Type 1 DiabetesMODE2022NCT05619198
The Effects of Different Exercise Modalities in Adolescents With Type 1 Diabetes Using AID Systems
A study testing High Intensity Interval Exercise and Moderate Intensity Continous Exercise in people with Type 1 Diabetes, run by Steno Diabetes Center Copenhagen at 1 site in Denmark.
Trial summary
Objective: The overall objective of this study is to assess the efficacy of the current recommended guidelines for physical activity (PA) in response to acute moderate intensity continous exercise (MICE) and high intensity interval exercise (HIIE) among adolescents with type 1 diabetes (T1D) using automated insulin… Read more about this study
- Who is it for?
- Ages 13 to 17 years
- Conditions the study is for
- Type 1 Diabetes
- What is being tested?
- High Intensity Interval Exercise and Moderate Intensity Continous Exercise
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 24 participants
- Where
- 1 siteDenmark
- Study dates
- 19 Dec 2022to Nov 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 13 to 17 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Age 13-17 years old
- Type 1 diabetes > 1 year
- Use of Tandem t:slim X2 Control-IQ or Medtronic MiniMed 780G with connected continous glucose monitor > 3 months
- HbA1c below 75 mmol/L
Who cannot join
- Use of anti-diabetic medicine other than insulin
- Breastfeeding, pregnancy or planning to become pregnant
- Lack of compliance with key study procedures at the discretion of the investigator
Trial locations and contacts
1 site in 1 country.
Kirsten Nørgaard contact
Denmark1 site, 1 recruiting
- Recruiting
Steno Diabetes Center Copenhagen
Herlev, 2730
Emilie B Lindkvist, +4520187762, emilie.lindkvist@regionh.dk
Jannet Svensson, jannet.svensson.01@regionh.dk
About this study
Objective:
The overall objective of this study is to assess the efficacy of the current recommended guidelines for physical activity (PA) in response to acute moderate intensity continous exercise (MICE) and high intensity interval exercise (HIIE) among adolescents with type 1 diabetes (T1D) using automated insulin delivery (AID) systems (MiniMed 780G and Tandem Control-IQ).
Read more
Methods:
This study will be a two-period, cross-over, clinical trial with between and within cohort comparisons of two different exercise modalities among a total of 24 age-, sex-, and insulin-dose-matched adolescents with T1D (12 using MiniMed 780G and 12 using Tandem Control-IQ).
Endpoint:
The primary endpoint is sensor-derived time in range (3.9 mmol/L-10.0 mmol/L) around exercise
Read the detailed description
Participants included in the study will perform a cardiopulmonary exercise testing (CPET) before the exercise study visits, to prescribe subsequent exercise intensity thresholds. Participants will have a canula placed in a antecubital vein for plasma sampling during the test.
Participants will undertake two exercise visits each including a bout of exercise on a stationary bicycle of either one of two exercise modalities; i.) high-intensity interval exercise with sprints at ~85% of VO2max (HIIE); ii.) moderate intensity continuous exercise at ~60% of VO2max (MICE).
Participants will arrive at the research facility, Steno Diabetes Center Copenhagen, in the afternoon. As per the current recommended guidelines, the MICE-session will be announced to the AID systems 60 minutes in advance, whereas the HIIE-session will not be announced. Participants will have a canula placed in a antecubital vein for plasma sampling.
Participants will rest for 60 minutes, exercise for 45 minutes and rest again for 75 minutes before leaving the research facility. During exercise participants will be fitted with a spirometry face mask to compute ventilatory thresholds and indirect calorimetry (Vyaire Vyntus® CPX, Intramedic A/S) and a telemetry chest strap (Polar H10) for integrated HR heart rate (HR) measurements with the spirometry device.
In the MICE session: After 15 minutes post-exercise rest the temporary target/exercise mode is turned off.
Around each study visit (24 hours prior until 24 hours after), sensor glucose as well as sleep and physical activity will be recorded. Sensor glucose will be measured by participants' own devices. Sleep and physical activity level will be assessed with a wrist-worn accelerometer, ActiGraph wGT3X-BT (ActiGraph, Pensacola, FL).
Study days will be separated by at least three days.
- Conditions
- Type 1 Diabetes
- Being tested
- High Intensity Interval Exercise, Moderate Intensity Continous Exercise
- 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.
High Intensity Interval ExerciseBehavioural
High Intensity Interval Exercise:
- 5 minutes resting phase @ 0 watts.
