Sudden Sensorineural Hearing Loss (SSNHL)SHIPNCT07652528
CGM-guided Patch Pump vs Basal-Bolus Injection for Steroid-Induced Hyperglycemia in Sudden Sensorineural Hearing Loss: SHIP Trial
A study testing CareLevo Patch-type Insulin Pump, Insulin Glargine U-100 (Lantus) and Fast-acting Insulin Aspart (Fiasp) in people with Sudden Sensorineural Hearing Loss (SSNHL) and Prediabetes / Type 2 Diabetes, run by Hallym University.
Trial summary
This exploratory randomized controlled trial evaluates whether a CGM-guided temporary patch pump (CareLevo CSII) reduces glucocorticoid-induced hyperglycemia (GIH) compared to a Lantus-based basal-bolus injection (MDI) regimen in patients with sudden sensorineural hearing loss (SSNHL) and type 2 diabetes or… Read more about this study
- Who is it for?
- Ages 19 years and older
- Conditions the study is for
- Sudden Sensorineural Hearing Loss (SSNHL), Prediabetes / Type 2 Diabetes
- What is being tested?
- CareLevo Patch-type Insulin Pump, Insulin Glargine U-100 (Lantus) and Fast-acting Insulin Aspart (Fiasp)
- Type of treatment
- Injection or infusion, Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- No sites listed yet
- Study dates
- Aug 2026to Dec 2028
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 19 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age ≥19 years
- Idiopathic SSNHL: ≥30 dB sensorineural hearing loss across ≥3 consecutive frequencies within 72 hours
- Affected ear PTA4 (mean of 0.5/1/2/4 kHz) ≥40 dB HL (moderate or greater)
- Planned methylprednisolone 48 mg/day orally once in the morning
- At least one of: known T2DM; HbA1c 5.7-10.0% within 3 months; POC glucose ≥140 mg/dL ×2 (≥2h apart, ≥1 postprandial) within 24h of steroid
- If on prior insulin: outpatient TDD ≤30 U/day
Show all 9Show fewer
- Able to eat ≥2 meals/day, wear CGM and patch pump, use smartphone
- Willing to undergo 2-night inpatient admission (Day 1-3)
- Written informed consent
Who cannot join
- Type 1 DM, LADA, pancreatogenic DM, DKA/HHS within 12 months, ketonuria at enrollment
- Enrollment POC ≥350 mg/dL or immediate IV insulin requirement
- HbA1c ≥10.0%
- eGFR <30 mL/min/1.73m² or dialysis
- Pregnancy/breastfeeding; women of childbearing potential: positive urine hCG
- ICU, sepsis, NPO, TPN/enteral nutrition
Show all 13Show fewer
- Severe hepatic failure (Child-Pugh C)
- Dexamethasone, divided-dose, or pulse steroids planned
- Prior CSII or AID device user
- Skin adhesive allergy precluding CGM or patch pump use
- Insufficient cognitive function for device or dosing table use
- Planned MRI requiring repeated CGM/pump removal
- PTA >70 dB (profound hearing loss requiring combined intratympanic steroid)
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Steroid-induced Hyperglycemia Management With Insulin Patch Pump in Sudden Sensorineural Hearing Loss: a CGM-guided Exploratory Randomized Controlled Trial (SHIP Trial)
This exploratory randomized controlled trial evaluates whether a CGM-guided temporary patch pump (CareLevo CSII) reduces glucocorticoid-induced hyperglycemia (GIH) compared to a Lantus-based basal-bolus injection (MDI) regimen in patients with sudden sensorineural hearing loss (SSNHL) and type 2 diabetes or prediabetes receiving high-dose systemic corticosteroids (methylprednisolone 48 mg/day).
Patients with SSNHL are treated with high-dose oral corticosteroids as standard of care, which often causes significant postprandial hyperglycemia - particularly in patients with pre-existing diabetes or prediabetes. No randomized trial has investigated the optimal insulin delivery strategy for this specific clinical scenario.
Read more
All enrolled participants undergo a 2-night inpatient admission (Day 1-3) for safe insulin initiation and device education, followed by outpatient management (Day 4-14). All participants wear a CareSens Air continuous glucose monitor (CGM, 15-day sensor) throughout Day 1-14.
