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Diabetes MellitusNCT04714216

Automated Insulin Delivery for INpatients With DysGlycemia (AIDING) Feasibility

A study testing The Omnipod 5/Horizon HCL system in people with Diabetes Mellitus, run by Emory University at 3 sites 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 single-arm stepwise feasibility study will test initial deployment of hybrid closed-loop (HCL) automated insulin delivery (AID) using the Omnipod 5/Horizon HCL system with remote monitoring and device operation capabilities to hospitalized patients admitted to the general medical/surgical floor with diabetes… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Diabetes Mellitus
What is being tested?
The Omnipod 5/Horizon HCL system
Could I receive a placebo?
No, everyone receives an active treatment
How many people
22 participants
Where
3 sitesUnited States
Study dates
29 Jun 2021to 11 Aug 2022
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients ≥18 years of age with insulin-treated T1 or Type 2 diabetes mellitus (T2DM) admitted to general (non-intensive care) medical-surgical hospital service requiring inpatient insulin therapy.

Who cannot join

  • Patients admitted the ICU or anticipated to require ICU transfer
  • Anticipated length of hospital stay <48 hours.
  • Evidence of hyperglycemic crises (diabetic ketoacidosis or hyperosmolar hyperglycemic state) at enrollment
  • Severely impaired renal function (eGFR < 30 ml/min/1.73m2) or clinically significant liver failure
  • Severe anemia with hemoglobin <7 g/dL
  • Evidence of hemodynamic instability
Show all 13Show fewer
  • Hypoxia (SpO2 <95% on supplemental oxygen)
  • Pre-admission or inpatient total daily insulin dose >100 units
  • Mental condition rendering the participant unable to consent or answer questionnaires
  • Pregnant or breast feeding at time of enrollment
  • Unable or unwilling to use rapid-acting insulin analogs (Humalog, Admelog, Novolog or Apidra) during the study
  • Use of hydroxyurea or high-dose ascorbic acid (>1g/day)
  • Coronavirus Disease 2019 (COVID-19) infection or person under investigation (PUI) on isolation precautions

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • Grady Health System (non-CRN)

    Atlanta, Georgia, 30322

  • University of Virginia School of Medicine

    Charlottesville, Virginia, 22903

  • Stanford University School of Medicine

    Stanford, California, 94305

Other trials in United States

About this study

Official title: Automated Insulin Delivery for INpatients With DysGlycemia (AIDING) Feasibility Study

This single-arm stepwise feasibility study will test initial deployment of hybrid closed-loop (HCL) automated insulin delivery (AID) using the Omnipod 5/Horizon HCL system with remote monitoring and device operation capabilities to hospitalized patients admitted to the general medical/surgical floor with diabetes (type 1 or type 2) requiring insulin therapy.

Read the detailed description

This single-arm stepwise feasibility study will test initial deployment of hybrid closed-loop (HCL) automated insulin delivery (AID) using the Omnipod 5/Horizon HCL system with remote monitoring and device operation capabilities to hospitalized patients admitted to the general medical/surgical floor with diabetes (type 1 or type 2) requiring insulin therapy. All enrolled participants will be placed on HCL insulin therapy for 10 days or until hospital discharge (if less than 10 days) to determine functional operability of the system and its effect on glycemic control in the hospital setting. This study will generate preliminary data to inform the design of a large multi-institution randomized controlled trial to assess superiority of HCL compared to standard inpatient insulin therapy.

Being tested
The Omnipod 5/Horizon HCL system
Keywords
Automated insulin delivery, Hybrid closed-loop system, Inpatient insulin therapy
Medical subject headings
Diabetes Mellitus

What participants receive

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

  • The Omnipod 5/Horizon HCL systemDevice

    The Omnipod 5/Horizon HCL system, consists of a disposable insulin infusion pump (or "pod"), a built-in model predictive control (MPC) insulin dosing algorithm, and a remote Personal Diabetes Manager (PDM) interface, that interact with a Dexcom G6 continuous glucose monitor (CGM) to automatically control insulin delivery based upon real-time glucose values. The PDM component also enables remote interaction with the system, including glucose monitoring as well as insulin dosing management and adjustments.

