AzTrials
AzTrials

Type 1 DiabetesABC-WITNCT05610111

Adaptive Biobehavioral Control (ABC) in a Closed-Loop System

A study testing CLC + BAM and CLC + ABC in people with Type 1 Diabetes, run by Sue Brown 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
Search all trials

Trial summary

This study is intended to test a Web-based Information Tool (WIT) software providing additional information regarding time in range, GMI, hypo- and hyperglycemia risks, variability tracker, daily glycemic profiles, and potential changes of insulin pump parameters, to users of a commercially available Closed-Loop… 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?
CLC + BAM and CLC + ABC
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
73 participants
Where
1 siteUnited States
Study dates
18 Jan 2023to 28 Sep 2024
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 an insulin pump for at least six months
  • Currently using insulin for at least six months
  • Currently using the t:slim X2 insulin pump for at least two months
  • Currently using or anticipated to be using the t:slim X2 insulin pump with Control-IQ technology at randomization (Visit 3).
Show all 15Show fewer
  • Using or willing to use 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
  • Willing to use an app on a smart phone during the study.
  • For females, not currently known to be pregnant or breastfeeding
  • If female, sexually active, and of childbearing potential, 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 use only insulin analogs approved for use in the t:slim X2 pump such as lispro (Humalog) or as part (Novolog) and not use ultra-rapid acting insulin analogs (e.g., FiAsp) during the study
  • Total daily insulin dose (TDD) at least 10 units per day
  • Willingness not to start any new non-insulin glucose-lowering agent during the course of the trial (including metformin (biguanides), GLP-1 receptor agonists, pramlintide, DPP-4 inhibitors, SGLT-2 inhibitors, sulfonylureas)
  • An understanding and willingness to follow the protocol and signed informed consent

Who cannot join

  • Concurrent use of any non-insulin glucose-lowering agent other than metformin or GLP-1 receptor agonists following screening (including pramlintide, DPP-4 inhibitors, SGLT-2 inhibitors, sulfonylureas)
  • A condition, which in the opinion of the investigator or designee, would put the participant at risk or interfere with the completion of the protocol.
  • 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
  • Currently being treated for a seizure disorder
  • Hemophilia or any other bleeding disorder
Show all 9Show fewer
  • Planned surgery during study duration
  • Participation in another pharmaceutical or device trial at the time of enrollment or during the study
  • Having a direct supervisor at place of employment who is also directly involved in conducting the clinical trial (e.g., study investigator, coordinator, etc.); or having a first-degree relative who is directly involved in conducting the clinical trial.

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

Official title: Adaptive Biobehavioral Control (ABC) in a Closed-Loop System: A Randomized Crossover Clinical Trial

This study is intended to test a Web-based Information Tool (WIT) software providing additional information regarding time in range, GMI, hypo- and hyperglycemia risks, variability tracker, daily glycemic profiles, and potential changes of insulin pump parameters, to users of a commercially available Closed-Loop Control (CLC) System (Control-IQ Technology).

Read the detailed description

This is a randomized two-arm crossover group trial in which both groups will use the CLC (Control-IQ) plus WIT. The difference between the two groups will be the order of the interventions. Each group will undergo screening and collection of baseline data from their personal AID system (Control-IQ) followed by randomization 1:1 into two groups. Both groups will have the same three interventions but will progress in the study in a different order allowing for crossover comparisons. The three interventions are:

  • Use of personal CLC system for 2 weeks
  • Use of personal CLC system and adding a behavioral adaptation module (BAM) for 4 weeks
  • Use of personal CLC system and adding the ABC which includes: BAM and PAM (which includes ATM and WST described below) for 16 weeks.

The BAM will consist of modules in which information only is given to participants (e.g. time in range, Glucose Management Indicator (GMI), hyper-and hypoglycemic risks, daily glycemic profiles, and variability tracker). The PAM includes auto suggestions for titration of insulin pump parameters every two weeks (ATM) and is aided by a web simulation tool (WST) which can replay 'what if' scenarios for the participant based on various combinations of insulin pump parameter changes.