- 5-minute warm up phase @ 20 watts.
- 40 minutes of interval work consisting of eight bouts of 1-minute cycling at a power output corresponding to ~85% of VO2max interspersed with 4-minute recovery periods at 20 watts.
- 5 minutes resting phase @ 0 watts.
Moderate Intensity Continous ExerciseBehavioural
Moderate Intensity Continous Exercise:
- 5 minutes resting phase @ 0 watts.
- 5-minute warm up phase @ 20 watts.
- 40 minutes of MICE 65% VO2max.
- 5 minutes resting phase @ 0 watts.
| Study group | Role | What they receive |
|---|---|---|
| High Intensity Interval Exercise | Active comparator | Plasma and sensor glucose is monitored before, during and after a bout of high intensity interval exercise Receives: Behavioral: High Intensity Interval Exercise |
| Moderate Intensity Continous Exercise | Active comparator | Plasma and sensor glucose is monitored before, during and after a bout of moderate intensity continous exercise Receives: Behavioral: Moderate Intensity Continous Exercise |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of time spent in sensor-derived time in range (3.9-10.0 mmol/L) during and after a bout of exercise
Percentage
Measured: T = 0 to T = +120 (120 minutes)
Secondary outcomes (32)
Number of hypo- (<3.9 mmol/L) and hyperglycemic (>10.0 mmol/L) occurrences during exercise session as measured by sensor and plasma sampling
Number
Measured: T = 0 to T = +45 (45 minutes)
Percentage of time spent below (<3.9 mmol/L), in (3.9-10.0 mmol/L) and above (>10.0 mmol/L) range during in-clinic phase, measured by sensor and plasma sampling
Percentage
Measured: T= -60 minutes to T= +120 minutes (3 hours)
Percentage of time spent below (<3.9 mmol/L), in (3.9-10.0 mmol/L) and above (>10.0 mmol/L) range during home-phase, measured by glucose sensor
Percentage
Measured: 24 hours
Glycemic variability as coefficient of variation, measured by sensor during in-clinic phase
Percentage
Measured: T= -60 minutes to T= +120 minutes (3 hours)
Glycemic variability as coefficient of variation, measured by plasma sampling during in-clinic phase
Percentage
Measured: T= -60 minutes to T= +120 minutes (3 hours)
Glycemic variability as standard deviation, measured by sensor during in-clinic phase
mmol/L
Measured: T= -60 minutes to T= +120 minutes (3 hours)
Glycemic variability as standard deviation, measured by plasma sampling during in-clinic phase
mmol/L
Measured: T= -60 minutes to T= +120 minutes (3 hours)
Glycemic variability as coefficient of variation measured by glucose sensor during home-phase
Percentage
Measured: 24 hours
Glycemic variability as standard deviation measured by glucose sensor during home-phase
Mmol/L
Measured: 24 hours
Number of rescue glucose interventions to treat hypoglycemia (<3.9 mmol/L) during in-clinic and home-phase
Number
Measured: 27 hours
Area Under the Curve and absolute concentration of serum total insulin during in-clinic phase
Units
Measured: T= -60 minutes to T= +120 minutes (3 hours)
Dynamics of plasma glucoregulatory hormone responses during in-clinic phase
Change in concentration
Measured: T= -60 minutes to T= +120 minutes (3 hours)
Dynamics of plasma metabolites during in-clinic phase
Change in concentration
Measured: T= -60 minutes to T= +120 minutes (3 hours)
Glucose changes during exercise (delta change expressed as absolute [mmol/L]) during in-clinic phase
mmol/L
Measured: T= -60 minutes to T= +120 minutes (3 hours)
Glucose changes during exercise (delta change relativized as a rate of change [mmol/min]) during in-clinic phase
mmol/min
Measured: T= -60 minutes to T= +120 minutes (3 hours)
Amount of correction boluses given by each automated insulin delivery system during activation of temporary target and exercise mode
Number
Measured: T= -60 minutes to T= +60 minutes (2 hours)
Comparison of heart rate (HR) during high intensity interval exercise and moderate intensity continous exercise session
Beats pr minute
Measured: T = 0 to T = +45 (45 minutes)
Comparison of respiratory exchange ratio (RER) during high intensity interval exercise and moderate intensity continous exercise session
Ratio
Measured: T = 0 to T = +45 (45 minutes)
Comparison of oxygen consumption (VO2) during high intensity interval exercise and moderate intensity continous exercise session
L/min
Measured: T = 0 to T = +45 (45 minutes)