Participants meeting insulin activation criteria are randomized 1:1 to:
- Arm A (CSII): CareLevo patch pump using a steroid-wave basal profile and carbohydrate-band meal bolus via the app's bolus calculator (CGM-integrated, IOB-adjusted)
- Arm B (MDI): Insulin glargine U-100 (Lantus) qAM plus Fiasp prandial bolus via pen using a pre-printed dose table with identical carbohydrate-band algorithm
Both arms use identical glycemic targets, carbohydrate-band bolus algorithm (ICR/ISF identical), and correction rules. The primary difference is insulin delivery (patch pump vs. pen injection) and basal profile (steroid-wave CSII vs. flat glargine). The primary outcome is 24-hour CGM Time Above Range (TAR) >180 mg/dL averaged over the 9-day high-dose steroid period (Day 1-9).
Read the detailed description
BACKGROUND SSNHL is treated with high-dose systemic corticosteroids (methylprednisolone 48 mg/day, prednisolone-equivalent 60 mg/day). In patients with diabetes or prediabetes, GIH is characterized by afternoon-to-evening postprandial predominance. Despite guideline recommendations for insulin-based management, no randomized evidence exists to guide optimal insulin delivery for this short-term, high-dose steroid course. ADA Standards of Care 2026 acknowledges glargine- or NPH-based basal-bolus insulin as established approaches for GIH; however, neither addresses the potential advantage of steroid-wave basal profiling achievable with CSII.
STUDY DESIGN Single-center, open-label, exploratory RCT. Day 1-3: 2-night inpatient admission. Day 4-14: outpatient management with fixed discharge dosing plan provided at Day 3.
STEROID PROTOCOL (standard of care):
Day 1-9: Methylprednisolone 48 mg/day | Day 10-11: 32 mg/day | Day 12-13: 16 mg/day | Day 14: 8 mg/day | Day 15~: discontinuation
CGM:
All participants: CareSens Air CGM (i-SENS, South Korea), 15-day sensor, attached on Day 0 (study-funded). CGM data collected Day 1-14. Primary endpoint computed from Day 1-9 24-hour data. Steroid-wave window (10:00-22:00) TAR is a pre-specified key secondary endpoint.
INSULIN PROTOCOLS - COMMON ELEMENTS:
Initial study TDD: 0.35-0.40 U/kg/day (T2DM insulin-naïve, PE ≥60 mg/day); 0.20-0.25 U/kg/day (prediabetes). Upper limit: 0.50 U/kg/day or 60 U/day.
Basal budget: 35-45% of study TDD for both arms (delivery method differs). Carbohydrate-band meal bolus: Patients select from 6 meal-size categories (0/30/45/60/75/90g). ICR: breakfast ~45g/(0.15×TDD); lunch/dinner ~60g/(0.20×TDD). Identical algorithm for both arms.
Correction: ISF = 1500/TDD (daytime); 2×ISF (nighttime). Fixed correction table provided at discharge (calculated once; not recalculated during outpatient period). No routine post-meal correction. Rescue correction only: ≥3h after last bolus, sustained POC/CGM ≥300 mg/dL.
Arm A (CSII): CareLevo patch pump with fast-acting insulin aspart (Fiasp). Steroid-wave basal profile: 00:00-04:00 8%, 04:00-07:00 12%, 07:00-10:00 15%, 10:00-16:00 35%, 16:00-22:00 25%, 22:00-24:00 5% of basal budget. Bolus calculator integrated with CGM; patient selects carbohydrate band. IOB reflected in all bolus calculations. Patch replaced Day 8.
Arm B (MDI): Insulin glargine U-100 (Lantus) qAM = 45% of TDD, administered with morning steroid. Fiasp prandial bolus via insulin pen using pre-printed dose table (same carbohydrate-band algorithm as Arm A). Fixed correction table provided at discharge.
SAMPLE SIZE:
44 participants (22 per arm). Two-sided α=0.05, 80% power, assumed Δ=15%p (MDI TAR=55%, CSII TAR=40%), SD=16%, 20% dropout (Cohen's d=0.94). ANCOVA covariates: baseline POC glucose, HbA1c, diabetes category, BMI.
- Being tested
- CareLevo Patch-type Insulin Pump, Insulin Glargine U-100 (Lantus), Fast-acting Insulin Aspart (Fiasp), CareSens Air Continuous Glucose Monitor
- Keywords
- Sudden Sensorineural Hearing Loss, Glucocorticoid-Induced Hyperglycemia, Steroid-Induced Hyperglycemia, Continuous Glucose Monitoring, Insulin Pump Therapy, Patch Pump
- Medical subject headings
- Hearing Loss, Sudden, Prediabetic State, Diabetes Mellitus, Type 2
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CareLevo Patch-type Insulin PumpDevice
CareLevo (CareMedi Inc., South Korea): tubeless patch pump, 300U reservoir, max 7-day wear, basal 0.05-15 U/hr, bolus 0.05-25 U, CareSens Air CGM integration via smartphone app. Steroid-wave basal profile (highest during 10:00-16:00, 35% of basal budget). App bolus calculator accepts CGM glucose + patient-selected carbohydrate band (0/30/45/60/75/90g) and computes dose based on ICR, ISF, and IOB. Provided free by manufacturer (CareMedi); manufacturer has no role in study design, data analysis, or publication.
