering (CGM) artificial pancreas hypoglycemia post-bariatric hypoglycemia bionic pancreas bariatric surgery

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
Glucagon and placebo were blinded by the research pharmacy. Subjects were given bags of blinded medication labeled with which day they were to be used, and then were asked to label the bags with which day the medication was actually used. The contents of the bags were verified with the research pharmacy's blinding key upon completion of the study.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Glucagon-only bionic pancreas - glucagon

Subjects will wear the bionic pancreas that consists of a continuous glucose monitor linked to a smartphone running a hypoglycemia prevention algorithm that doses glucagon from an insulin pump through a subcutaneous infusion set.

Subjects will continue to manage any hypoglycemia that occurs according to the current recommendations of their care provider.

Group Type EXPERIMENTAL

Glucagon-only bionic pancreas - glucagon

Intervention Type DEVICE

A computer algorithm will automatically deliver glucagon based on the signal from a minimally invasive continuous glucose monitor.

Glucagon-only bionic pancreas - placebo

Subjects will wear the bionic pancreas that consists of a continuous glucose monitor linked to a smartphone running a hypoglycemia prevention algorithm that doses placebo from an insulin pump through a subcutaneous infusion set.

Subjects will continue to manage any hypoglycemia that occurs according to the current recommendations of their care provider.

Group Type PLACEBO_COMPARATOR

Glucagon-only bionic pancreas - placebo

Intervention Type DEVICE

A computer algorithm will automatically deliver placebo based on the signal from a minimally invasive continuous glucose monitor.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Glucagon-only bionic pancreas - glucagon

A computer algorithm will automatically deliver glucagon based on the signal from a minimally invasive continuous glucose monitor.

Intervention Type DEVICE

Glucagon-only bionic pancreas - placebo

A computer algorithm will automatically deliver placebo based on the signal from a minimally invasive continuous glucose monitor.

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Age 21 years or older with a gastric bypass for more than 1 year.
* Post-bariatric hypoglycemia with prior episodes of neuroglycopenia, unresponsive to dietary intervention (low glycemic index, controlled carbohydrate portions) and trial of acarbose therapy at the maximally tolerated dose. Other therapies will not exclude a subject as long as the therapy is continued during the study.
* Otherwise healthy (mild chronic disease such as asthma, hypertension, and depression will be allowed if well controlled).
* Self-reported frequency of documented hypoglycemia (BG \< 60 mg/dl verified by capillary blood glucose measurements) of at least 2 times per week.

Exclusion Criteria

* Unable to provide informed consent.
* Unable to comply with study procedures.
* Current participation in another hypoglycemia related clinical trial other than one that is primarily observational in nature.
* Pregnancy (positive urine HCG), breast feeding, plan to become pregnant in the immediate future, or sexually active without use of contraception.
* Use of insulin and/or insulin secretogues as sulfonylurea, metglitides, and glitazones.
* History of cystic fibrosis, pancreatitis, type 1 diabetes or other pancreatic disease.
* End stage renal disease on dialysis (hemodialysis or peritoneal dialysis).
* Any known liver or biliary disease including cirrhosis, alcoholic liver disease, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, any form of viral hepatitis.
* Congestive heart failure (established history of CHF, paroxysmal nocturnal dyspnea, or orthopnea).
* Acute illness or exacerbation of chronic illness at the time of the study.
* Known insulinoma or predominantly fasting pattern of hypoglycemia
* Adrenal insufficiency. Congenital hyperinsulinemia presenting with hypoglycemia during infancy.
* History of pheochromocytoma. Fractionated metanephrines will be tested in patients with history increasing the risk for a catecholamine secreting tumor:
* Paroxysms of tachycardia, pallor, or headache.
* Personal or family history of MEN 2A, MEN 2B, neurofibromatosis, or von Hippel-Lindau disease.
* Episodic or treatment refractory (requiring 4 or more medications to achieve normotension) hypertension.
* Untreated or inadequately treated mental illness (indicators would include symptoms such as psychosis, hallucinations, mania, and/or any psychiatric hospitalization in the last year).
* Current alcohol abuse (intake averaging \> 3 drinks daily in last 30 days) or substance abuse (any use within the last 6 months of controlled substances without a prescription).
* Unwilling or unable to refrain from drinking more than two drinks in an hour or more than four drinks in a day during the trial.
* Electrically powered implants (e.g. cochlear implants, neurostimulators) that might be susceptible to RF interference.
* History of adverse reaction to glucagon (including allergy) besides nausea and vomiting.
* Unwilling or unable to completely avoid acetaminophen during the study period.
* Any factors that, in the opinion of the principal investigator, would interfere with the safe completion of the study procedures.
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Joslin Diabetes Center

OTHER

Sponsor Role collaborator

Massachusetts General Hospital

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Steven J. Russell, MD, PhD

Assistant Professor of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Steven J Russell, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Massachusetts General Hospital, Boston, Massachusetts

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Massachusetts General Hospital

Boston, Massachusetts, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

Access external resources that provide additional context or updates about the study.

http://bionicpancreas.org

Information about this and related studies

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2016P000710

Identifier Type: -

Identifier Source: org_study_id