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Type 1 DiabetesNCT04877730

Diabetes Closed-Loop Project 6 (DCLP6): Fully Automated Closed-Loop Control in Type 1 Diabetes Using Meal Anticipation

A study testing Fully Closed Loop (FCL), Fully Closed Loop with meal anticipation module (FCL+) and Hybrid Closed Loop (HCL) in people with Type 1 Diabetes, run by University of Virginia 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

The purpose of this study is to test the meal anticipation module on a closed loop algorithm, assessing efficacy and safety. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Type 1 Diabetes
What is being tested?
Fully Closed Loop (FCL), Fully Closed Loop with meal anticipation module (FCL+) and Hybrid Closed Loop (HCL)
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteUnited States
Study dates
21 May 2021to 6 Mar 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 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥18.0 and ≤70 years old at time of consent
  • Clinical diagnosis, based on investigator assessment, of type 1 diabetes for at least one year
  • Currently using insulin for at least six months
  • Currently using insulin pump for at least three months
  • Using insulin parameters such as carbohydrate ratio and correction factors consistently on their pump in order to dose insulin for meals or corrections
  • Access to internet and willingness to upload data during the study as needed
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  • For females, not currently known to be pregnant or breastfeeding
  • If female and sexually active, must agree to use a form of contraception to prevent pregnancy while a participant in the study. A negative serum or urine pregnancy test will be required for all females of childbearing potential. Participants who become pregnant will be discontinued from the study. Also, participants who during the study develop and express the intention to become pregnant within the timespan of the study will be discontinued.
  • Willingness to suspend use of any personal CGM for the duration of the clinical trial once the study CGM is in use
  • Willingness to use the University of Virginia (UVa) closed-loop system throughout study admission
  • Willingness to use the insulin supplied by the study for the hotel stay, if not already using that preparation. Study insulin will be lispro (Humalog) or aspart (Novolog)
  • Willingness not to start any new non-insulin glucose-lowering agent during the course of the trial (including metformin, GLP-1 agonists, pramlintide, DPP-4 inhibitors, biguanides, sulfonylureas and naturaceuticals)
  • Willingness to eat at least 1g/kg of carbohydrate per day during the hotel admission
  • Willingness to reschedule if placed on oral steroids
  • An understanding and willingness to follow the protocol and signed informed consent
  • Willingness to commit to self-quarantine for at least 5 days before COVID-19 testing (If participant has received a full course of COVID-19 vaccine and data emerge suggesting significantly reduced transmissibility among those receiving that vaccine, this self-quarantine requirement can be waived.)

Who cannot join

  • History of diabetic ketoacidosis (DKA) in the 12 months prior to enrollment
  • Severe hypoglycemia resulting in seizure or loss of consciousness in the 12 months prior to enrollment
  • Pregnancy or intent to become pregnant during the trial
  • Currently being treated for a seizure disorder
  • Planned surgery during study duration
  • Treatment with any non-insulin glucose-lowering agent (including metformin, GLP-1 agonists, pramlintide, DPP-4 inhibitors, SGLT-2 inhibitors, biguanides, sulfonylureas and naturaceuticals)
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  • A known medical condition that in the judgment of the investigator might interfere with the completion of the protocol.
  • Use of an automated insulin delivery mechanism that is not downloadable by the subject or study team
  • Known contact with a COVID-19 positive individual within 14 days of the hotel/rental house studies.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Virginia Center for Diabetes Technology

    Charlottesville, Virginia, 22903

Other trials in United States

About this study

The purpose of this study is to test the meal anticipation module on a closed loop algorithm, assessing efficacy and safety.

Read the detailed description

This is a pilot study to assess glycemic responses to three different approaches to insulin dosing for carbohydrate ingestion, with different approaches to a closed-loop system in random order;

  1. without the meal anticipation module and without carbohydrate announcement (FCL)
  2. with the meal anticipation module and without carbohydrate announcement (FCL+)
  3. without the meal anticipation module and with carbohydrate announcement (HCL),

This study will target completion of up to 36 adults in a randomized cross-over trial, comparing blood glucose time in range 70-180 mg/dL following meals with and without the meal anticipation module in use (FCL+ vs FCL), and comparing to a system with carb announcement instead of a meal anticipation module (HCL). The study will also assess safety when dinner is consumed later than usual and when a lunch is consumed without having been entrained in the meal anticipation module. Each participant will complete each of the 3 modules in random order.