Insulin Glargine U-100 (Lantus)Drug
Lantus administered subcutaneously once daily in the morning with steroid intake. Dose = 45% of study TDD. De-escalated proportionally: Day 10-11 ×0.67, Day 12-13 ×0.33, Day 14 ×0.17 or discontinuation. Selected over NPH for practical utility and supply stability; evidence supports comparable efficacy to NPH for GIH in BBI framework (Ruiz de Adana et al. 2018). Toujeo/Tresiba excluded due to prolonged time to steady-state (≥5 days) incompatible with 14-day protocol.
Fast-acting Insulin Aspart (Fiasp)Drug
Fiasp used as prandial and correction insulin in both arms. Meal bolus via carbohydrate-band selection (0/30/45/60/75/90g). ICR: breakfast 45g/(0.15×TDD); lunch/dinner 60g/(0.20×TDD). ISF = 1500/TDD (daytime), 2×ISF (night). Arm A: app auto-calculation with IOB. Arm B: pre-printed dose table (same algorithm). No routine postprandial correction. Rescue correction: ≥3h post-bolus + POC/CGM ≥300 mg/dL sustained.
CareSens Air Continuous Glucose MonitorDevice
CareSens Air (i-SENS, South Korea), 15-day sensor attached Day 0. 5-minute interval glucose transmitted to smartphone and Sens365 platform for research team monitoring. Arm A: real-time CGM integrated into CareLevo bolus calculator. Primary endpoint (24h TAR) and key secondary endpoint (window TAR 10:00-22:00) computed from Sens365 raw export. 15-day sensor covers entire study period (Day 1-14) without sensor change. Provided free by manufacturer (i-SENS); manufacturer has no role in study design, analysis, or publication.
| Study group | Role | What they receive |
|---|---|---|
| CareLevo CSII (Arm A) | Experimental | Participants are fitted with the CareLevo patch pump loaded with Fiasp. A steroid-wave basal profile concentrates insulin delivery during afternoon-evening (10:00-22:00) to match methylprednisolone pharmacodynamics, while minimizing overnight basal. Meal bolus uses a carbohydrate-band calculator integrated with CareSens Air CGM. IOB is reflected in all bolus decisions. Patch replaced Day 8. Insulin tapered proportionally to steroid reduction from Day 10. Receives: Device: CareLevo Patch-type Insulin Pump; Drug: Fast-acting Insulin Aspart (Fiasp); Device: CareSens Air Continuous Glucose Monitor |
| Lantus-based MDI (Arm B) | Active comparator | Participants receive Lantus (insulin glargine U-100) once daily in the morning (45% of study TDD) with steroid. Fiasp prandial bolus via insulin pen using a pre-printed dose table based on the same carbohydrate-band algorithm as Arm A. Correction via the same fixed printed table. Insulin tapered from Day 10 proportionally to steroid taper. Receives: Drug: Insulin Glargine U-100 (Lantus); Drug: Fast-acting Insulin Aspart (Fiasp); Device: CareSens Air Continuous Glucose Monitor |
What is being measured
The primary outcome is the main question the study is designed to answer.
24-hour CGM Time Above Range (TAR) >180 mg/dL (%) - averaged over Day 1-9
Percentage of CGM readings exceeding 180 mg/dL over 24 hours, averaged across the 9-day high-dose corticosteroid period (Day 1-9). Calculated from 5-minute interval CareSens Air CGM raw data exported from Sens365 platform. 24-hour TAR is the standard CGM metric per international consensus guidelines and AGP reporting framework, enabling direct comparison with published literature on glucocorticoid-induced hyperglycemia. Minimum 70% CGM data completeness per day required for inclusion in primary analysis; days with <70% completeness handled by multiple imputation in primary analysis and complete-case analysis as sensitivity analysis.
