Trial to Investigate the in Silico Optimization of Insulin Treatments

NCT ID: NCT03895138

Last Updated: 2019-03-29

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

35 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-03-19

Study Completion Date

2019-04-30

Brief Summary

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The primary objective of this study is to assess the performance of an in silico designed alternative protocol for control of stress hyperglycemia of inpatients treated for Coronary Artery Bypass Graft (CABG) or valve replacement surgery in the University of Virginia cardiothoracic ICU.

Detailed Description

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The hypothesis of the study is that settings for the Glucommander protocol can be optimized in silico to achieve statistically improved low blood glucose index (LBGI) within the subpopulation of CABG and valve replacement patients who both receive Glucommander-based insulin therapy and meet Manufacturer's guidelines for starting with an initial multiplier value of .052, without risking clinically significant increase in exposure to hyperglycemia.

Conditions

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Coronary Artery Bypass

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Subjects with CABG or open heart valve surgery will be enrolled in the study. They will be randomized to receive one of the following treatments:

1. Standard Glucommander Protocol (SGP)
2. Optimized Glucommander (OGM)
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Standard Glucommander Protocol (SGP)

CABG or open valve surgery patients treated for stress hyperglycemia with the standard Glucomander protocol according to the manufacturer recommendations

Group Type ACTIVE_COMPARATOR

Standard Glucommander Protocol (SGP)

Intervention Type OTHER

Subjects receive standard Glucommander-based insulin therapy from the clinical staff of U.Va.'s cardiothoracic ICU and follow manufacturer's guidelines for starting with an initial multiplier value of .05.

Optimized Glucommander (OGM)

CABG or open valve surgery patients treated for stress hyperglycemia with in silico optimized Glucomander protocol

Group Type EXPERIMENTAL

Optimized Glucommander (OGM)

Intervention Type OTHER

The experimental arm of the study involves treating subjects with a lower initial multiplier (.02 versus .05), a higher set of BG thresholds (140-180 mg/dl vs 120-160) in the first eight (8) hours of care for avoidance of hypoglycemia in that time period, and a requirement for consistent hourly-or-faster sampling of BG (as opposed to the Glucommander recommendation which is dependent on the trajectory of BG and can sometimes allow intervals of two hours between samples). After the eight (8) hours, the Glucommander is set back to the standard protocol for the entire duration of the subject's post-operative hospital stay.

Interventions

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Standard Glucommander Protocol (SGP)

Subjects receive standard Glucommander-based insulin therapy from the clinical staff of U.Va.'s cardiothoracic ICU and follow manufacturer's guidelines for starting with an initial multiplier value of .05.

Intervention Type OTHER

Optimized Glucommander (OGM)

The experimental arm of the study involves treating subjects with a lower initial multiplier (.02 versus .05), a higher set of BG thresholds (140-180 mg/dl vs 120-160) in the first eight (8) hours of care for avoidance of hypoglycemia in that time period, and a requirement for consistent hourly-or-faster sampling of BG (as opposed to the Glucommander recommendation which is dependent on the trajectory of BG and can sometimes allow intervals of two hours between samples). After the eight (8) hours, the Glucommander is set back to the standard protocol for the entire duration of the subject's post-operative hospital stay.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Patients admitted for CABG and/or open heart valve surgery
2. Must have a 0.05 initial multiplier setting for the Glucommander based on the manufacturers recommendations
3. Age of 40-75, inclusive

Exclusion Criteria

1. History of severe hypoglycemia within six months of hospital admission
2. Currently undergoing dialysis or renal replacement therapy
3. Women of childbearing potential
4. Patients with endocarditis needing valve replacement
5. Participation in another clinical trial at the time of screening.
Minimum Eligible Age

40 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute for Biomedical Imaging and Bioengineering (NIBIB)

NIH

Sponsor Role collaborator

University of Virginia

OTHER

Sponsor Role lead

Responsible Party

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Anthony McCall

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University of Vrginia

Charlottesville, Virginia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Anna Buhle

Role: CONTACT

Phone: 4349898257

Email: [email protected]

leon farhi, PhD

Role: CONTACT

Phone: 4342966583

Email: [email protected]

Facility Contacts

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Anna Buhle

Role: primary

Other Identifiers

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5R21EB018052

Identifier Type: NIH

Identifier Source: secondary_id

View Link

20164

Identifier Type: -

Identifier Source: org_study_id