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Type 1 DiabetesNCT02105324

The Summer Camp Study 2: Blood Glucose Control With a Bi-Hormonal Endocrine Pancreas

A study testing Bionic Pancreas in people with Type 1 Diabetes, run by Massachusetts General Hospital at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study will test the hypothesis that a wearable automated bionic pancreas system that automatically delivers both insulin and glucagon can improve glycemic control vs. usual care for young people with type 1 diabetes ages 6-11 years old in a diabetes camp environment. Read more about this study

Who is it for?
Ages 6 to 11 years
Conditions the study is for
Type 1 Diabetes
What is being tested?
Bionic Pancreas
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
19 participants
Where
1 siteUnited States
Study dates
Jun 2014to Aug 2014
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 to 11 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Age 6-11 years with type 1 diabetes for at least one year
  • Diabetes managed using an insulin infusion pump for ≥ three months
  • Willing to wear two infusion sets and continuous glucose monitoring (CGM) sensor and change sets frequently (at least one new glucagon infusion set daily)
  • Otherwise healthy (mild chronic disease such as asthma will be allowed if well controlled that do not require medications that result in exclusion)

Who cannot join

  • Unable to provide informed consent, informed assent or parental consent
  • Unable to comply with study procedures
  • Current participation in another diabetes-related clinical trial that, in the judgment of the principal investigator, will compromise the results of this study or the safety of the subject
  • End stage renal disease on dialysis (hemodialysis or peritoneal dialysis)
  • Pregnancy (positive urine human chorionic gonadotropin [HCG])
  • History of liver disease that is expected to interfere with the anti-hypoglycemia action of glucagon (e.g. liver failure or cirrhosis). Other liver disease (i.e. active hepatitis, steatosis, active biliary disease, any tumor of the liver, hemochromatosis, glycogen storage disease) may exclude the subject if it causes significant compromise to liver function or may do so in an unpredictable fashion
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  • Personal history of cystic fibrosis, pancreatitis, or other pancreatic disease, including pancreatic tumor or insulinoma
  • History of prolonged QT or arrhythmia, congenital heart disease or current known cardiac disease
  • Acute illness (other than non-vomiting viral illness) or exacerbation of chronic illness other than type 1 diabetes (T1D) at the time of the study
  • Seizure disorder, history of any seizure within the last two years, or ongoing treatment with anticonvulsants
  • Untreated or inadequately treated mental illness (indicators would include symptoms such as psychosis, hallucinations, mania, and any psychiatric hospitalization in the last year), or treatment with second generation anti-psychotic medications, which are known to affect glucose regulation.
  • Electrically powered implants (e.g. cochlear implants, neurostimulators) that might be susceptible to radio-frequency (RF) interference
  • Use of oral (e.g. thiazolidinediones, biguanides, sulfonylureas, glitinides, dipeptidyl peptidase 4 (DPP-4) inhibitors, sodium-glucose linked transporter 2 (SGLT-2) inhibitors) anti-diabetic medications
  • History of adverse reaction to glucagon (including allergy) besides nausea and vomiting.
  • Unwilling or unable to completely avoid acetaminophen during the comparator and bionic pancreas arms of the study
  • History of eating disorder such as anorexia, bulimia, or diabulemia or omission of insulin to manipulate weight
  • History of intentional, inappropriate administration of insulin leading to severe hypoglycemia requiring treatment
  • Any factors that, in the opinion of the principal investigator, would interfere with the safe completion of the study procedures

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

Other trials in United States

About this study

Official title: The Summer Camp Study 2: Outpatient Automated Blood Glucose Control With a Bi-Hormonal Bionic Endocrine Pancreas in a Pediatric Population Ages 6-11 at the Clara Barton Diabetes Camps

This study will test the hypothesis that a wearable automated bionic pancreas system that automatically delivers both insulin and glucagon can improve glycemic control vs. usual care for young people with type 1 diabetes ages 6-11 years old in a diabetes camp environment.