Measured: Day 1 through Day 9 (24 hours per day)
Secondary outcomes (18)
CGM TAR >180 mg/dL (%) during steroid pharmacodynamic window (10:00-22:00) - pre-specified exploratory analysis of the steroid-specific time period corresponding to peak methylprednisolone effect
Measured: Day 1-9, 10:00-22:00 window
Time In Range (TIR) 70-180 mg/dL (%, 24-hour)
Measured: Day 1-9
Time Above Range >250 mg/dL (%, 24-hour)
Measured: Day 1-9
Postprandial incremental AUC >180 mg/dL (breakfast, lunch, dinner - 2-4h post-meal)
Measured: Day 1-9
Time Below Range (TBR) <70 mg/dL (%, 24-hour) - key safety outcome to verify TAR reduction is not accompanied by increased hypoglycemia
Measured: Day 1-9
Nocturnal Time Below Range <70 mg/dL (00:00-06:00)
Measured: Day 1-9
Severe hypoglycemia rate (requiring third-party assistance)
Measured: Day 1-14
Glycemic variability: Coefficient of Variation (CV%), SD, MAGE
Measured: Day 1-9
Number of daily needle punctures (bolus + correction injections/activations) - key treatment burden metric
Measured: Day 1-14
Total daily insulin dose and correction insulin proportion
Measured: Day 1-9
Rate of rescue therapy (protocol stop criteria reached)
Measured: Day 1-14
CGM TAR >180 mg/dL and TBR <70 mg/dL during steroid taper period (Day 10-14) - exploratory safety
Measured: Day 10-14
Hearing recovery: PTA change (4-frequency average 0.5/1/2/4 kHz)
Measured: Baseline and Day 60 (±14 days)
Hearing recovery: Siegel criteria classification (Complete/Partial/Minimal/No Recovery)
Measured: Day 60 (±14 days)
Salvage intratympanic steroid injection rate
Measured: Day 60 (±14 days)
Treatment satisfaction and device burden: ITSQ Inconvenience of Regimen subscale (Q1-Q5) and Insulin Delivery Device Satisfaction subscale (Q17-Q22); Anderson et al. Clin Ther 2004. Permission obtained.
Measured: Day 10-15 (outpatient visit)
CGM data completeness and device-related events (patch premature removal, occlusion - Arm A)
Measured: Day 1-14
Treatment-related cost (CGM, insulin, device consumables)
Measured: Day 1-15
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Jun 2026
- Study startAug 2026 (estimated)
- Primary completionJun 2028 (estimated)
- Study completionDec 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (7)Papers the sponsor has linked to this study.
- Other trials for Sudden Sensorineural Hearing Loss (SSNHL)Studies 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
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Hallym University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Hun Jee Choe, Hallym University Dongtan Sacred Heart Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07652528
- Sponsor's protocol ID
- HDSH-ENDO-2026-SHIP-001
- Acronym
- SHIP
- Status last verified
- Jul 2026
- First submitted
- 11 Jun 2026
- Last updated
- 22 Jul 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data sharing is not planned. De-identified aggregate results will be published in a peer-reviewed journal.
Publications
American Diabetes Association Professional Practice Committee for Diabetes*. 16. Diabetes Care in the Hospital: Standards of Care in Diabetes-2026. Diabetes Care. 2026 Jan 1;49(Supplement_1):S339-S355. doi: 10.2337/dc26-S016.
PubMed 41358892Chang LL, Umpierrez GE, Inzucchi SE. Management of Hyperglycemia in Hospitalized, Non-Critically Ill Adults. N Engl J Med. 2022 Sep 15;387(11):1040-1042. doi: 10.1056/NEJMclde2204691. No abstract available.
PubMed 36103419Anderson RT, Skovlund SE, Marrero D, Levine DW, Meadows K, Brod M, Balkrishnan R. Development and validation of the insulin treatment satisfaction questionnaire. Clin Ther. 2004 Apr;26(4):565-78. doi: 10.1016/s0149-2918(04)90059-8.
PubMed 15189754Cho JH, Suh S. Glucocorticoid-Induced Hyperglycemia: A Neglected Problem. Endocrinol Metab (Seoul). 2024 Apr;39(2):222-238. doi: 10.3803/EnM.2024.1951. Epub 2024 Mar 27.
PubMed 38532282Chandrasekhar SS, Tsai Do BS, Schwartz SR, Bontempo LJ, Faucett EA, Finestone SA, Hollingsworth DB, Kelley DM, Kmucha ST, Moonis G, Poling GL, Roberts JK, Stachler RJ, Zeitler DM, Corrigan MD, Nnacheta LC, Satterfield L. Clinical Practice Guideline: Sudden Hearing Loss (Update). Otolaryngol Head Neck Surg. 2019 Aug;161(1_suppl):S1-S45. doi: 10.1177/0194599819859885.