Comparison of carbon dioxide output (VCO2) during high intensity interval exercise and moderate intensity continous exercise session
L/min
Measured: T = 0 to T = +45 (45 minutes)
Comparison of carbohydrate oxidation during high intensity interval exercise and moderate intensity continous exercise session
g/min
Measured: T = 0 to T = +45 (45 minutes)
Comparison of lipid oxidation during high intensity interval exercise and moderate intensity continous exercise session
g/min
Measured: T = 0 to T = +45 (45 minutes)
Comparison of resting metabolic rate after exercise session
kj/min
Measured: T =+45 to T=+120 (75 minutes)
Plasma lactate response before, during and after cardiopulmonary exercise testing
mmol/L
Measured: 30 minutes
Plasma glucose response before, during and after cardiopulmonary exercise testing
mmol/L
Measured: 30 minutes
Respiratory exchange ratio (RER) collected continuously during cardiopulmonary exercise testing visit
L/min
Measured: 30 minutes
Oxygen consumption (VO2) collected continuously during cardiopulmonary exercise testing visit
L/min
Measured: 30 minutes
Carbon dioxide output (VCO2) collected continuously during cardiopulmonary exercise testing visit
L/min
Measured: 30 minutes
Sleep efficiency assessed by Actigraph GT3x the night before study visits compared to after study visits.
Percentage
Measured: Night 1-2
Wake time after sleep onset assessed by Actigraph GT3x the night before study visits compared to after study visits
Mins
Measured: Night 1- 2
Energy expenditure assessed by Actigraph GT3x.
Kcal
Measured: Day 1-3
Physical activity level assessed by Actigraph GT3x
sedentary, light or moderate-to-vigorous
Measured: Day1-3
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Nov 2022
- Study start19 Dec 2022
- Primary completionNov 2024 (estimated)
- Study completionNov 2024 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Type 1 DiabetesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Prevention
- Allocation
- Non-randomised
- Intervention model
- Crossover
- Model description
- A two-period, cross-over, clinical trial with between and within cohort comparisons of two different exercise modalities in adolescents with type 1 diabetes
- Masking
- None (open label)
- Enrolment
- 24 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Steno Diabetes Center Copenhagen
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Emilie Lindkvist, MD, Principal investigator, Steno Diabetes Center Copenhagen, Clinical Research
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05619198
- Sponsor's protocol ID
- MODE2022
- Acronym
- MODE2022
- Status last verified
- Nov 2022
- First submitted
- 5 Oct 2022
- Last updated
- 14 Apr 2023
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 14 Apr 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effects of Different Exercise Modalities in Adolescents With Type 1 Diabetes Using AID Systems
- ClinicalTrials.gov ID
- NCT05619198
- Acronym / sponsor ID
- MODE2022 / MODE2022
- Conditions
- Type 1 Diabetes
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 24 participants (estimated)
- Lead sponsor
- Steno Diabetes Center CopenhagenUniversity, hospital or other
- Study start
- 19 Dec 2022 (actual)
- Primary completion
- Nov 2024 (estimated)
- Study completion
- Nov 2024 (estimated)
- First posted
- 16 Nov 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Objective:
The overall objective of this study is to assess the efficacy of the current recommended guidelines for physical activity (PA) in response to acute moderate intensity continous exercise (MICE) and high intensity interval exercise (HIIE) among adolescents with type 1 diabetes (T1D) using automated insulin delivery (AID) systems (MiniMed 780G and Tandem Control-IQ).
Methods:
This study will be a two-period, cross-over, clinical trial with between and within cohort comparisons of two different exercise modalities among a total of 24 age-, sex-, and insulin-dose-matched adolescents with T1D (12 using MiniMed 780G and 12 using Tandem Control-IQ).
Endpoint:
The primary endpoint is sensor-derived time in range (3.9 mmol/L-10.0 mmol/L) around exercise
Detailed description
Participants included in the study will perform a cardiopulmonary exercise testing (CPET) before the exercise study visits, to prescribe subsequent exercise intensity thresholds. Participants will have a canula placed in a antecubital vein for plasma sampling during the test.