Study groups in NCT04714216
Study groupRoleWhat they receive
Hybrid closed-loop (HCL) automated insulin delivery (AID)ExperimentalHybrid closed-loop (HCL) automated insulin delivery (AID) using the Omnipod 5/Horizon HCL system with remote monitoring and device operation capabilities will be deployed to hospitalized patients admitted to the general medical/surgical floor with diabetes (type 1 or type 2) requiring insulin therapy.
Receives: Device: The Omnipod 5/Horizon HCL system

What is being measured

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

  1. Percentage of Time Spent in HCL After CGM Sensor Meets Initial Validation Criteria

    The percentage of time spent in HCL after CGM sensor met initial validation criteria of sensor glucose value being within ±20% of point of care (POC) values (for glucose levels ≥70 mg/dL) or ±20 mg/dL for POC glucose values <70 mg/dL.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  2. Percentage of Time Sensor Glucose is Within Target Glucose Range

    The percentage of time that the sensor glucose measurement is within the target glucose range of 70-180 mg/dL.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

Secondary outcomes (26)
  1. Time From Enrollment to Start of HCL Therapy (After Initial CGM Validation)

    The time from enrollment to start of HCL therapy, after initial CGM validation, was recorded.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  2. Percentage of Time With CGM Readings

    The percentage of time during study participation with CGM readings was calculated.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  3. Percentage of CGM Values Meeting Accuracy Criteria for Bolus/Correction Insulin Dosing

    The percentage of CGM values meeting accuracy criteria for bolus/correction insulin dosing was calculated.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  4. Percentage of CGM Readings Within %15/15 of POC Readings and Within %20/20 of POC Readings With the Cut Point at 70 mg/dL

    The percentage of CGM values within 15% or 15 mg/dL (%15/15) and within 20% or 20 mg/dL (%20/20) of POC reference values for blood glucose, using a cut point at 70 mg/dL. The reference values are derived from a total of 597 paired CGM and reference capillary glucose values.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  5. Number of Hypoglycemic (<70 mg/dL) Episodes Per Patient

    The number of hypoglycemic (<70 mg/dL) episodes per patient.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  6. Number of Hypoglycemic (<70 mg/dL) Episodes Per Patient-day

    The number of hypoglycemic (<70 mg/dL) episodes per patient-day in hospital.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  7. Number Clinically Important Hypoglycemic (<54 mg/dL) Episodes Per Patient

    The number clinically important hypoglycemic (<54 mg/dL) episodes per patient.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  8. Percent Time Below Range (TBR) of <70mg/dL

    The percent time below range (TBR), defined as blood glucose <70mg/dL.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  9. Percent Time Below Range (TBR) of <54 mg/dL

    The percentage of time below range (TBR) of <54 mg/dL.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  10. Percent Time Above Range (TAR) of >180 mg/dL

    The percentage of time above range (TAR) of >180 mg/dL.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  11. Percent Time in Severe Hyperglycemia (>250 mg/dL)

    The percentage of time in severe hyperglycemia, defined as >250 mg/dL.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  12. Frequency of Setting Overall Adjustments for Clinically-important Hypoglycemia (<54 mg/dL)

    The frequency of setting adjustments across all participants for clinically-important hypoglycemia, defined as <54 mg/dL.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  13. Frequency of Setting Adjustments for Clinically-important Hypoglycemia (<54 mg/dL) to Basal Rate

    The frequency of setting adjustments across all participants for clinically-important hypoglycemia (<54 mg/dL) to basal rate.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  14. Frequency of Setting Adjustments for Clinically-important Hypoglycemia (<54 mg/dL) to Insulin Carb Ratio (ICR)

    The frequency of setting adjustments across all participants for clinically-important hypoglycemia (<54 mg/dL) to insulin carb ratio (ICR).

