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AzTrials

Type 1 DiabetesREVERSIBLENCT04876079

Prevention of Mild-to-moderate Hypoglycemia in Type 1 Diabetes

A study testing Test to induce a decline in plasma glucose, Dexcom G6 and Dex4 in people with Type 1 Diabetes, run by Institut de Recherches Cliniques de Montreal at 1 site in Canada.

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

According to guidelines, when a mild-to-moderate hypoglycemia occurs (capillary blood glucose < 4.0 mmol/L), 15-20g of rapidly absorbed carbohydrates should be ingested. Patients should re-test and re-ingest 15-20g carbohydrates every 15 minutes until they recover from hypoglycemia. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Type 1 Diabetes
What is being tested?
Test to induce a decline in plasma glucose, Dexcom G6 and Dex4
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteCanada
Study dates
1 Jun 2021to 30 Jun 2023
Phase
Interventional
Are there results?
None posted in the registry

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

  • Males and females ≥ 18 years old
  • Clinical diagnosis of type 1 diabetes for at least one year
  • Treatment with multiple daily insulin injections or insulin pump therapy with insulin analogs (rapid, ultra-rapid and basal insulin)
  • A glycated hemoglobin A1c ≤ 10%

Who cannot join

  • Clinically significant microvascular complications: nephropathy (eGFR < 40 ml/min), severe proliferative retinopathy as judged by the investigator, neuropathy (particularly diagnosed gastroparesis)
  • Recent (< 3 months) acute macrovascular event (e.g., acute coronary syndrome or cardiac surgery)
  • Known significant cardiac rhythm abnormality based on investigator's judgement
  • Known significant neurological abnormality (e.g., seizure disorder) based on investigator's judgement
  • Ongoing pregnancy or breastfeeding
  • Severe hypoglycemia episode within 1 month of screening
  • Known uncorrected hypokalemia within the past 3 months (potassium < 3.5 mmol/L)

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • Montreal Clinical Research Institute

    Montreal, Quebec, H2W 1R7

Other trials in Canada

About this study

Official title: Towards Prevention of Mild-to-moderate Hypoglycemia in Type 1 Diabetes With Oral Glucose at a Higher Blood Glucose Threshold

According to guidelines, when a mild-to-moderate hypoglycemia occurs (capillary blood glucose < 4.0 mmol/L), 15-20g of rapidly absorbed carbohydrates should be ingested. Patients should re-test and re-ingest 15-20g carbohydrates every 15 minutes until they recover from hypoglycemia. These recommendations were principally based on two studies conducted in the 80s before the introduction of intensive insulin therapy. In practice, only 32-50% of patients follow the current guidelines. In addition, recent studies suggest that under current intensive insulin therapies, an initial correction with 15g of oral glucose may be insufficient to rapidly correct mild-to-moderate hypoglycemia. With the development and increasing usage of newer glucose monitoring technologies, the community is witnessing a shift in hypoglycemia management, from a reactive to a proactive approach (e.g., prevent imminent episodes rather than treating established episodes).

Conditions
Type 1 Diabetes
Being tested
Test to induce a decline in plasma glucose, Dexcom G6, Dex4, Insulin
Keywords
Hypoglycemia, Type 1 diabetes, Carbohydrates
Medical subject headings
Diabetes Mellitus, Type 1, Hypoglycemia

What participants receive

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

  • Test to induce a decline in plasma glucoseOther

    Participants will be admitted at the research center at 7:00 after an overnight fast. A venous catheter will be inserted into an arm vein for blood sampling purposes. A subcutaneous insulin bolus will be administered to bring plasma glucose to the glycemic threshold. Oral carbohydrates (16g) will be given when plasma glucose levels are at the target threshold. Sixty minutes after carbohydrates consumption, a standardized meal will be provided and participants will be discharged 90 minutes after the meal.

  • Dexcom G6Device

    Participants will have to wear a Dexcom G6 during study interventions

  • Dex4Other

    When the glycemic threshold is reach, participants will be given 16g of Dex4

  • InsulinDrug

    A subcutaneous insulin bolus will be given to induce a decline in plasma glucose and reach the glycemic threshold.

Study groups in NCT04876079
Study groupRoleWhat they receive
16g of carbohydrates - Plasma glucose < 4.0 mmol/LActive comparator16g of carbohydrates will be given when glucose levels are below 4.0 mmol/L (management per guidelines)
Receives: Other: Test to induce a decline in plasma glucose; Device: Dexcom G6; Other: Dex4; Drug: Insulin
16g of carbohydrates - Plasma glucose ≤ 4.5 mmol/LActive comparator16g of carbohydrates will be given when glucose levels are equal or below 4.5 mmol/L.
Receives: Other: Test to induce a decline in plasma glucose; Device: Dexcom G6; Other: Dex4; Drug: Insulin
16g of carbohydrates - Plasma glucose ≤ 5.0 mmol/LActive comparator16g of carbohydrates will be given when glucose levels are equal or below 5.0 mmol/L.
Receives: Other: Test to induce a decline in plasma glucose; Device: Dexcom G6; Other: Dex4; Drug: Insulin

What is being measured

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

  1. Time spent of glucose levels < 4.0 mmol/L

    Measured: 60 minutes after carbohydrates consumption

Secondary outcomes (27)
  1. Plasma glucose levels at 5 minutes after carbohydrates consumption