PubMed 31369359Kleinhans M, Albrecht LJ, Benson S, Fuhrer D, Dissemond J, Tan S. Continuous Glucose Monitoring of Steroid-Induced Hyperglycemia in Patients With Dermatologic Diseases. J Diabetes Sci Technol. 2024 Jul;18(4):904-910. doi: 10.1177/19322968221147937. Epub 2023 Jan 5.
PubMed 36602041Achanta M, Kasetti P, Fortune-Ely M, Ross T, Magos T, Manjaly JG. Adverse Effects of Steroid Therapy in Sudden Sensorineural Hearing Loss: A Scoping Review. Clin Otolaryngol. 2025 Sep;50(5):821-830. doi: 10.1111/coa.14339. Epub 2025 May 30.
PubMed 40444483
Study at a glance
From the registry record, last updated by the sponsor on 22 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Steroid-induced Hyperglycemia Management With Insulin Patch Pump in Sudden Sensorineural Hearing Loss: a CGM-guided Exploratory Randomized Controlled Trial (SHIP Trial)
- ClinicalTrials.gov ID
- NCT07652528
- Acronym / sponsor ID
- SHIP / HDSH-ENDO-2026-SHIP-001
- Keywords
- Sudden Sensorineural Hearing Loss, Glucocorticoid-Induced Hyperglycemia, Steroid-Induced Hyperglycemia, Continuous Glucose Monitoring, Insulin Pump Therapy, Patch Pump
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- Hallym UniversityUniversity, hospital or other
- Study start
- Aug 2026 (estimated)
- Primary completion
- Jun 2028 (estimated)
- Study completion
- Dec 2028 (estimated)
- First posted
- 17 Jun 2026 (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.
This exploratory randomized controlled trial evaluates whether a CGM-guided temporary patch pump (CareLevo CSII) reduces glucocorticoid-induced hyperglycemia (GIH) compared to a Lantus-based basal-bolus injection (MDI) regimen in patients with sudden sensorineural hearing loss (SSNHL) and type 2 diabetes or prediabetes receiving high-dose systemic corticosteroids (methylprednisolone 48 mg/day).
Patients with SSNHL are treated with high-dose oral corticosteroids as standard of care, which often causes significant postprandial hyperglycemia - particularly in patients with pre-existing diabetes or prediabetes. No randomized trial has investigated the optimal insulin delivery strategy for this specific clinical scenario.
All enrolled participants undergo a 2-night inpatient admission (Day 1-3) for safe insulin initiation and device education, followed by outpatient management (Day 4-14). All participants wear a CareSens Air continuous glucose monitor (CGM, 15-day sensor) throughout Day 1-14.
Participants meeting insulin activation criteria are randomized 1:1 to:
- Arm A (CSII): CareLevo patch pump using a steroid-wave basal profile and carbohydrate-band meal bolus via the app's bolus calculator (CGM-integrated, IOB-adjusted)
- Arm B (MDI): Insulin glargine U-100 (Lantus) qAM plus Fiasp prandial bolus via pen using a pre-printed dose table with identical carbohydrate-band algorithm
Both arms use identical glycemic targets, carbohydrate-band bolus algorithm (ICR/ISF identical), and correction rules. The primary difference is insulin delivery (patch pump vs. pen injection) and basal profile (steroid-wave CSII vs. flat glargine). The primary outcome is 24-hour CGM Time Above Range (TAR) >180 mg/dL averaged over the 9-day high-dose steroid period (Day 1-9).
Detailed description
BACKGROUND SSNHL is treated with high-dose systemic corticosteroids (methylprednisolone 48 mg/day, prednisolone-equivalent 60 mg/day). In patients with diabetes or prediabetes, GIH is characterized by afternoon-to-evening postprandial predominance. Despite guideline recommendations for insulin-based management, no randomized evidence exists to guide optimal insulin delivery for this short-term, high-dose steroid course. ADA Standards of Care 2026 acknowledges glargine- or NPH-based basal-bolus insulin as established approaches for GIH; however, neither addresses the potential advantage of steroid-wave basal profiling achievable with CSII.
STUDY DESIGN Single-center, open-label, exploratory RCT. Day 1-3: 2-night inpatient admission. Day 4-14: outpatient management with fixed discharge dosing plan provided at Day 3.
STEROID PROTOCOL (standard of care):
Day 1-9: Methylprednisolone 48 mg/day | Day 10-11: 32 mg/day | Day 12-13: 16 mg/day | Day 14: 8 mg/day | Day 15~: discontinuation
CGM:
All participants: CareSens Air CGM (i-SENS, South Korea), 15-day sensor, attached on Day 0 (study-funded). CGM data collected Day 1-14. Primary endpoint computed from Day 1-9 24-hour data. Steroid-wave window (10:00-22:00) TAR is a pre-specified key secondary endpoint.
