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Type 1 DiabetesAID-CompNCT05477030

Effect of Automated Insulin Delivery on Early-stage Diabetic Complications

A study testing Medtronic MiniMed 780G with SmartGuard activation and Medtronic MiniMed 780G without SmartGuard activation in people with Type 1 Diabetes, run by University of Milan at 1 site in Italy.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Aim of this study is to verify the effects of an advanced HCL (Medtronic Minimed™ 780G) compared to SAP with PLGS on metabolic outcomes and markers of early microvascular damage in a population of adults with T1D previously treated with CSII. 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?
Medtronic MiniMed 780G with SmartGuard activation and Medtronic MiniMed 780G without SmartGuard activation
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
52 participants
Where
1 siteItaly
Study dates
23 Feb 2022to 23 Feb 2024
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

  • Male and female patients
  • T1D patients above 18 years in CSII treatment for at least 3 months
  • HbA1c values between 6.0% and 9.5%
  • Disease duration ≥ 2 years
  • Written informed consent obtained from the patient

Who cannot join

  • Pregnancy
  • Participation to other clinical trials
  • A history of alcohol or drug abuse
  • Advanced diabetic nephropathy defined as presence of albuminuria ≥ 300 mg/g or eGFR < 60 ml/min/1,73m2
  • Proliferative Diabetic retinopathy or macular edema
  • Established Atherosclerotic Cardiovascular Disease (ASCVD) or history of heart failure
Show all 9Show fewer
  • Presence of serious diseases or conditions which in the opinion of the Investigator makes patient non-eligible for the study
  • Hypoglycemia Unawareness (Clarke score > 4)
  • Patients unable to understand spoken and written Italian language

Trial locations and contacts

1 site in 1 country.

Italy1 site, 1 recruiting
  • ASST FBF Sacco

    Milan, 20157

    Elio Ippolito, Dr., 02 39042648, ippolito.elio@asst-fbf-sacco.it

    Paolo Fiorina, MD, PhD

    Recruiting

Other trials in Italy

About this study

Official title: Effect of Automated Insulin Delivery With Advanced Closed-loop on Glucose Outcomes and Early-stage Diabetic Complications

Aim of this study is to verify the effects of an advanced HCL (Medtronic Minimed™ 780G) compared to SAP with PLGS on metabolic outcomes and markers of early microvascular damage in a population of adults with T1D previously treated with CSII. Evaluation of endothelial disfunction and autonomic neuropathy will also be performed.

Read the detailed description

New algorithms for the automation of insulin delivery (AID) are showing great benefit on glucose control in people with type 1 diabetes. Indeed, Hybrid closed loop (HCL) systems can improve HbA1c levels, percentage of time in defined glucose range, time below range and time over range, according to RCT and observational studies results. However, scientific evidences demonstrating potential benefits on the reduction of diabetes complications are limited regarding CSII or SAP with demonstrated reduction of cardiovascular mortality, improvement of albuminuria and peripheral nerve damage.

Data on AID effects on complications of diabetes are missing. In this study intermediate damage markers will be measured to assess potential effects of AID in comparison to sensor augmented pumps.

Conditions
Type 1 Diabetes
Being tested
Medtronic MiniMed 780G with SmartGuard activation, Medtronic MiniMed 780G without SmartGuard activation
Keywords
Automated insulin delivery, Type 1 Diabetes complications
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.

  • Medtronic MiniMed 780G with SmartGuard activationDevice

    Insulin pump implemented with alghoritm for automatic modulation of insulin delivery (to increase time in glucose range 70-180 mg/dl)

  • Medtronic MiniMed 780G without SmartGuard activationDevice

    Insulin pump implemented with alghoritm for low glucose insulin suspension (to reduce hypoglycemia rate)

Study groups in NCT05477030
Study groupRoleWhat they receive
Study Group A (Intervention)Active comparatorGroup treated with automated insulin delivery (advanced hybrid closed-loop)
Receives: Device: Medtronic MiniMed 780G with SmartGuard activation
Study Group B (Control)Active comparatorGroup treated with predictive low glucose suspend (sensor augmented pump - PLGS)
Receives: Device: Medtronic MiniMed 780G without SmartGuard activation

What is being measured

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

  1. Time in glycemic range 70-180 mg/dl

    time spent by the patient in glucose range

    Measured: From Baseline to 26 weeks

  2. Glycated Hemoglobin (HbA1c)

    percentage of hemoglobin glycosylated

    Measured: From Baseline to 26 weeks

Secondary outcomes (7)
  1. Early microangiopathic damage markers: sTNFR-1/2

    sTNFR-1/2 (pg/ml)