Conditions
Type 1 Diabetes
Being tested
CLC + BAM, CLC + ABC
Keywords
Type 1 Diabetes, Closed-Loop Control (CLC), Continuous Glucose Monitoring (CGM), Artificial Pancreas (AP), Tandem t:slim Insulin Pump with Control-IQ Technology
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.

  • CLC + BAMDevice

    Closed Loop Control with the Behavioral Adaption Module for 4 weeks

  • CLC + ABCDevice

    Closed Loop Control with Adaptive Biobehavioral Control for 16 weeks

Study groups in NCT05610111
Study groupRoleWhat they receive
CLC, then CLC+BAM, then CLC+ABCActive comparatorParticipants will be using closed loop control (CLC) for 2 weeks. Participants will then use closed loop control (CLC) with behavioral adaption module (BAM) for 4 weeks, followed by closed loop control (CLC) adaptive biobehavioral control (ABC) for 16 weeks.
Receives: Device: CLC + BAM; Device: CLC + ABC
CLC+ABC, then CLC+BAM, then CLCActive comparatorParticipants will be using closed loop control (CLC) with adaptive biobehavioral control (ABC) for 16 weeks. Participants will then use closed loop control (CLC) with behavioral adaptation module (BAM) for 4 weeks, followed by closed loop control (CLC) for 2 weeks.
Receives: Device: CLC + BAM; Device: CLC + ABC

What is being measured

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

  1. CGM-measured Percent Time in Range 70-180 mg/dL

    The primary outcome for this study is CGM-measured percent time in range 70-180 mg/dL over the last 4-week periods on CLC+ABC versus 2 weeks of the current CLC system.

    Measured: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC

Secondary outcomes (17)
  1. CGM-measured Percent Above 180 mg/dL During the Day

    A key secondary outcome is CGM-measured percent above 180mg/dL during the day comparing last 4 weeks of CLC+ABC to 2 weeks of the CLC system alone.

    Measured: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC

  2. CGM-measured Percent Below 70 mg/dL During the Day

    A key secondary outcome is CGM-measured percent below 70mg/dL during the day comparing last 4 weeks of CLC+ABC to 2 weeks of the CLC system alone.

    Measured: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC

  3. CGM-measured Mean Glucose

    A key secondary outcome is CGM-measured mean glucose comparing the last 4 weeks of CLC+ABC to 2 weeks of the CLC system alone.

    Measured: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC

  4. CGM-measured Coefficient of Variation During the Day

    A key secondary outcome is CGM-measured percent coefficient of variation during the day comparing last 4 weeks of CLC+ABC to 2 weeks of the CLC system alone.

    Measured: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC

  5. Time in Range (70-140 mg/dL)

    A key secondary outcome is CGM-measured time in range from 70-140 mg/dL comparing the last 4 weeks of CLC+ABC to 2 weeks of the CLC system alone.

    Measured: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC

  6. TIR <60 mg/dL

    Time below 60 mg/dL as measured by CGM.

    Measured: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC

  7. Low Blood Glucose Index (LBGI)

    The low blood glucose index (LBGI) is based on a nonlinear transformation of blood glucose values that corrects for the asymmetry of the glucose scale. This transformation maps glucose values into a risk space (minimum risk = 0), where higher values correspond to higher risk. Values <1 suggest low risk of hypoglycemia.

    Measured: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC

  8. High Blood Glucose Index (HBGI)

    The high blood glucose index (HBGI) is based on a nonlinear transformation of blood glucose values that corrects for the asymmetry of the glucose scale. This transformation maps glucose values into a risk space (minimum risk = 0), where higher values correspond to higher risk. Values below 10 suggest low to moderate risk.

    Measured: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC

  9. TIR >250 mg/dL

    Time above 250 mg/dL as measured by CGM.

    Measured: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC

  10. TIR >300 mg/dL

    Time above 300 mg/dL as measured by CGM.

    Measured: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC

  11. HbA1c (%) at End of Study

    The percentage of glycated hemoglobin. A higher percentage indicates a worse outcome.

    Measured: Labs taken at the completion of study, approximately 6 months after enrollment; hence, results are stratified only by arm and not by intervention.