Conditions
Type 1 Diabetes
Being tested
Fully Closed Loop (FCL), Fully Closed Loop with meal anticipation module (FCL+), Hybrid Closed Loop (HCL)
Keywords
Type 1 Diabetes (T1D), Continuous Glucose Monitor (CGM), Insulin Pump, Fully Automated Closed Loop (FCL), Hybrid Closed Loop (HCL)
Medical subject headings
Diabetes Mellitus, Type 1

What participants receive

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

  • Fully Closed Loop (FCL)Device

    Closed loop without a meal anticipation module without announced carbohydrate

  • Fully Closed Loop with meal anticipation module (FCL+)Device

    Closed loop with a meal anticipation module and without announced carbohydrate

  • Hybrid Closed Loop (HCL)Device

    Closed loop without a meal anticipation module with announced carbohydrate

Study groups in NCT04877730
Study groupRoleWhat they receive
FCL (Fully Closed Loop)ExperimentalClosed-loop control without meal anticipation module without meal bolus
Receives: Device: Fully Closed Loop (FCL)
FCL+ (Fully Closed Loop with meal anticipation)ExperimentalClosed-loop control with meal anticipation module without meal bolus
Receives: Device: Fully Closed Loop with meal anticipation module (FCL+)
HCL (Hybrid Closed Loop)ExperimentalClosed-loop control without meal anticipation module with meal bolus
Receives: Device: Hybrid Closed Loop (HCL)

What is being measured

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

  1. Time in Range (TIR) 70-180 mg/dL From Breakfast Time + 5 Hours

    Frequency of CGM values falling between 70 mg/dL and 180mg/dL (included) in the 5 hours following breakfast. Higher TIR is a positive outcome.

    Measured: The 5 hour period following breakfast during the study admission

Secondary outcomes (26)
  1. Time in Range (TIR) 70-180 mg/dL Overall

    Frequency of CGM values falling between 70 mg/dL and 180mg/dL (included) during the 24hr study admission. Higher TIR is a positive outcome.

    Measured: The 24 hour study admission from 4pm to 4pm

  2. Time in Range (TIR) 70-180 mg/dL From Dinner Time + 5 Hours

    Frequency of CGM values falling between 70 mg/dL and 180mg/dL (included) in the 5 hours following dinner. Higher TIR is a positive outcome.

    Measured: The 5 hour period following dinner during the study admission

  3. Time in Range (TIR) 70-180 mg/dL From Lunch Time + 5 Hours

    Frequency of CGM values falling between 70 mg/dL and 180mg/dL (included) in the 5 hours following lunch. Higher TIR is a positive outcome.

    Measured: The 5 hour period following lunch during the study admission

  4. Time Below Range (TBR) From Breakfast Time + 5 Hours

    Frequency of CGM values falling below 70 mg/dL (excluded) in the 5 hours following breakfast.

    Measured: The 5 hour period following breakfast during the study admission

  5. Time Below Range (TBR) Overall

    Frequency of CGM values falling below 70 mg/dL (excluded) during the 24hr study admission.

    Measured: The 24 hour study admission from 4pm to 4pm

  6. Time Below Range (TBR) From Dinner Time + 5 Hours

    Frequency of CGM values falling below 70 mg/dL (excluded) in the 5 hours following dinner.

    Measured: The 5 hour period following dinner during the study admission

  7. Time Below Range (TBR) From Lunch Time + 5 Hours

    Frequency of CGM values falling below 70 mg/dL (excluded) in the 5 hours following lunch.

    Measured: The 5 hour period following lunch during the study admission

  8. Time Above Range (TAR) From Breakfast Time + 5 Hours

    Frequency of CGM values falling above 180 mg/dL (excluded) in the 5 hours following breakfast.

    Measured: The 5 hour period following breakfast during the study admission

  9. Time Above Range (TAR) Overall

    Frequency of CGM values falling above 180 mg/dL (excluded) during the 24hr study admission.

    Measured: The 24 hour study admission from 4pm to 4pm

  10. Time Above Range (TAR) From Dinner Time + 5 Hours

    Frequency of CGM values falling above 180 mg/dL (excluded) in the 5 hours following dinner.

    Measured: The 5 hour period following dinner during the study admission

  11. Time Above Range (TAR) From Lunch Time + 5 Hours

    Frequency of CGM values falling above 180 mg/dL (excluded) in the 5 hours following lunch.

    Measured: The 5 hour period following lunch during the study admission

  12. Time in Significant Hyperglycemia From Breakfast Time + 5 Hours

    Frequency of CGM values falling above 250 mg/dL (excluded) in the 5 hours following breakfast.

    Measured: The 5 hour period following breakfast during the study admission

  13. Time in Significant Hyperglycemia Overall

    Frequency of CGM values falling above 250 mg/dL (excluded) during the 24hr study admission.

    Measured: The 24 hour study admission from 4pm to 4pm

  14. Time in Significant Hyperglycemia From Dinner Time + 5 Hours

    Frequency of CGM values falling above 250 mg/dL (excluded) in the 5 hours following dinner.

    Measured: The 5 hour period following dinner during the study admission

  15. Time in Significant Hyperglycemia From Lunch Time + 5 Hours

    Frequency of CGM values falling above 250 mg/dL (excluded) in the 5 hours following lunch.