    Measured: From Baseline to 26 weeks

  2. Early microangiopathic damage markers: B-2 microglobulin

    B-2 microglobulin (pg/ml)

    Measured: From Baseline to 26 weeks

  3. Early microangiopathic damage markers: cystatin C

    cystatin C (ng/ml)

    Measured: From Baseline to 26 weeks

  4. Early microangiopathic damage markers: neutrophil gelatinase-associated lipocalin

    neutrophil gelatinase-associated lipocalin (ng/ml)

    Measured: From Baseline to 26 weeks

  5. Early microangiopathic damage markers: osteopontin

    osteopontin (pg/ml)

    Measured: From Baseline to 26 weeks

  6. Early microangiopathic damage markers: vWF levels

    vWF levels (ng/ml)

    Measured: From Baseline to 26 weeks

  7. Endothelial disfunction

    Endothelial-dependent dilation (EDD) is considered a marker of dysfunctional abnormalities involved in early phases of atherosclerosis development. Changes in EDD precede structural changes and occurs in the preclinical phase of vascular disease.

    In the present study endothelial dependent dilation is assessed by color Doppler evaluation of flow increase after hyperemia.

    Measured: From Baseline to 26 weeks

Timeline

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

  1. First posted28 Jul 2022
  2. Study start23 Feb 2022
  3. Primary completion31 Jan 2023 (estimated)
  4. Study completion23 Feb 2024 (estimated)

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
Other
Allocation
Randomised
Intervention model
Parallel groups
Model description
Open label randomized controlled trial
Masking
None (open label)
Enrolment
52 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05477030
Sponsor's protocol ID
2022004
Acronym
AID-Comp
Status last verified
Jul 2022
First submitted
16 Jun 2022
Last updated
28 Jul 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Diabetes Control and Complications Trial Research Group; Nathan DM, Genuth S, Lachin J, Cleary P, Crofford O, Davis M, Rand L, Siebert C. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993 Sep 30;329(14):977-86. doi: 10.1056/NEJM199309303291401.

    PubMed 8366922
  • Writing Team for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Effect of intensive therapy on the microvascular complications of type 1 diabetes mellitus. JAMA. 2002 May 15;287(19):2563-9. doi: 10.1001/jama.287.19.2563.

    PubMed 12020338
  • Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM, Orchard TJ, Raskin P, Zinman B; Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005 Dec 22;353(25):2643-53. doi: 10.1056/NEJMoa052187.

    PubMed 16371630
  • Pettus JH, Zhou FL, Shepherd L, Preblick R, Hunt PR, Paranjape S, Miller KM, Edelman SV. Incidences of Severe Hypoglycemia and Diabetic Ketoacidosis and Prevalence of Microvascular Complications Stratified by Age and Glycemic Control in U.S. Adult Patients With Type 1 Diabetes: A Real-World Study. Diabetes Care. 2019 Dec;42(12):2220-2227. doi: 10.2337/dc19-0830. Epub 2019 Sep 23.

    PubMed 31548241
  • Pickup JC, Sutton AJ. Severe hypoglycaemia and glycaemic control in Type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion. Diabet Med. 2008 Jul;25(7):765-74. doi: 10.1111/j.1464-5491.2008.02486.x.

    PubMed 18644063
  • Pankowska E, Blazik M, Dziechciarz P, Szypowska A, Szajewska H. Continuous subcutaneous insulin infusion vs. multiple daily injections in children with type 1 diabetes: a systematic review and meta-analysis of randomized control trials. Pediatr Diabetes. 2009 Feb;10(1):52-8. doi: 10.1111/j.1399-5448.2008.00440.x. Epub 2008 Aug 27.

    PubMed 18761648
  • EQuality1 Study Group--Evaluation of QUALITY of Life and Costs in Diabetes Type 1; Nicolucci A, Maione A, Franciosi M, Amoretti R, Busetto E, Capani F, Bruttomesso D, Di Bartolo P, Girelli A, Leonetti F, Morviducci L, Ponzi P, Vitacolonna E. Quality of life and treatment satisfaction in adults with Type 1 diabetes: a comparison between continuous subcutaneous insulin infusion and multiple daily injections. Diabet Med. 2008 Feb;25(2):213-20. doi: 10.1111/j.1464-5491.2007.02346.x. Epub 2008 Jan 14.

