Clinical Effectiveness of Advanced Hybrid Closed-loop Systems for Achieving Time in Tight Range Among T1D Patients

NCT ID: NCT06834334

Last Updated: 2025-02-28

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

RECRUITING

Total Enrollment

189 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-02-27

Study Completion Date

2025-12-31

Brief Summary

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Diabetes is a chronic disease with a relevant public health burden. Maintaining blood glucose levels as close to normal as possible is essential to avoid the associated microvascular and macrovascular complications. Therefore, the key to prevent and/or reduce the development of these chronic complications lies in an adequate and strict glycemic control.

This study consist of a cross-sectional observational study among adult patients with type 1 diabetes (T1D). The main objective is to analyze the effect on time in tight range (TiTR, 70-140 mg/dL) of interstitial glucose between three different advanced hybrid closed-loop (AHCL) systems.

Detailed Description

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Diabetes is a chronic disease with a relevant public health burden. Type 1 diabetes (T1D) is characterized by the autoimmune destruction of insulin-producing pancreatic beta cells, which requires the administration of exogenous insulin for its treatment. Maintaining blood glucose levels as close to normal as possible is essential to avoid the associated microvascular and macrovascular complications that affect quality of life, as well as morbidity and mortality due to the deleterious long-term effects of suboptimal control. Therefore, the key to prevent and/or reduce the development of these complications lies in adequate and strict glycemic control.

The use of advanced hybrid closed-loop (AHCL) systems in patients with T1D is associated with improved glycemic control and quality of life in both controlled clinical trials and real-life studies. Since 2021, AHCL systems are considered the standard of care, ahead of traditional MDI.

There are three main types of AHCL systems marketed in Spain: SmartGuard in Medtronic Minimed 780G (MM780G), Control-IQ in Tandem T Slim X2 (TTSX2) and CamAPS in Ypsopump (CamAPS).

All three systems have been shown indepently to significantly improve glycaemic control in people with DM1 as expressed by the classic control targets of the International Time in Range Consensus (percentage of interstitial glucose time in range 70-180 mg/dL \>70%). So much so that it has been suggested to further intensify the possible glucose targets in patients treated with AHCL systems to a time in tight range (TITR) of interstitial glucose (70-140 mg/dL) \>50%.

However, there is little information on the benefits and safety of using tighter control targets. Furthermore, there is no evidence about comparing the clinical benefit differences between these three types of technology.

The main objective is to analyze the effect on time in tight range (TiTR, 70-140 mg/dL) of interstitial glucose between three different advanced hybrid closed-loop (AHCL) systems among adult people with T1D.

This is multicenter (3 centers) cross-sectional observational clinical study (non-randomized). The target population will be adult T1D patients treated with any of the aforementioned AHCL systems followed in any of the three participant centers.

Conditions

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Type 1 Diabetes (T1D)

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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MM780G

Patients with type 1 diabetes treated with Medtronic Minimed 780G hybrid closed-loop systems

MM780G

Intervention Type DEVICE

SmartGuard in Medtronic Minimed 780G advaced hybrid closed-loop

TTSX2

Patients with type 1 diabetes treated with Tandem T Slim X2 hybrid closed-loop system

TTSX2

Intervention Type DEVICE

Control-IQ in Tandem T Slim X2 advanced hybrid closed-loop

CamAPS

Patients with type 1 diabetes treated with CamAPS hybrid closed-loop system

CamAPS

Intervention Type DEVICE

CamAPS Fx in Ypsopump advanced hybrid closed-loop

Interventions

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MM780G

SmartGuard in Medtronic Minimed 780G advaced hybrid closed-loop

Intervention Type DEVICE

TTSX2

Control-IQ in Tandem T Slim X2 advanced hybrid closed-loop

Intervention Type DEVICE

CamAPS

CamAPS Fx in Ypsopump advanced hybrid closed-loop

Intervention Type DEVICE

Other Intervention Names

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Medtronic Minimed 780G Tandem T Slim X2 CamAPS Fx

Eligibility Criteria

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Inclusion Criteria

* Patients with type 1 diabetes.
* Age greater than or equal to 18 years.
* Treated with advanced hybrid closed-loop systems (AHCL) for at least 3 months
* Actived continuous glucose monitoring data in the last 14 days.