    Measured: 5 minutes after carbohydrates consumption

  2. Plasma glucose levels at 10 minutes after carbohydrates consumption

    Measured: 10 minutes after carbohydrates consumption

  3. Plasma glucose levels at 15 minutes after carbohydrates consumption

    Measured: 15 minutes after carbohydrates consumption

  4. Plasma glucose levels at 20 minutes after carbohydrates consumption

    Measured: 20 minutes after carbohydrates consumption

  5. Plasma glucose levels at 30 minutes after carbohydrates consumption

    Measured: 30 minutes after carbohydrates consumption

  6. Plasma glucose levels at 45 minutes after carbohydrates consumption

    Measured: 45 minutes after carbohydrates consumption

  7. Plasma glucose levels at 60 minutes after carbohydrates consumption

    Measured: 60 minutes after carbohydrates consumption

  8. Lowest plasma glucose level eached after CHO consumption

    Measured: 60 minutes after carbohydrates consumption

  9. Time from CHO consumption to the lowest plasma glucose level reached

    Measured: 60 minutes after carbohydrates consumption

  10. Time from CHO consumption to plasma glucose < 3.5 mmol/L

    Measured: 60 minutes after carbohydrates consumption

  11. Percentage of participants reaching hypoglycemia (< 4.0 mmol/L) after CHO consumption

    Measured: 60 minutes after carbohydrates consumption

  12. Percentage of participants for whom hypoglycemia was corrected at 10 minutes after CHO consumption

    Only calculated for participants who will have glucose levels < 4.0 mmol/L

    Measured: 10 minutes after carbohydrates consumption

  13. Percentage of participants for whom hypoglycemia was corrected at 15 minutes after CHO consumption

    Only calculated for participants who will have glucose levels < 4.0 mmol/L

    Measured: 15 minutes after carbohydrates consumption

  14. Percentage of participants for whom hypoglycemia was corrected at 20 minutes after CHO consumption

    Only calculated for participants who will have glucose levels < 4.0 mmol/L

    Measured: 20 minutes after carbohydrates consumption

  15. Percentage of participants for whom hypoglycemia was corrected at 25 minutes after CHO consumption

    Only calculated for participants who will have glucose levels < 4.0 mmol/L

    Measured: 25 minutes after carbohydrates consumption

  16. Percentage of participants for whom hypoglycemia was corrected at 30 minutes after CHO consumption

    Only calculated for participants who will have glucose levels < 4.0 mmol/L

    Measured: 30 minutes after carbohydrates consumption

  17. Percentage of participants for whom hypoglycemia was corrected at 35 minutes after CHO consumption

    Only calculated for participants who will have glucose levels < 4.0 mmol/L

    Measured: 35 minutes after carbohydrates consumption

  18. Percentage of hypoglycemic events that were corrected at 10 minutes after CHO consumption

    Only calculated for events with glucose level < 4.0 mmol/L

    Measured: 10 minutes after carbohydrates consumption

  19. Percentage of hypoglycemic events that were corrected at 15 minutes after CHO consumption

    Only calculated for events with glucose level < 4.0 mmol/L

    Measured: 15 minutes after carbohydrates consumption

  20. Percentage of hypoglycemic events that were corrected at 20 minutes after CHO consumption

    Only calculated for events with glucose level < 4.0 mmol/L

    Measured: 20 minutes after carbohydrates consumption

  21. Percentage of hypoglycemic events that were corrected at 25 minutes after CHO consumption

    Only calculated for events with glucose level < 4.0 mmol/L

    Measured: 25 minutes after carbohydrates consumption

  22. Percentage of hypoglycemic events that were corrected at 30 minutes after CHO consumption

    Only calculated for events with glucose level < 4.0 mmol/L

    Measured: 30 minutes after carbohydrates consumption

  23. Percentage of hypoglycemic events that were corrected at 35 minutes after CHO consumption

    Only calculated for events with glucose level < 4.0 mmol/L

    Measured: 35 minutes after carbohydrates consumption

  24. Percentage of participants requiring a second treatment with carbohydrates at 20 minutes after the first CHO consumption

    Only calculated for participants who will have glucose levels < 4.0 mmol/L

    Measured: 20 minutes after carbohydrates consumption

  25. Percentage of participants requiring a second treatment with carbohydrates at 40 minutes after the first CHO consumption

    Only calculated for participants who will have glucose levels < 4.0 mmol/L

    Measured: 40 minutes after carbohydrates consumption

  26. Percentage of participants requiring a second treatment with carbohydrates at 60 minutes after the first CHO consumption

    Only calculated for participants who will have glucose levels < 4.0 mmol/L

    Measured: 60 minutes after carbohydrates consumption

  27. Percentage of participants experiencing a rebound hyperglycemia (≥ 10.0 mmol/L) within the first hour following the first carbobydrates consumption

    Measured: 60 minutes after carbohydrates consumption

Timeline

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

  1. First posted6 May 2021
  2. Study start1 Jun 2021
  3. Primary completion1 Jun 2023
  4. Study completion30 Jun 2023

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
30 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04876079
Sponsor's protocol ID
2022-1119
Acronym
REVERSIBLE
Status last verified
Mar 2026
First submitted
3 May 2021
Last updated
5 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Cheng R, Taleb N, Wu Z, Bouchard D, Parent V, Lalanne-Mistrih ML, Boudreau V, Messier V, Lacombe MJ, Grou C, Brazeau AS, Rabasa-Lhoret R. Managing Impending Nonsevere Hypoglycemia With Oral Carbohydrates in Type 1 Diabetes: The REVERSIBLE Trial. Diabetes Care. 2024 Mar 1;47(3):476-482. doi: 10.2337/dc23-1328.

    PubMed 38194601

Questions about this trial

What is this clinical trial studying?

A study testing Test to induce a decline in plasma glucose, Dexcom G6 and Dex4 in people with Type 1 Diabetes, run by Institut de Recherches Cliniques de Montreal at 1 site in Canada.

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 7 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 5 Mar 2026. 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 Canada. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Time spent of glucose levels < 4.0 mmol/L (time frame: 60 minutes after carbohydrates consumption). 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 NCT04876079, 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 5 Mar 2026.

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