  12. Technology Expectations Survey

    This questionnaire is rated on a 5-point Likert scale and is the baseline version of the Technology Acceptance Survey. Technology Expectations and Technology Experience Survey have identical items, except future tense is used in the Technology Expectations Survey (administered at randomization), while past tense is used in the Technology Experience Survey (administered at the end of each intervention). These surveys yield two subscale scores (burdens and benefits); the score of the items in the burden subscale are inverted before averaging the score of all the items to obtain the total technology acceptance reported here (range: 1-5, with 5 indicating higher acceptance).

    Measured: Participant baseline

  13. Clarke's Hypoglycemia Awareness Scale

    Number of individuals with hypoglycemia awareness, reduced hypoglycemia awareness, and in between, based on Clarke's Hypoglycemia Awareness Scale.

    Measured: 22 weeks

  14. Technology Experience Survey

    This questionnaire is rated on a 5-point Likert scale and is the endpoint version of the Technology Acceptance Survey. Technology Expectations and Technology Experience Survey have identical items, except future tense is used in the Technology Expectations Survey (administered at randomization), while past tense is used in the Technology Experience Survey (administered at the end of each intervention). These surveys yield two subscale scores (burdens and benefits); the score of the items in the burden subscale are inverted before averaging the score of all the items to obtain the total technology acceptance reported here (range: 1-5, with 5 indicating higher acceptance). The score is not reported for CLC only, as no technology was used during this intervention.

    Measured: At participant completion, approximately 6 months

  15. High Blood Glucose Levels Survey

    This questionnaire evaluates generalized avoidance of hyperglycemia across 4 subcategories using items rated on a 5-point Likert scale. Range is 1-5, with 5 indicating higher hyperglycemia avoidance and worry. The total score reported is obtained by averaging the scores of all the items in the survey.

    Measured: 22 weeks

  16. Hypoglycemia Fear Survey

    This questionnaire evaluates Fear of Hypoglycemia and each item is rated on a 5-point Likert scale. Range is 1-5, with 5 indicating higher hypoglycemia fear and worry. The total score reported is obtained by averaging the scores of all the items in the survey.

    Measured: 22 weeks

  17. Diabetes Distress Scale

    A questionnaire evaluating different domains of diabetes-related distress. Each item is scored on a 6 point Likert scale. Range is 1-6- with scores of 2-2.9 indicating moderate distress and scores > 3.0 indicating severe distress. The total score reported is obtained by averaging the scores of all the items in the survey.

    Measured: 22 weeks

Timeline

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

  1. First posted9 Nov 2022
  2. Study start18 Jan 2023
  3. Primary completion26 Sep 2024
  4. Study completion28 Sep 2024

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
73 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05610111
Sponsor's protocol ID
220300
Other IDs
2R01DK085623
Acronym
ABC-WIT
Status last verified
Apr 2026
First submitted
2 Nov 2022
Last updated
7 Jul 2026
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. Limited deidentified data will be shared while sharing of complete data sets will be regulated by Data-Sharing Agreements.

Publications

  • Kovatchev BP, Colmegna P, Pavan J, Diaz Castaneda JL, Villa-Tamayo MF, Koravi CLK, Santini G, Alix C, Stumpf M, Brown SA. Human-machine co-adaptation to automated insulin delivery: a randomised clinical trial using digital twin technology. NPJ Digit Med. 2025 May 6;8(1):253. doi: 10.1038/s41746-025-01679-y.

    PubMed 40329052

Questions about this trial

What is this clinical trial studying?

A study testing CLC + BAM and CLC + ABC in people with Type 1 Diabetes, run by Sue Brown 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 15 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 7 Jul 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 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 7 Jul 2026). 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?

CGM-measured Percent Time in Range 70-180 mg/dL (time frame: 2 weeks of CLC, 4 weeks of CLC+BAM, last 4 weeks of CLC+ABC). 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 NCT05610111, 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 7 Jul 2026.

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free AzTrials account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in
ABC-WIT Clinical Trial NCT05610111 | AzTrials