New Insulin Therapy by Multiwave Bolus

NCT ID: NCT03311516

Last Updated: 2020-07-23

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-10

Study Completion Date

2021-06-30

Brief Summary

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The aim of the study is to evaluate the effect of insulin therapy when the bolus dose of insulin is calculated on the basis of protein and fat content in food intake, in addition to that of carbohydrates in T1D patients treated by insulin pump. The study is planned to recruit 150 patients with type1 diabetes already practicing functional insulin therapy based on carbohydrate counting in meals. We will therefore study the effect on continuous glucose measured by subcutaneous sensor, of meal bolus adjustments by comparing two groups of T1D patients:

* Groupe A takes into account the lipid and protein content in addition to the carbohydrate content
* Group B takes into account the carbohydrate content only At randomization, all patients receive dietary and adjustment of bolus doses instructions according to the randomization group. They have to apply these instructions for 3 months. At the end of 3 months, the study groups will be under glucose monitoring during two weeks in the Outpatient Clinic but returns to the investigational site in hospital to download data from the continuous measurement of glucose. In addition, we propose a period of extension similar to that of the main period, namely 3 months of application of dietetic and adaptation of bolus doses instructions and 2 weeks of continuous measurement of glucose.

During each 2 weeks period will be assessed specific glucose parameters in the post-prandial period over 4hours (glycemic sensor values in the glucose range between 70-140 mg / dl, glycemic sensor values in the glucose range between 140 -180 mg /dl and \> 180 mg /dl) after taking each meal during the 13 days of Glucose Continuous Measurement (GCM), average daily glucose per meal, average blood glucose over the 13-day period after each meal.

Detailed Description

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Conditions

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Type1diabetes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group A

Group A = intervention group (new functional insulin therapy) who adjusts the insulin bolus according to a dose titration algorithm taking into account the lipid and protein content in addition to that of carbohydrates. The functional insulin therapy is based on a Carbohydrate / Lipid / Protein count

Group Type EXPERIMENTAL

New functional insulin therapy

Intervention Type OTHER

the patient receives the dietary devices and the instructions for the adaptation of the insulin bolus dose according to a new FIT

Group B

Group B=control group (functional insulin tehrapy) who adjusts the insulin bolus taking into account only the carbohydrate content. The functional insulin therapy is based on a Carbohydrate count only.

Group Type OTHER

functional insulin therapy

Intervention Type OTHER

the patient receives the dietary devices and the instructions for the adaptation of the insulin bolus dose according to FIT

Interventions

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New functional insulin therapy

the patient receives the dietary devices and the instructions for the adaptation of the insulin bolus dose according to a new FIT

Intervention Type OTHER

functional insulin therapy

the patient receives the dietary devices and the instructions for the adaptation of the insulin bolus dose according to FIT

Intervention Type OTHER

Other Intervention Names

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FIT based on a Carbohydrate / Lipid / Protein count FIT based on a carbohydrate count only

Eligibility Criteria

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Inclusion Criteria

* Type 1 diabetic patient for more than one year, practicing functional insulin for at least 3 months but not more than 5 years
* Patient treated with external insulin pump (Medtronic or Omnipod pump)
* Patient performing intermittent blood glucose monitoring by the continuous interstitial glucose measurement system (Freestyle Libre) and who regularly wears this device with an achievement of at least 4 scans per day to obtain at least 90% of the possible values
* Patient with HbA1c ≤10.0% less than 3 months
* Patient with a willingness and ability to comply with study requirements and schedule of visits
* Patient who received complete information and signed informed consent

Exclusion Criteria

* Patient with contraindication for rapid or ultra-rapid insulin analogues
* Patient for whom a change of insulin in the next 3 to 6 months is planned
* Women of childbearing age who do not have effective contraception
* Women who are pregnant or breast feeding or plan on becoming pregnant during the study
* Patient taking medication that interferes with interpretation of study results such as chronic corticosteroid therapy
* Patient with a chimio - or radiotherapy is in progress or is planned
* Patient abusing substances
* Patient who participated in another clinical study in the four weeks prior to inclusion
* Patient with or suspected of having any physical, psychological or cognitive disorders interfering with adherence to insulin therapy by pump, or compliance with dietary advice, or completion of the patient's diary
* Patient unable to comply with clinical guidelines, and unable to comply with 3-month follow-up
* Patient unable to understand information, to sign informed consent or to manage glycemic sensor
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Central Hospital, Reims, France

UNKNOWN

Sponsor Role collaborator

Central Hospital, Toulouse, France

UNKNOWN

Sponsor Role collaborator

Central Hospital, Strasbourg, France

UNKNOWN

Sponsor Role collaborator

Central Hospital, Besançon, France

UNKNOWN

Sponsor Role collaborator

Central Hospital, Dijon, France

UNKNOWN

Sponsor Role collaborator

Central Hospital, Nancy, France

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Service d'Endocrinologie-Métabolisme et Diabétologie-Nutrition

Besançon, , France

Site Status NOT_YET_RECRUITING

Service d'endocrinologie et maladies métaboliques

Dijon, , France

Site Status RECRUITING

Service d'Endocrinologie, Diabétologie et Nutrition

Nancy, , France

Site Status RECRUITING

Service Endocrinologie Diabète Nutrition

Reims, , France

Site Status NOT_YET_RECRUITING

Structure d'Endocrinologie, Diabète et Nutrition

Strasbourg, , France

Site Status NOT_YET_RECRUITING

Service de diabétologie, maladies métaboliques et nutrition

Toulouse, , France

Site Status NOT_YET_RECRUITING

Countries

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France

Central Contacts

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SIHAM BENZIRAR

Role: CONTACT

0033383155028

JULIE LECOMTE-LEHMANN

Role: CONTACT

0033383155278

Facility Contacts

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Sophie BOROT

Role: primary

0033381668229

Sabine RUDONI

Role: primary

0033380293453

Siham BENZIRAR

Role: primary

0033383155028

Sandrine PLISSON-RONEZ

Role: primary

0033326787159

Stéphanie Kocakaya

Role: primary

0033388116603

Laurent CAZALS

Role: primary

0033561323361

Other Identifiers

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2017-A02414-49

Identifier Type: -

Identifier Source: org_study_id

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