Exclusion Criteria

* Other types of diabetes.
* Receiving treatment with insulin regimens other than AHCL.
* Having received AHCL treatment for less than 3 months in a row prior to inclusion in the study with the same system.
* No data on use of the AHCL system during the previous 14 days.
* Severe or uncontrolled psychiatric disorder.
* Pregnancy or end of pregnancy less than 3 months ago or preparation for pregnancy.
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Servicio Extremeño de Salud (Spain)

UNKNOWN

Sponsor Role collaborator

Hospital Universitari Mutua Terrassa

UNKNOWN

Sponsor Role collaborator

Castilla-La Mancha Health Service

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jesus Moreno Fernandez, PhD

Role: PRINCIPAL_INVESTIGATOR

Castilla-La Mancha Health Public Service

Locations

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Badajoz University Hospital

Badajoz, Badajoz, Spain

Site Status RECRUITING

Hospital Universitario Mutua de Tarrasa

Terrassa, Barcelona, Spain

Site Status RECRUITING

Ciudad Real General University Hospital

Ciudad Real, Ciudad Real, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Jesus Moreno, PhD

Role: CONTACT

926278000 ext. 79509

Maria Dolores Moya

Role: CONTACT

Facility Contacts

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Pilar Beato Vibora, PhD, MD

Role: primary

924218100

Carmen Quiros, MD

Role: primary

937 36 50 50

Jesus Moreno-Fernandez, PhD

Role: primary

926278000

References

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American Diabetes Association Professional Practice Committee. 7. Diabetes Technology: Standards of Care in Diabetes-2024. Diabetes Care. 2024 Jan 1;47(Suppl 1):S126-S144. doi: 10.2337/dc24-S007.

Reference Type BACKGROUND
PMID: 38078575 (View on PubMed)

Di Molfetta S, Di Gioia L, Caruso I, Cignarelli A, Green SC, Natale P, Strippoli GFM, Sorice GP, Perrini S, Natalicchio A, Laviola L, Giorgino F. Efficacy and Safety of Different Hybrid Closed Loop Systems for Automated Insulin Delivery in People With Type 1 Diabetes: A Systematic Review and Network Meta-Analysis. Diabetes Metab Res Rev. 2024 Sep;40(6):e3842. doi: 10.1002/dmrr.3842.

Reference Type BACKGROUND
PMID: 39298688 (View on PubMed)

Beck RW, Kanapka LG, Breton MD, Brown SA, Wadwa RP, Buckingham BA, Kollman C, Kovatchev B. A Meta-Analysis of Randomized Trial Outcomes for the t:slim X2 Insulin Pump with Control-IQ Technology in Youth and Adults from Age 2 to 72. Diabetes Technol Ther. 2023 May;25(5):329-342. doi: 10.1089/dia.2022.0558. Epub 2023 Apr 12.

Reference Type BACKGROUND
PMID: 37067353 (View on PubMed)

Castaneda J, Arrieta A, van den Heuvel T, Battelino T, Cohen O. Time in Tight Glucose Range in Type 1 Diabetes: Predictive Factors and Achievable Targets in Real-World Users of the MiniMed 780G System. Diabetes Care. 2024 May 1;47(5):790-797. doi: 10.2337/dc23-1581.

Reference Type BACKGROUND
PMID: 38113453 (View on PubMed)

Beck RW, Raghinaru D, Calhoun P, Bergenstal RM. A Comparison of Continuous Glucose Monitoring-Measured Time-in-Range 70-180 mg/dL Versus Time-in-Tight-Range 70-140 mg/dL. Diabetes Technol Ther. 2024 Mar;26(3):151-155. doi: 10.1089/dia.2023.0380. Epub 2023 Oct 13.

Reference Type BACKGROUND
PMID: 37870460 (View on PubMed)

Beato-Vibora PI, Chico A, Moreno-Fernandez J, Bellido-Castaneda V, Nattero-Chavez L, Picon-Cesar MJ, Martinez-Brocca MA, Gimenez-Alvarez M, Aguilera-Hurtado E, Climent-Biescas E, Azriel-Mir S, Rebollo-Roman A, Yoldi-Vergara C, Pazos-Couselo M, Alonso-Carril N, Quiros C. A Multicenter Prospective Evaluation of the Benefits of Two Advanced Hybrid Closed-Loop Systems in Glucose Control and Patient-Reported Outcomes in a Real-world Setting. Diabetes Care. 2024 Feb 1;47(2):216-224. doi: 10.2337/dc23-1355.

Reference Type BACKGROUND
PMID: 37948469 (View on PubMed)

Other Identifiers

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C-790

Identifier Type: -

Identifier Source: org_study_id

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