    Measured: The 5 hour period following lunch during the study admission

  16. Time in Significant Hypoglycemia From Breakfast Time +5 Hours

    Frequency of CGM values falling below 54 mg/dL (excluded) in the 5 hours following breakfast.

    Measured: The 5 hour period following breakfast during the study admission

  17. Time in Significant Hypoglycemia Overall

    Frequency of CGM values falling below 54 mg/dL (excluded) during the 24hr study admission.

    Measured: The 24 hour study admission from 4pm to 4pm

  18. Time in Significant Hypoglycemia Dinner Time + 5 Hours

    Frequency of CGM values falling below 54 mg/dL (excluded) in the 5 hours following dinner.

    Measured: The 5 hour period following dinner during the study admission

  19. Time in Significant Hypoglycemia Lunch Time + 5 Hours

    Frequency of CGM values falling below 54 mg/dL (excluded) in the 5 hours following lunch

    Measured: The 5 hour period following lunch during the study admission

  20. Number of Hypoglycemia Events From Breakfast Time + 5 Hours

    Number of hypoglycemia events in the 5 hours following breakfast. A hypoglycemia event is defined as at least two consecutive CGM values <70mg/dL or a hypoglycemia treatment (two events separated by less than 30 minutes are counted as one). Metrics are number of hypoglycemia events per participant.

    Measured: The 5 hour period following breakfast during the study admission

  21. Number of Hypoglycemia Events Overall

    Number of hypoglycemia events during the 24hr study admission. A hypoglycemia event is defined as at least two consecutive CGM values <70mg/dL or a hypoglycemia treatment (two events separated by less than 30 minutes are counted as one). Values reported as the number of hypoglycemia events per participant.

    Measured: The 24 hour study admission from 4pm to 4pm

  22. Number of Hypoglycemia Events Dinner Time + 5 Hours

    Number of hypoglycemia events in the 5 hours following dinner. A hypoglycemia event is defined as at least two consecutive CGM values <70mg/dL or a hypoglycemia treatment (two events separated by less than 30 minutes are counted as one). Values reported as the number of hypoglycemia events per participant.

    Measured: The 5 hour period following dinner during the study admission

  23. Number of Hypoglycemia Events Lunch Time + 5 Hours

    Number of hypoglycemia events in the 5 hours following lunch. A hypoglycemia event is defined as at least two consecutive CGM values <70mg/dL or a hypoglycemia treatment (two events separated by less than 30 minutes are counted as one).

    Measured: The 5 hour period following lunch during the study admission

  24. Units of Insulin Injected Between 2 Hours Before and 5 Hours After Breakfast

    Sum of all system provided insulin for breakfast (as planned) post-prandial excursion, including anticipation

    Measured: The 7 hour period including the two hours before and the 5 hours after breakfast

  25. Units of Insulin Injected (Units/kg) Overall

    Calculation of all system-provided insulin (units/kg) injected during the 24hr study admission.

    Measured: The 24 hour study admission from 4pm to 4pm

  26. Units of Insulin Injected Between 2 Hours Before and 5 Hours After Dinner

    Sum of all system provided insulin for dinner (late) post-prandial excursion, including anticipation

    Measured: The 7 hour period including the 2 hours before and 5 hours after dinner

Timeline

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

  1. First posted7 May 2021
  2. Study start21 May 2021
  3. Primary completion4 Mar 2022
  4. Study completion6 Mar 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
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
50 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04877730
Sponsor's protocol ID
210035
Other IDs
UC4DK108483
Status last verified
May 2024
First submitted
26 Apr 2021
Last updated
23 May 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
Yes: Will follow the NIH Data Sharing Policy and Implementation Guidance on sharing research resources for research purposes to qualified individuals within the scientific community.

Publications

  • Garcia-Tirado J, Colmegna P, Villard O, Diaz JL, Esquivel-Zuniga R, Koravi CLK, Barnett CL, Oliveri MC, Fuller M, Brown SA, DeBoer MD, Breton MD. Assessment of Meal Anticipation for Improving Fully Automated Insulin Delivery in Adults With Type 1 Diabetes. Diabetes Care. 2023 Sep 1;46(9):1652-1658. doi: 10.2337/dc23-0119.

    PubMed 37478323

Questions about this trial

What is this clinical trial studying?

A study testing Fully Closed Loop (FCL), Fully Closed Loop with meal anticipation module (FCL+) and Hybrid Closed Loop (HCL) in people with Type 1 Diabetes, run by University of Virginia 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 16 inclusion and 9 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 May 2024. 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 17 May 2023). 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?

Time in Range (TIR) 70-180 mg/dL From Breakfast Time + 5 Hours (time frame: The 5 hour period following breakfast during the study admission). 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 NCT04877730, 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 23 May 2024.

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Clinical Trial NCT04877730 | AzTrials