    PubMed 18201210
  • Maniatis AK, Toig SR, Klingensmith GJ, Fay-Itzkowitz E, Chase HP. Life with continuous subcutaneous insulin infusion (CSII) therapy: child and parental perspectives and predictors of metabolic control. Pediatr Diabetes. 2001 Jun;2(2):51-7. doi: 10.1034/j.1399-5448.2001.002002051.x.

    PubMed 15016198
  • Bergenstal RM, Tamborlane WV, Ahmann A, Buse JB, Dailey G, Davis SN, Joyce C, Perkins BA, Welsh JB, Willi SM, Wood MA; STAR 3 Study Group. Sensor-augmented pump therapy for A1C reduction (STAR 3) study: results from the 6-month continuation phase. Diabetes Care. 2011 Nov;34(11):2403-5. doi: 10.2337/dc11-1248. Epub 2011 Sep 20.

    PubMed 21933908
  • Forlenza GP, Li Z, Buckingham BA, Pinsker JE, Cengiz E, Wadwa RP, Ekhlaspour L, Church MM, Weinzimer SA, Jost E, Marcal T, Andre C, Carria L, Swanson V, Lum JW, Kollman C, Woodall W, Beck RW. Predictive Low-Glucose Suspend Reduces Hypoglycemia in Adults, Adolescents, and Children With Type 1 Diabetes in an At-Home Randomized Crossover Study: Results of the PROLOG Trial. Diabetes Care. 2018 Oct;41(10):2155-2161. doi: 10.2337/dc18-0771. Epub 2018 Aug 8.

    PubMed 30089663
  • Bergenstal RM, Garg S, Weinzimer SA, Buckingham BA, Bode BW, Tamborlane WV, Kaufman FR. Safety of a Hybrid Closed-Loop Insulin Delivery System in Patients With Type 1 Diabetes. JAMA. 2016 Oct 4;316(13):1407-1408. doi: 10.1001/jama.2016.11708. No abstract available.

    PubMed 27629148
  • Nimri R, Muller I, Atlas E, Miller S, Fogel A, Bratina N, Kordonouri O, Battelino T, Danne T, Phillip M. MD-Logic overnight control for 6 weeks of home use in patients with type 1 diabetes: randomized crossover trial. Diabetes Care. 2014 Nov;37(11):3025-32. doi: 10.2337/dc14-0835. Epub 2014 Jul 30.

    PubMed 25078901
  • Garg SK, Weinzimer SA, Tamborlane WV, Buckingham BA, Bode BW, Bailey TS, Brazg RL, Ilany J, Slover RH, Anderson SM, Bergenstal RM, Grosman B, Roy A, Cordero TL, Shin J, Lee SW, Kaufman FR. Glucose Outcomes with the In-Home Use of a Hybrid Closed-Loop Insulin Delivery System in Adolescents and Adults with Type 1 Diabetes. Diabetes Technol Ther. 2017 Mar;19(3):155-163. doi: 10.1089/dia.2016.0421. Epub 2017 Jan 30.

    PubMed 28134564
  • Salehi P, Roberts AJ, Kim GJ. Efficacy and Safety of Real-Life Usage of MiniMed 670G Automode in Children with Type 1 Diabetes Less than 7 Years Old. Diabetes Technol Ther. 2019 Aug;21(8):448-451. doi: 10.1089/dia.2019.0123. Epub 2019 Jun 5.

    PubMed 31166801
  • Lepore G, Scaranna C, Corsi A, Dodesini AR, Trevisan R. Switching from Suspend-Before-Low Insulin Pump Technology to a Hybrid Closed-Loop System Improves Glucose Control and Reduces Glucose Variability: A Retrospective Observational Case-Control Study. Diabetes Technol Ther. 2020 Apr;22(4):321-325. doi: 10.1089/dia.2019.0302. Epub 2020 Feb 11.

    PubMed 31617752

Questions about this trial

What is this clinical trial studying?

A study testing Medtronic MiniMed 780G with SmartGuard activation and Medtronic MiniMed 780G without SmartGuard activation in people with Type 1 Diabetes, run by University of Milan at 1 site in Italy.

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 5 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: status not confirmed, as of the sponsor's last update on 28 Jul 2022. 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 Italy. 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?

Results are not available in the source record.

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

Contact Elio Ippolito, MS (0239042648 ext. +39, elio.ippolito@unimi.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time in glycemic range 70-180 mg/dl (time frame: From Baseline to 26 weeks). 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 NCT05477030, which also lists 25 linked publications.

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 28 Jul 2022.

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