Participants will undertake two exercise visits each including a bout of exercise on a stationary bicycle of either one of two exercise modalities; i.) high-intensity interval exercise with sprints at ~85% of VO2max (HIIE); ii.) moderate intensity continuous exercise at ~60% of VO2max (MICE).
Participants will arrive at the research facility, Steno Diabetes Center Copenhagen, in the afternoon. As per the current recommended guidelines, the MICE-session will be announced to the AID systems 60 minutes in advance, whereas the HIIE-session will not be announced. Participants will have a canula placed in a antecubital vein for plasma sampling.
Participants will rest for 60 minutes, exercise for 45 minutes and rest again for 75 minutes before leaving the research facility. During exercise participants will be fitted with a spirometry face mask to compute ventilatory thresholds and indirect calorimetry (Vyaire Vyntus® CPX, Intramedic A/S) and a telemetry chest strap (Polar H10) for integrated HR heart rate (HR) measurements with the spirometry device.
In the MICE session: After 15 minutes post-exercise rest the temporary target/exercise mode is turned off.
Around each study visit (24 hours prior until 24 hours after), sensor glucose as well as sleep and physical activity will be recorded. Sensor glucose will be measured by participants' own devices. Sleep and physical activity level will be assessed with a wrist-worn accelerometer, ActiGraph wGT3X-BT (ActiGraph, Pensacola, FL).
Study days will be separated by at least three days.
Study design
- Primary purpose
- Prevention
- Allocation
- Non-randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- A two-period, cross-over, clinical trial with between and within cohort comparisons of two different exercise modalities in adolescents with type 1 diabetes
| Arm | Type | Receives |
|---|---|---|
| High Intensity Interval Exercise | Active comparator | Behavioral: High Intensity Interval ExercisePlasma and sensor glucose is monitored before, during and after a bout of high intensity interval exercise |
| Moderate Intensity Continous Exercise | Active comparator | Behavioral: Moderate Intensity Continous ExercisePlasma and sensor glucose is monitored before, during and after a bout of moderate intensity continous exercise |
Who may qualify
- Ages
- 13 to 17 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (4 listed)
- Age 13-17 years old
- Type 1 diabetes > 1 year
- Use of Tandem t:slim X2 Control-IQ or Medtronic MiniMed 780G with connected continous glucose monitor > 3 months
- HbA1c below 75 mmol/L
Key exclusion criteria (3 listed)
- Use of anti-diabetic medicine other than insulin
- Breastfeeding, pregnancy or planning to become pregnant
- Lack of compliance with key study procedures at the discretion of the investigator
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| High Intensity Interval ExerciseHigh Intensity Interval Exercise: * 5 minutes resting phase @ 0 watts. * 5-minute warm up phase @ 20 watts. * 40 minutes of interval work consisting of eight bouts of 1-minute cycling at a power output corresponding to ~85% of VO2max interspersed with 4-minute recovery periods at 20 watts. * 5 minutes resting phase @ 0 watts. | Behavioural | High Intensity Interval Exercise |
| Moderate Intensity Continous ExerciseModerate Intensity Continous Exercise: * 5 minutes resting phase @ 0 watts. * 5-minute warm up phase @ 20 watts. * 40 minutes of MICE 65% VO2max. * 5 minutes resting phase @ 0 watts. | Behavioural | Moderate Intensity Continous Exercise |
Primary outcome
Percentage of time spent in sensor-derived time in range (3.9-10.0 mmol/L) during and after a bout of exercise
Time frame: T = 0 to T = +120 (120 minutes)
Percentage
32 secondary outcomes
Number of hypo- (<3.9 mmol/L) and hyperglycemic (>10.0 mmol/L) occurrences during exercise session as measured by sensor and plasma sampling
Time frame: T = 0 to T = +45 (45 minutes)
Percentage of time spent below (<3.9 mmol/L), in (3.9-10.0 mmol/L) and above (>10.0 mmol/L) range during in-clinic phase, measured by sensor and plasma sampling
Time frame: T= -60 minutes to T= +120 minutes (3 hours)
Percentage of time spent below (<3.9 mmol/L), in (3.9-10.0 mmol/L) and above (>10.0 mmol/L) range during home-phase, measured by glucose sensor
Time frame: 24 hours
Glycemic variability as coefficient of variation, measured by sensor during in-clinic phase
Time frame: T= -60 minutes to T= +120 minutes (3 hours)
Glycemic variability as coefficient of variation, measured by plasma sampling during in-clinic phase
Time frame: T= -60 minutes to T= +120 minutes (3 hours)