INSULIN PROTOCOLS - COMMON ELEMENTS:
Initial study TDD: 0.35-0.40 U/kg/day (T2DM insulin-naïve, PE ≥60 mg/day); 0.20-0.25 U/kg/day (prediabetes). Upper limit: 0.50 U/kg/day or 60 U/day.
Basal budget: 35-45% of study TDD for both arms (delivery method differs). Carbohydrate-band meal bolus: Patients select from 6 meal-size categories (0/30/45/60/75/90g). ICR: breakfast ~45g/(0.15×TDD); lunch/dinner ~60g/(0.20×TDD). Identical algorithm for both arms.
Correction: ISF = 1500/TDD (daytime); 2×ISF (nighttime). Fixed correction table provided at discharge (calculated once; not recalculated during outpatient period). No routine post-meal correction. Rescue correction only: ≥3h after last bolus, sustained POC/CGM ≥300 mg/dL.
Arm A (CSII): CareLevo patch pump with fast-acting insulin aspart (Fiasp). Steroid-wave basal profile: 00:00-04:00 8%, 04:00-07:00 12%, 07:00-10:00 15%, 10:00-16:00 35%, 16:00-22:00 25%, 22:00-24:00 5% of basal budget. Bolus calculator integrated with CGM; patient selects carbohydrate band. IOB reflected in all bolus calculations. Patch replaced Day 8.
Arm B (MDI): Insulin glargine U-100 (Lantus) qAM = 45% of TDD, administered with morning steroid. Fiasp prandial bolus via insulin pen using pre-printed dose table (same carbohydrate-band algorithm as Arm A). Fixed correction table provided at discharge.
SAMPLE SIZE:
44 participants (22 per arm). Two-sided α=0.05, 80% power, assumed Δ=15%p (MDI TAR=55%, CSII TAR=40%), SD=16%, 20% dropout (Cohen's d=0.94). ANCOVA covariates: baseline POC glucose, HbA1c, diabetes category, BMI.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| CareLevo CSII (Arm A) | Experimental | Device: CareLevo Patch-type Insulin Pump, Drug: Fast-acting Insulin Aspart (Fiasp), Device: CareSens Air Continuous Glucose MonitorParticipants are fitted with the CareLevo patch pump loaded with Fiasp. A steroid-wave basal profile concentrates insulin delivery during afternoon-evening (10:00-22:00) to match methylprednisolone pharmacodynamics, while minimizing overnight basal. Meal bolus uses a carbohydrate-band calculator integrated with CareSens Air CGM. IOB is reflected in all bolus decisions. Patch replaced Day 8. Insulin tapered proportionally to steroid reduction from Day 10. |
| Lantus-based MDI (Arm B) | Active comparator | Drug: Insulin Glargine U-100 (Lantus), Drug: Fast-acting Insulin Aspart (Fiasp), Device: CareSens Air Continuous Glucose MonitorParticipants receive Lantus (insulin glargine U-100) once daily in the morning (45% of study TDD) with steroid. Fiasp prandial bolus via insulin pen using a pre-printed dose table based on the same carbohydrate-band algorithm as Arm A. Correction via the same fixed printed table. Insulin tapered from Day 10 proportionally to steroid taper. |
Who may qualify
- Ages
- 19 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (9 listed)
- Age ≥19 years
- Idiopathic SSNHL: ≥30 dB sensorineural hearing loss across ≥3 consecutive frequencies within 72 hours
- Affected ear PTA4 (mean of 0.5/1/2/4 kHz) ≥40 dB HL (moderate or greater)
- Planned methylprednisolone 48 mg/day orally once in the morning
- At least one of: known T2DM; HbA1c 5.7-10.0% within 3 months; POC glucose ≥140 mg/dL ×2 (≥2h apart, ≥1 postprandial) within 24h of steroid
Key exclusion criteria (13 listed)
- Type 1 DM, LADA, pancreatogenic DM, DKA/HHS within 12 months, ketonuria at enrollment
- Enrollment POC ≥350 mg/dL or immediate IV insulin requirement
- HbA1c ≥10.0%
- eGFR <30 mL/min/1.73m² or dialysis
- Pregnancy/breastfeeding; women of childbearing potential: positive urine hCG
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 |
|---|---|---|
| CareLevo Patch-type Insulin PumpCareLevo (CareMedi Inc., South Korea): tubeless patch pump, 300U reservoir, max 7-day wear, basal 0.05-15 U/hr, bolus 0.05-25 U, CareSens Air CGM integration via smartphone app. Steroid-wave basal profile (highest during 10:00-16:00, 35% of basal budget). App bolus calculator accepts CGM glucose + patient-selected carbohydrate band (0/30/45/60/75/90g) and computes dose based on ICR, ISF, and IOB. Provided free by manufacturer (CareMedi); manufacturer has no role in study design, data analysis, or publication. | Device | CareLevo CSII (Arm A) |