Conditions
Type 1 Diabetes
Being tested
Bionic Pancreas, Usual Care
Keywords
bionic pancreas, artificial pancreas, insulin, glucagon, continuous glucose monitoring (CGM), outpatient, insulin pump, pediatrics, children, camp, summer camp
Medical subject headings
Diabetes Mellitus, Type 1, Insulin Resistance, Muscle Cramp

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Bionic PancreasDevice

    Also called Boston University Bionic Pancreas

    Automated blood glucose control via a closed-loop bionic pancreas device.

  • Usual CareOther

    As a comparator control, usual diabetes camp care with the participant's own insulin pump.

Study groups in NCT02105324
Study groupRoleWhat they receive
Bionic PancreasExperimentalBionic Pancreas diabetes management, a wearable bionic pancreas system that automatically delivers insulin and glucagon using a continuous glucose monitoring (CGM) device, for 5 days.
Receives: Device: Bionic Pancreas
Usual CareExperimentalUsual Care diabetes management in a diabetes camp environment including a nurse or nursing student assigned to each cabin and review and adjustment of the insulin regimen daily by a physician or nurse practitioner, all participants using the participant's own insulin pump and a continuous glucose monitor if they use one as part of their usual care, for 5 days.
Receives: Other: Usual Care

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean Continuous Glucose Monitoring Glucose (CGMG) Values During Days 2 to 5

    Glucose reading were taken every 5 minutes by the CGM. The CGM glucose results during Days 2 through 5 were averaged.

    Measured: Days 2 to 5 of each period

  2. Percentage of Time Spent With CGMG Concentration < 60 mg/dL During Days 2 to 5

    Glucose reading were taken every 5 minutes by the CGM. The percentage of time that the glucose concentration was less than 60 mg/dL [3.3 millimoles/liter (mmol/L)] during Days 2 through 5 was calculated.

    Measured: Days 2 to 5 of each period

Secondary outcomes (38)
  1. Mean CGMG Values

    Glucose reading were taken every 5 minutes by the CGM. The glucose results for each time frame were averaged.

    Measured: Day 1 and Days 1-5 in each period

  2. Percentage of Time With CGMG Concentration by Ranges During Day 1

    Glucose readings were taken every 5 minutes by the CGM. The percentage of time that the glucose concentration was less than the following ranges were calculated: < 50 mg/dL(2.8 mmol/L), < 70 mg/dL (3.9 mmol/L), 70-180 mg/dL (3.9 to 10.0 mmol/L), > 180 mg/dL (10.0 mmol/L).

    Measured: Day 1 of each period

  3. Percentage of Time With CGMG Concentration by Ranges During Days 1 to 5

    Glucose readings were taken every 5 minutes by the CGM. The percentage of time that the glucose concentration was less than the following ranges were calculated: < 50 mg/dl (2.8 mmol/L), < 70 mg/dl (3.9 mmol/L), 70-180 mg/dl (3.9 to 10.0 mmol/L), > 180 mg/dL (10.0 mmol/L).

    Measured: Days 1 to 5 of each period

  4. Percentage of Time With CGMG Concentration by Ranges During Days 2 to 5

    Glucose readings were taken every 5 minutes by the CGM. The percentage of time that the glucose concentration was less than the following ranges were calculated: < 50 mg/dl (2.8 mmol/L), < 70 mg/dl (3.9 mmol/L), 70-180 mg/dl (3.9 to 10.0 mmol/L), > 180 mg/dL (10.0 mmol/L).

    Measured: Days 2 to 5 of each period

  5. Percentage of Participants With Mean CGMG Glucose <154 mg/dL

    Glucose reading were taken every 5 minutes by the CGM. The glucose readings were averaged. 154 mg/dL was the estimated average glucose corresponding to a Hemoglobin A1C of 7.0%.

    Measured: Day 1, Days 1-5, and Days 2-5 of each period

  6. Percentage of Participants With Mean CGMG Glucose <169 mg/dL

    Glucose reading were taken every 5 minutes by the CGM. The glucose readings were averaged. 169 mg/dL was the estimated average glucose corresponding to a Hemoglobin A1C of 7.5%.

    Measured: Day 1, Days 1-5, and Days 2-5 of each period

  7. Percentage of Participants With Mean CGMG Glucose <183 mg/dL

    Glucose reading were taken every 5 minutes by the CGM. The glucose readings were averaged. 183 mg/dL was the estimated average glucose corresponding to a Hemoglobin A1C of 8.0%.