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  15. Frequency of Setting Adjustments for Clinically-important Hypoglycemia (<54 mg/dL) to Insulin Sensitivity Factor (ISF)

    The frequency of setting adjustments across all participants for clinically-important hypoglycemia (<54 mg/dL) to insulin sensitivity factor (ISF).

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  16. Frequency of Setting Overall Adjustments for Prolonged Hyperglycemia (>250 mg/dL for >1 Hour)

    The frequency of setting adjustments across all participants for prolonged hyperglycemia, defined as blood glucose >250 mg/dL for over one hour.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  17. Frequency of Setting Adjustments for Prolonged Hyperglycemia (>250 mg/dL for >1 Hour) to Basal Rate

    The frequency of setting adjustments across all participants for prolonged hyperglycemia, defined as blood glucose >250 mg/dL for over one hour, to basal rate.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  18. Frequency of Setting Adjustments for Prolonged Hyperglycemia (>250 mg/dL for >1 Hour) to ICR

    The frequency of setting adjustments across all participants for prolonged hyperglycemia, defined as >250 mg/dL for over one hour, to ICR.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  19. Frequency of Setting Adjustments for Prolonged Hyperglycemia (>250 mg/dL for >1 Hour) to ISF

    The frequency of setting adjustments across all participants for prolonged hyperglycemia, defined as blood glucose >250 mg/dL for over one hour, to ISF.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  20. Total Daily Insulin (TDI)

    The total daily insulin (TDI) was calculated.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  21. Total Daily Basal Insulin (TBI)

    The total daily basal insulin (TBI) was calculated.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  22. Total Daily Bolus Meal/Correction

    The total daily bolus meal/correction was recorded

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  23. Number of Hypoglycemic Events That Required Assistance of Another Person

    The number of hypoglycemic events across all participants that required assistance of another person due to altered consciousness to actively administer carbohydrate, glucagon, or other resuscitative actions.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  24. Number of Diabetic Ketoacidosis Events

    The number of diabetic ketoacidosis (DKA) events across all participants.

    Measured: Up to 10 days (or hospital discharge if before 10 days)

  25. Patient Acceptability of HCL System

    To assesses acceptability of the HCL system participants responded to the statement "Overall, I liked using the Omnipod 5/Horizon system to treat my blood sugar in the hospital" with five (5) options to choose from: Strongly Agree, Agree, Neither Agree nor Disagree, Disagree, and Strongly Disagree. The responses were not assigned a score, rather the number of participants for each response were examined.

    Measured: At time of device discontinuation (up to 10 days of use or hospital discharge if before 10 days)

  26. Patient Perceptions of HCL System Use

    Participants were asked to provide their perceptions of the HCL system with four questions that were responded to with "Yes" or "No". Responses are assigned a score and a summary score is not calculated, rather the number of participants responding "Yes" or "No" to each of the individual questions is examined.

    Measured: At time of device discontinuation (up to 10 days of use or hospital discharge if before 10 days)

Timeline

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

  1. First posted19 Jan 2021
  2. Study start29 Jun 2021
  3. Primary completion11 Aug 2022
  4. Study completion11 Aug 2022

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
22 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04714216
Sponsor's protocol ID
STUDY00001835
Status last verified
Mar 2024
First submitted
14 Jan 2021
Last updated
23 Apr 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing The Omnipod 5/Horizon HCL system in people with Diabetes Mellitus, run by Emory University at 3 sites 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 1 inclusion and 13 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 23 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites 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 23 Apr 2024). 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?

Percentage of Time Spent in HCL After CGM Sensor Meets Initial Validation Criteria (time frame: Up to 10 days (or hospital discharge if before 10 days)). 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?
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 23 Apr 2024.

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