| Insulin Glargine U-100 (Lantus)Lantus administered subcutaneously once daily in the morning with steroid intake. Dose = 45% of study TDD. De-escalated proportionally: Day 10-11 ×0.67, Day 12-13 ×0.33, Day 14 ×0.17 or discontinuation. Selected over NPH for practical utility and supply stability; evidence supports comparable efficacy to NPH for GIH in BBI framework (Ruiz de Adana et al. 2018). Toujeo/Tresiba excluded due to prolonged time to steady-state (≥5 days) incompatible with 14-day protocol. | Drug | Lantus-based MDI (Arm B) |
| Fast-acting Insulin Aspart (Fiasp)Fiasp used as prandial and correction insulin in both arms. Meal bolus via carbohydrate-band selection (0/30/45/60/75/90g). ICR: breakfast 45g/(0.15×TDD); lunch/dinner 60g/(0.20×TDD). ISF = 1500/TDD (daytime), 2×ISF (night). Arm A: app auto-calculation with IOB. Arm B: pre-printed dose table (same algorithm). No routine postprandial correction. Rescue correction: ≥3h post-bolus + POC/CGM ≥300 mg/dL sustained. | Drug | CareLevo CSII (Arm A), Lantus-based MDI (Arm B) |
| CareSens Air Continuous Glucose MonitorCareSens Air (i-SENS, South Korea), 15-day sensor attached Day 0. 5-minute interval glucose transmitted to smartphone and Sens365 platform for research team monitoring. Arm A: real-time CGM integrated into CareLevo bolus calculator. Primary endpoint (24h TAR) and key secondary endpoint (window TAR 10:00-22:00) computed from Sens365 raw export. 15-day sensor covers entire study period (Day 1-14) without sensor change. Provided free by manufacturer (i-SENS); manufacturer has no role in study design, analysis, or publication. | Device | CareLevo CSII (Arm A), Lantus-based MDI (Arm B) |
Primary outcome
24-hour CGM Time Above Range (TAR) >180 mg/dL (%) - averaged over Day 1-9
Time frame: Day 1 through Day 9 (24 hours per day)
Percentage of CGM readings exceeding 180 mg/dL over 24 hours, averaged across the 9-day high-dose corticosteroid period (Day 1-9). Calculated from 5-minute interval CareSens Air CGM raw data exported from Sens365 platform. 24-hour TAR is the standard CGM metric per international consensus guidelines and AGP reporting framework, enabling direct comparison with published literature on glucocorticoid-induced hyperglycemia. Minimum 70% CGM data completeness per day required for inclusion in primary analysis; days with <70% completeness handled by multiple imputation in primary analysis and complete-case analysis as sensitivity analysis.
18 secondary outcomes
CGM TAR >180 mg/dL (%) during steroid pharmacodynamic window (10:00-22:00) - pre-specified exploratory analysis of the steroid-specific time period corresponding to peak methylprednisolone effect
Time frame: Day 1-9, 10:00-22:00 window
Time In Range (TIR) 70-180 mg/dL (%, 24-hour)
Time frame: Day 1-9
Time Above Range >250 mg/dL (%, 24-hour)
Time frame: Day 1-9
Postprandial incremental AUC >180 mg/dL (breakfast, lunch, dinner - 2-4h post-meal)
Time frame: Day 1-9
Time Below Range (TBR) <70 mg/dL (%, 24-hour) - key safety outcome to verify TAR reduction is not accompanied by increased hypoglycemia
Time frame: Day 1-9
Nocturnal Time Below Range <70 mg/dL (00:00-06:00)
Time frame: Day 1-9
Severe hypoglycemia rate (requiring third-party assistance)
Time frame: Day 1-14
Glycemic variability: Coefficient of Variation (CV%), SD, MAGE
Time frame: Day 1-9
Number of daily needle punctures (bolus + correction injections/activations) - key treatment burden metric
Time frame: Day 1-14
Total daily insulin dose and correction insulin proportion
Time frame: Day 1-9
Rate of rescue therapy (protocol stop criteria reached)
Time frame: Day 1-14
CGM TAR >180 mg/dL and TBR <70 mg/dL during steroid taper period (Day 10-14) - exploratory safety
Time frame: Day 10-14
Hearing recovery: PTA change (4-frequency average 0.5/1/2/4 kHz)
Time frame: Baseline and Day 60 (±14 days)
Hearing recovery: Siegel criteria classification (Complete/Partial/Minimal/No Recovery)
Time frame: Day 60 (±14 days)
Salvage intratympanic steroid injection rate
Time frame: Day 60 (±14 days)
Treatment satisfaction and device burden: ITSQ Inconvenience of Regimen subscale (Q1-Q5) and Insulin Delivery Device Satisfaction subscale (Q17-Q22); Anderson et al. Clin Ther 2004. Permission obtained.