    Measured: Day 1, Days 1-5, and Days 2-5 of each period

  8. Number of CGMG Reported Hypoglycemic Events (< 70 mg/dL, < 60 mg/dL, <50 mg/dL)

    A series of hypoglycemic measurements is defined as a single event until there is a break of ≥ 30 minutes between measurements below the defined thresholds of < 70, < 60, and <50 mg/dL.

    Measured: Days 1-5

  9. Mean Plasma Glucose Values

    Fingerstick plasma glucose measurements were obtained before meals, at bedtime, at midnight, and at about 3:45 AM (six scheduled measurements). The plasma glucose readings were averaged. The plasma glucose results on Day 1, Days 1 to 5 and Days 2 to 5 were averaged.

    Measured: Day 1, Days 1 to 5, and Days 2 to 5 of each period

  10. Percentage of Time With Plasma Glucose Values by Ranges on Day 1

    Fingerstick plasma glucose measurements were obtained before meals, at bedtime, at midnight, and at about 3:45 AM (six scheduled measurements). The percentage of time that the plasma glucose concentration was less than the following ranges were calculated: < 70 mg/dl (3.9 mmol/L), < 60 mg/dL (3.3 mmol/L), < 50 mg/dl (2.8 mmol/L).

    Measured: Day 1 of each period

  11. Percentage of Time With Plasma Glucose Values by Ranges on Days 1 to 5

    Fingerstick plasma glucose measurements were obtained before meals, at bedtime, at midnight, and at about 3:45 AM (six scheduled measurements). The percentage of time that the plasma glucose concentration was less than the following ranges were calculated: < 70 mg/dL (3.9 mmol/L), < 60 mg/dL (3.3 mmol/L), < 50 mg/dL (2.8 mmol/L).

    Measured: Days 1 to 5 of each period

  12. Percentage of Time With Plasma Glucose Values by Ranges on Days 2 to 5

    Fingerstick plasma glucose measurements were obtained before meals, at bedtime, at midnight, and at about 3:45 AM (six scheduled measurements). The percentage of time that the plasma glucose concentration was less than the following ranges were calculated: < 70 mg/dl (3.9 mmol/L), < 60 mg/dL (3.3 mmol/L), < 50 mg/dl (2.8 mmol/L).

    Measured: Days 2 to 5 of each period

  13. Percentage of Participants With Mean Plasma Glucose <154 mg/dL

    Fingerstick plasma glucose measurements were obtained before meals, at bedtime, at midnight, and at about 3:45 AM (six scheduled measurements). The plasma glucose readings were averaged. 154 mg/dL was the estimated average glucose corresponding to a Hemoglobin A1C of 7.0%.

    Measured: Day 1, Days 1 to 5, and Days 2 to 5 of each period

  14. Percentage of Participants With Mean Plasma Glucose <169 mg/dL

    Fingerstick plasma glucose measurements were obtained before meals, at bedtime, at midnight, and at about 3:45 AM (six scheduled measurements). The plasma glucose readings were averaged. 169 mg/dL was the estimated average glucose corresponding to a Hemoglobin A1C of 7.5%.

    Measured: Day 1, Days 1 to 5, and Days 2 to 5 of each period

  15. Percentage of Participants With Mean Plasma Glucose <183 mg/dL

    Fingerstick plasma glucose measurements were obtained before meals, at bedtime, at midnight, and at about 3:45 AM (six scheduled measurements). The plasma glucose readings were averaged. 183 mg/dL was the estimated average glucose corresponding to a Hemoglobin A1C of 8.0%.

    Measured: Day 1, Days 1 to 5, and Days 2 to 5 of each period

  16. Number of Plasma Glucose Reported Hypoglycemic Events (< 70 mg/dL, < 60 mg/dL, <50 mg/dL)

    A series of hypoglycemic measurements is defined as a single event until there is a break of ≥ 30 minutes between measurements below the defined thresholds of < 70, < 60, and <50 mg/dL.