Glycemic variability as standard deviation, measured by sensor during in-clinic phase
Time frame: T= -60 minutes to T= +120 minutes (3 hours)
Glycemic variability as standard deviation, measured by plasma sampling during in-clinic phase
Time frame: T= -60 minutes to T= +120 minutes (3 hours)
Glycemic variability as coefficient of variation measured by glucose sensor during home-phase
Time frame: 24 hours
Glycemic variability as standard deviation measured by glucose sensor during home-phase
Time frame: 24 hours
Number of rescue glucose interventions to treat hypoglycemia (<3.9 mmol/L) during in-clinic and home-phase
Time frame: 27 hours
Area Under the Curve and absolute concentration of serum total insulin during in-clinic phase
Time frame: T= -60 minutes to T= +120 minutes (3 hours)
Dynamics of plasma glucoregulatory hormone responses during in-clinic phase
Time frame: T= -60 minutes to T= +120 minutes (3 hours)
Dynamics of plasma metabolites during in-clinic phase
Time frame: T= -60 minutes to T= +120 minutes (3 hours)
Glucose changes during exercise (delta change expressed as absolute [mmol/L]) during in-clinic phase
Time frame: T= -60 minutes to T= +120 minutes (3 hours)
Glucose changes during exercise (delta change relativized as a rate of change [mmol/min]) during in-clinic phase
Time frame: T= -60 minutes to T= +120 minutes (3 hours)
Amount of correction boluses given by each automated insulin delivery system during activation of temporary target and exercise mode
Time frame: T= -60 minutes to T= +60 minutes (2 hours)
Comparison of heart rate (HR) during high intensity interval exercise and moderate intensity continous exercise session
Time frame: T = 0 to T = +45 (45 minutes)
Comparison of respiratory exchange ratio (RER) during high intensity interval exercise and moderate intensity continous exercise session
Time frame: T = 0 to T = +45 (45 minutes)
Comparison of oxygen consumption (VO2) during high intensity interval exercise and moderate intensity continous exercise session
Time frame: T = 0 to T = +45 (45 minutes)
Comparison of carbon dioxide output (VCO2) during high intensity interval exercise and moderate intensity continous exercise session
Time frame: T = 0 to T = +45 (45 minutes)
Comparison of carbohydrate oxidation during high intensity interval exercise and moderate intensity continous exercise session
Time frame: T = 0 to T = +45 (45 minutes)
Comparison of lipid oxidation during high intensity interval exercise and moderate intensity continous exercise session
Time frame: T = 0 to T = +45 (45 minutes)
Comparison of resting metabolic rate after exercise session
Time frame: T =+45 to T=+120 (75 minutes)
Plasma lactate response before, during and after cardiopulmonary exercise testing
Time frame: 30 minutes
Plasma glucose response before, during and after cardiopulmonary exercise testing
Time frame: 30 minutes
Respiratory exchange ratio (RER) collected continuously during cardiopulmonary exercise testing visit
Time frame: 30 minutes
Oxygen consumption (VO2) collected continuously during cardiopulmonary exercise testing visit
Time frame: 30 minutes
Carbon dioxide output (VCO2) collected continuously during cardiopulmonary exercise testing visit
Time frame: 30 minutes
Sleep efficiency assessed by Actigraph GT3x the night before study visits compared to after study visits.
Time frame: Night 1-2
Wake time after sleep onset assessed by Actigraph GT3x the night before study visits compared to after study visits
Time frame: Night 1- 2
Energy expenditure assessed by Actigraph GT3x.
Time frame: Day 1-3
Physical activity level assessed by Actigraph GT3x
Time frame: Day1-3
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Apr 2023.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Kirsten Nørgaard contact
Emilie Lindkvist, MD principal investigator
Steno Diabetes Center Copenhagen, Clinical Research
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing High Intensity Interval Exercise and Moderate Intensity Continous Exercise in people with Type 1 Diabetes, run by Steno Diabetes Center Copenhagen at 1 site in Denmark.
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 3 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 14 Apr 2023. 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 Denmark. 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 Emilie Lindkvist, MD (+45 20187762, emilie.lindkvist@regionh.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percentage of time spent in sensor-derived time in range (3.9-10.0 mmol/L) during and after a bout of exercise (time frame: T = 0 to T = +120 (120 minutes)). 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 14 Apr 2023.