Status:

COMPLETED

Integration of Continuous Glucose Monitoring Into a BiHormonal Closed-Loop Artificial Pancreas

Lead Sponsor:

Boston University Charles River Campus

Collaborating Sponsors:

Massachusetts General Hospital

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Conditions:

Diabetes Mellitus

Eligibility:

All Genders

12+ years

Phase:

NA

Brief Summary

The investigators hypothesize that our closed-loop glucose-control system can provide BG control in subjects with type 1 diabetes using the estimated BG signal from a CGM as the input signal to the co...

Detailed Description

To test the safety and efficacy of our control system in the bi-hormonal configuration in regulating BG in adults (18 years of age or older) and in children (12-17 years of age) with type 1 diabetes b...

Eligibility Criteria

Inclusion

  • Age 12 years or older with clinical type 1 diabetes for at least one year
  • Weight \> 41 kg
  • Otherwise healthy (mild chronic disease allowed if well controlled)
  • Diabetes managed using an insulin infusion pump and rapid- or very-rapid-acting insulins
  • Body mass index (BMI) between 20 and 35 for subjects \>18 years of age or BMI between the 5th and 95th percentile for age for subjects \< 18 years of age
  • Total daily dose (TDD) of insulin that is \< 1 U/kg
  • Stimulated C-peptide \< 0.1 nmol/L at 90 minutes after liquid mixed meal by DCCT protocol
  • Hemoglobin A1c \<= 9%
  • Prescription medication regimen stable for 1 month

Exclusion

  • Unable to provide informed consent for subjects \> 18 years of age or unable to provide assent if \< 18 years of age
  • Unable to comply with study procedures
  • Current participation in another diabetes-related clinical trial other than one that is primarily observational in nature. Potential subjects enrolled in trials of passive monitoring equipment are not excluded.
  • Anemia (HCT less than normal for age and sex)
  • Alanine aminotransferase \> 3 fold above upper limit of normal
  • Untreated or inadequately treated hyperthyroidism or hypothyroidism
  • Pregnancy
  • Renal insufficiency (creatinine clearance ≤ 50 ml/min)
  • Any known history of coronary artery disease
  • Abnormal EKG including, but not limited to evidence of active ischemia, prior myocardial infarction, proximal LAD critical stenosis (Wellen's sign), arrhythmia, tachycardia, and prolonged QT interval (\> 440 ms)
  • Congestive heart failure
  • History of TIA or stroke
  • Acute illness or exacerbation of chronic illness
  • History of seizures
  • History of pheochromocytoma (fractionated metanephrines will be tested in patients with history suggestive of pheochromocytoma)
  • History of adrenal disease or tumor
  • History of pancreatic tumor, including insulinoma
  • History of impaired gastric motility or gastroparesis requiring pharmacological or surgical treatment
  • Current alcohol abuse (intake averaging \> 3 drinks daily in last 30 days) or substance abuse (any use within the last 6 months of controlled substances without a prescription)
  • Untreated or inadequately treated mental illness (indicators would include symptoms such as psychosis, hallucinations, mania, and any psychiatric hospitalization in the last year)
  • Impaired cognition or altered mental status.
  • Hypertension (blood pressure \> 140/90 or \> 95% for age, height and weight in subjects \< 18 years of age) at the time of screening
  • Use of medications that reduce gastric motility (e.g. narcotics, anti-spasmodics, anticholinergics).
  • Electrically powered implants (e.g. cochlear implants, neurostimulators) that might be susceptible to RF interference
  • Use non-insulin, injectable anti-diabetic medications
  • History of adverse reaction to glucagon (including allergy) besides nausea and vomiting.
  • Established history of latex, adhesive, or tape allergy
  • Inadequate venous access
  • History of allergy to aspirin or any history of aspirin intolerance, including Reye syndrome, or gastric ulcer or bleeding associated with salicylates
  • Blood dyscrasia or bleeding diathesis, such as hemophilia, Von Willebrands disorder, and idiopathic thrombocytopenic purpura (ITP)
  • Peptic ulcer
  • Unable to perform 30 minutes of moderate exercise on a treadmill or exercise bicycle
  • Unable or unwilling to discontinue dietary supplements for at least 2 weeks prior to each CRC admission
  • History of celiac disease

Key Trial Info

Start Date :

July 1 2010

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

June 1 2013

Estimated Enrollment :

24 Patients enrolled

Trial Details

Trial ID

NCT01161862

Start Date

July 1 2010

End Date

June 1 2013

Last Update

November 14 2017

Active Locations (1)

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1

Massachusetts General Hospital

Boston, Massachusetts, United States, 02114