    Measured: Days 1-5

  17. Percentage of Days That CGM Data Was Used by Participants as Part of Their Usual Care

    The percentage of days during the Usual Care period that participants used CGM data as part of their diabetes management.

    Measured: Day 1, Days 1-5, and Days 2-5 of the Usual Care Period

  18. Number of Carbohydrate Interventions for Hypoglycemia When Plasma Glucose <70 mg/dL

    Fingerstick plasma glucose measurements were obtained before meals, at bedtime, at midnight, and at about 3:45 AM (six scheduled measurements). Participants were given 15 grams (g) of simple carbohydrates if their plasma glucose concentration dropped below 4.4 mmol/L. These simple carbohydrates were counted as interventions for study outcomes if the plasma glucose concentration was less than 3.9 mmol/L. A second intervention of 15 g of carbohydrate was given if a repeat measurement in 15-20 min was less than 3.9 mmol/L. The total number of carbohydrate interventions are reported.

    Measured: Day 1, Days 1-5, and Days 2-5 of each period

  19. Grams of Carbohydrate Taken for Hypoglycemia When Plasma Glucose <70 mg/dL

    Fingerstick plasma glucose measurements were obtained before meals, at bedtime, at midnight, and at about 3:45 AM (six scheduled measurements). Participants were given 15 grams (g) of simple carbohydrates if their plasma glucose concentration dropped below 4.4 mmol/L. These simple carbohydrates were counted as interventions for study outcomes if the plasma glucose concentration was less than 3.9 mmol/L. A second intervention of 15 g of carbohydrate was given if a repeat measurement in 15-20 min was less than 3.9 mmol/L.

    Measured: Day 1, Days 1-5, and Days 2-5 of each period

  20. Insulin Total Daily Dose

    Insulin total daily dose is reported in units per kilogram per day (U/kg/day).

    Measured: 11 days

  21. Glucagon Total Daily Dose Levels in the Bionic Pancreas Arm

    Glucagon dose level is reported in micrograms per kilogram of body mass per day (µg/kg/day).

    Measured: Day 1, Days 1-5, and Days 2-5 of each period

  22. Daily Basal Insulin Dose in the Bionic Pancreas Period

    The bionic pancreas automatically adapted insulin dosing to each individual's needs. When CGM data were not available (because of sensor failure or during the warm-up time after sensor replacement), the bionic pancreas automatically delivered a dose of basal insulin based on the mean basal dosing it had calculated at that time on previous days. Daily basal insulin dose is reported in units per kilogram (kg) per day (U/kg).

    Measured: Day 1 through Day 5

  23. Daily Bolus Insulin Dose in the Bionic Pancreas Period

    The first time the bionic pancreas was used in each participant, a partial meal-priming bolus based on the participant's body mass (0.05 units/kg) was delivered. After the first use, the size of the meal-priming bolus was adapted by the bionic pancreas to 75% of the 4-hour prandial insulin used for that meal type and size. Daily bolus insulin dose is reported in units per kilogram (kg) per day (U/kg).

    Measured: Day 1 through Day 5

  24. Carbohydrate Intake

    Carbohydrate intake included meals, snacks and unscheduled carbohydrates administered when a participant's blood glucose was <80 mg/dl (or for symptoms at any glucose level). Carbohydrate intake per day was averaged and is reported in grams (g) per kilogram (kg) per day (g/kg/day).

    Measured: Day 1, Days 1-5 and Days 2-5

  25. Number of Unscheduled Infusion Set Changes

    Infusion sets for administering insulin and glucagon were placed under the skin the in the abdomen, buttocks, arms, or legs. Infusion set changes due to pain, infusion set falling out or infusion set failure are reported. Camp policy was to suspect failure of the infusion set whenever ketonemia occurred, so failures may not have actually been set failures, but rather failure to deliver enough insulin.

    Measured: Day 1

  26. Number of Unscheduled Infusion Set Changes

    Infusion sets for administering insulin and glucagon were placed under the skin the in the abdomen, buttocks, arms, or legs. Infusion set changes due to pain, infusion set falling out or infusion set failure are reported. Camp policy was to suspect failure of the infusion set whenever ketonemia occurred, so failures may not have actually been set failures, but rather failure to deliver enough insulin.