Time frame: Day 10-15 (outpatient visit)
CGM data completeness and device-related events (patch premature removal, occlusion - Arm A)
Time frame: Day 1-14
Treatment-related cost (CGM, insulin, device consumables)
Time frame: Day 1-15
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 22 Jul 2026.
- Results publication: PubMed 41358892American Diabetes Association Professional Practice Committee for Diabetes*. 16. Diabetes Care in the Hospital: Standards of Care in Diabetes-2026. Diabetes Care. 2026 Jan 1;49(Supplement_1):S339-S355. doi: 10.2337/dc26-S016.
- Results publication: PubMed 36103419Chang LL, Umpierrez GE, Inzucchi SE. Management of Hyperglycemia in Hospitalized, Non-Critically Ill Adults. N Engl J Med. 2022 Sep 15;387(11):1040-1042. doi: 10.1056/NEJMclde2204691. No abstract available.
- Results publication: PubMed 15189754Anderson RT, Skovlund SE, Marrero D, Levine DW, Meadows K, Brod M, Balkrishnan R. Development and validation of the insulin treatment satisfaction questionnaire. Clin Ther. 2004 Apr;26(4):565-78. doi: 10.1016/s0149-2918(04)90059-8.
- Results publication: PubMed 38532282Cho JH, Suh S. Glucocorticoid-Induced Hyperglycemia: A Neglected Problem. Endocrinol Metab (Seoul). 2024 Apr;39(2):222-238. doi: 10.3803/EnM.2024.1951. Epub 2024 Mar 27.
- Results publication: PubMed 31369359Chandrasekhar SS, Tsai Do BS, Schwartz SR, Bontempo LJ, Faucett EA, Finestone SA, Hollingsworth DB, Kelley DM, Kmucha ST, Moonis G, Poling GL, Roberts JK, Stachler RJ, Zeitler DM, Corrigan MD, Nnacheta LC, Satterfield L. Clinical Practice Guideline: Sudden Hearing Loss (Update). Otolaryngol Head Neck Surg. 2019 Aug;161(1_suppl):S1-S45. doi: 10.1177/0194599819859885.
- Results publication: PubMed 36602041Kleinhans M, Albrecht LJ, Benson S, Fuhrer D, Dissemond J, Tan S. Continuous Glucose Monitoring of Steroid-Induced Hyperglycemia in Patients With Dermatologic Diseases. J Diabetes Sci Technol. 2024 Jul;18(4):904-910. doi: 10.1177/19322968221147937. Epub 2023 Jan 5.
- Results publication: PubMed 40444483Achanta M, Kasetti P, Fortune-Ely M, Ross T, Magos T, Manjaly JG. Adverse Effects of Steroid Therapy in Sudden Sensorineural Hearing Loss: A Scoping Review. Clin Otolaryngol. 2025 Sep;50(5):821-830. doi: 10.1111/coa.14339. Epub 2025 May 30.
- Individual participant dataSharing planned: No. Individual participant data sharing is not planned. De-identified aggregate results will be published in a peer-reviewed journal.
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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.
Questions about this trial
What is this clinical trial studying?
A study testing CareLevo Patch-type Insulin Pump, Insulin Glargine U-100 (Lantus) and Fast-acting Insulin Aspart (Fiasp) in people with Sudden Sensorineural Hearing Loss (SSNHL) and Prediabetes / Type 2 Diabetes, run by Hallym University.
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 9 inclusion and 13 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: opening soon, as of the sponsor's last update on 22 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Hun Jee Choe MD, PhD (+82-10-9493-5703, hunjeechoe@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
24-hour CGM Time Above Range (TAR) >180 mg/dL (%) - averaged over Day 1-9 (time frame: Day 1 through Day 9 (24 hours per day)). 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 NCT07652528, which also lists 7 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 22 Jul 2026.