Hybrid Closed-Loop for Perioperative Glycemic Control in T2DM With Parenteral Nutrition

NCT ID: NCT07121504

Last Updated: 2025-08-13

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

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-26

Study Completion Date

2026-06-01

Brief Summary

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Glycemic control in surgical patients with type 2 diabetes mellitus (T2DM) receiving parenteral nutrition represents a major clinical challenge. This randomized controlled trial evaluates the comparative effectiveness and safety of hybrid closed-loop (HCL) insulin delivery versus conventional insulin pumps combined with continuous glucose monitoring (CGM) in perioperative T2DM patients requiring short-term parenteral nutrition.

Detailed Description

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This study is a single-center, open-label, 1:1 randomized controlled exploratory trial. Participants were randomly allocated via complete randomization into two groups: the experimental group (hybrid closed-loop insulin delivery system) and the control group (using identical hardware devices, with the experimental group operating in closed-loop mode while the control group in open-loop mode). The intervention duration ranged from 5 to 7 days, adjusted based on glycemic control status, aiming to compare the efficacy and clinical benefits of hybrid closed-loop insulin delivery versus insulin pumps combined with CGM for glycemic management.

Conditions

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Type 2 Diabetes

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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Hybrid closed-loop insulin delivery system

T2DM patients in the experimental group will receive the hybrid closed-loop insulin delivery system.

Group Type EXPERIMENTAL

Hybrid closed-loop insulin delivery system

Intervention Type DEVICE

Perioperative patients with T2D receiving parenteral nutrition will receive hybrid closed-loop insulin delivery system for glycemic management.

Conventional insulin pump with CGM

T2DM patients in the control group will receive conventional insulin pump therapy with CGM.

Group Type ACTIVE_COMPARATOR

conventional insulin pumps combined with CGM

Intervention Type DEVICE

Perioperative patients with T2D receiving parenteral nutrition will receive conventional insulin pumps combined with CGM for glycemic management.

Interventions

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Hybrid closed-loop insulin delivery system

Perioperative patients with T2D receiving parenteral nutrition will receive hybrid closed-loop insulin delivery system for glycemic management.

Intervention Type DEVICE

conventional insulin pumps combined with CGM

Perioperative patients with T2D receiving parenteral nutrition will receive conventional insulin pumps combined with CGM for glycemic management.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Age ≥18 years.
2. Diagnosis of T2DM requiring surgical procedures (duration ≥2 hours) with anticipated short-term total parenteral nutrition (TPN) during the perioperative period (expected hospitalization \>72 hours).
3. Glycemic control criteria (meeting any of the following):

①HbA1c ≥7.5% or random plasma glucose ≥13.9 mmol/L
* Established T2DM with poor glycemic control (HbA1c ≥7.5%) despite combination therapy (≥2 oral antidiabetic drugs) ③Insulin-treated patients with suboptimal control (HbA1c ≥7.0%) after adequate dose adjustment.
4. Willing to sign the informed consent form.

Exclusion Criteria

1. Patients with acute diabetic complications, including: diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), etc.
2. Patients with type 1 diabetes or other specific types of diabetes.
3. Patients with severe organ dysfunction, defined as:

* Cardiac function ≥Class III (NYHA classification)

* ALT/AST \>3× upper limit of normal (ULN) ③ eGFR ≤30 mL/min/1.73 m²

* Hemoglobin \<90 g/L ⑤ WBC count \<4.0×10⁹/L or platelets \<90×10⁹/L ⑥ Hemodynamic instability
4. Patients with endocrine disorders affecting glucose metabolism, such as: hyperthyroidism, hypothyroidism, Cushing's syndrome, etc.
5. Patients with known hypersensitivity to any drugs or materials used in the study protocol.
6. Patients who have contraindications to conventional insulin pump therapy.
7. Patients with dermatological conditions (e.g., skin rash, prurigo) or coagulation disorders.
8. Patients with impaired consciousness or psychiatric disorders affecting decision-making capacity or communication ability.
9. Patients who have other conditions deemed unsuitable for trial participation by investigators.
10. Patients who suffer severe surgical complications.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Second Xiangya Hospital of Central South University

OTHER

Sponsor Role lead

Responsible Party

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Xia Li

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Xia Li, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Second Xiangya Hospial of Central South University

Locations

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Department of Metabolism and Endocrinology, Second Xiangya Hospital of Centra South University, Changsha, Hunan 410011

Changsha, Hunan, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xia Li, MD, PhD

Role: CONTACT

+86 13974885753

Facility Contacts

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Xia Li

Role: primary

+86 13974885753

Provided Documents

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Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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HCL-T2D 2025

Identifier Type: -

Identifier Source: org_study_id

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