    Measured: Days 1-5

  27. Number of Unscheduled Infusion Set Changes

    Infusion sets for administering insulin and glucagon were placed under the skin the in the abdomen, buttocks, arms, or legs. Infusion set changes due to pain, infusion set falling out or infusion set failure are reported. Camp policy was to suspect failure of the infusion set whenever ketonemia occurred, so failures may not have actually been set failures, but rather failure to deliver enough insulin.

    Measured: Days 2-5

  28. Number of Bionic Pancreas Local Infusion Site Reactions

    Local infusion site reactions are defined as pain at the infusion site of the Bionic Pancreas. Itching and redness may have also been present.

    Measured: Day 1, Days 1-5 and Days 2-5

  29. Mean Nausea Index Score Using a Visual Analogue Scale (VAS)

    Participants rated their nausea using a 0 to 10 centimeter (cm) VAS where 0=least severe nausea to 10=most severe nausea. The average nausea index scores from Day 1 to Day 5 were calculated

    Measured: Day 1, Days 1-5, and Days 2-5 in each period

  30. Number of Severe Hypoglycemic Events

    A severe hypoglycemic event is an event where the participant is unable to self-treat and requires the assistance of another person.

    Measured: Day 1, Days 1-5 and Days 2-5

  31. Percentage of Time Participants Were Not Under Bionic Pancreas Control During the Bionic Pancreas Period

    Percentage of time that the Bionic pancreas was not functioning properly due to loss of wireless connectivity.

    Measured: 5 days

  32. Percentage of Time Without CGM Monitoring Data

    Percentage of time without CGM monitoring data is the time when the participant's CGM device lost its CGM signal.

    Measured: 5 days

  33. Change From Baseline in Body Weight

    The change in body weight collected at Day 5 of each period relative to Baseline. A negative change from Baseline indicates a reduction in body weight and a positive change from Baseline indicates an increase in body weight.

    Measured: 5 days

  34. Reliability Index

    Reliability index was calculated as the percentage of time values were actually recorded by CGM.

    Measured: Day 1, Days 1-5, and Days 2-5 in each period

  35. List of Technical Faults Associated With the Bionic Pancreas Including Cause and Resolution

    Measured: 5 days

  36. Number of Unscheduled CGM Sensor Changes

    The number of time a CGM sensor was replaced due to falling out or failing to report a glucose value.

    Measured: 5 days

  37. Percentage of Participants Using a Glucagon-Like Peptide-1 (GLP-1) Agonist During the Usual Care Period

    The percentage of participants who used a GLP-1 agonist to manage their diabetes during the Usual Care period.

    Measured: 5 days

  38. Percentage of Participants Using Pramlintide During the Usual Care Period

    The percentage of participants who used pramlintide to manage their diabetes during the Usual Care period.

    Measured: 5 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Apr 2014 (estimated)
  2. Study startJun 2014
  3. Primary completionAug 2014
  4. Study completionAug 2014

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
19 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02105324
Sponsor's protocol ID
2014P000630
Status last verified
Oct 2017
First submitted
2 Apr 2014
Last updated
20 Oct 2017
Data monitoring committee
Yes

Publications

  • Russell SJ, Hillard MA, Balliro C, Magyar KL, Selagamsetty R, Sinha M, Grennan K, Mondesir D, Ekhlaspour L, Zheng H, Damiano ER, El-Khatib FH. Day and night glycaemic control with a bionic pancreas versus conventional insulin pump therapy in preadolescent children with type 1 diabetes: a randomised crossover trial. Lancet Diabetes Endocrinol. 2016 Mar;4(3):233-243. doi: 10.1016/S2213-8587(15)00489-1. Epub 2016 Feb 3.

    PubMed 26850709

Questions about this trial

What is this clinical trial studying?

A study testing Bionic Pancreas in people with Type 1 Diabetes, run by Massachusetts General Hospital at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Oct 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 20 Oct 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean Continuous Glucose Monitoring Glucose (CGMG) Values During Days 2 to 5 (time frame: Days 2 to 5 of each period). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02105324, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Oct 2017.

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Clinical Trial NCT02105324 | AzTrials