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Completed

NCT Number: NCT01490151

Medtronic Treat to Range (TTR) Closed-Loop Control

The purpose of this study is to evaluate a treat-to-range automated insulin management system using continuous glucose monitoring (CGM) and subcutaneous insulin pump infusion in individuals with type 1 diabetes.

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Key information

Age range

15 year–30 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Stanford University and Stanford Hospital & Clinics

Stanford, California, 94305, United States

About this study

The purpose of this study is to demonstrate the safety and efficacy of a closed-loop "treat-to-range" (TTR) system in an inpatient clinical research center setting. The TTR system only effects insulin delivery when the glucose is projected to be above or below specified target ranges. These initial studies will assess the safety of this algorithm (mathematical equation) under the extreme conditions of a missed meal insulin bolus and meal over-insulinization. This is a "hybrid" system, which allows the research team to deliver insulin boluses manually with the TTR controller only becoming active when blood glucose levels are projected to be out of the specified range.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Clinical diagnosis of type 1 diabetes and using daily insulin therapy for at least one year.
  • Age 15 years to less than 30 years old.
  • HbA1c < 10%.
  • Subject has used a downloadable insulin pump for at least 3 months.
  • Parent/guardian and subject understand the study protocol and agree to comply with it.
  • Subject comprehends written English.
  • Subject has a home computer with email access.
  • For females, subject not intending to become pregnant during the study.
  • No expectation that subject will be moving out of the area of the clinical center during the study.
  • Informed Consent Form signed by the subject or guardian.
  • Subjects cannot have had a severe hypoglycemic event described as a seizure, loss of consciousness requiring an emergency department visit or hospitalization within 6 months of enrollment.

Exclusion criteria

  • Asthma if treated with systemic or inhaled corticosteroids in the last 6 months; Subject has taken oral or injectable corticosteroids within the last 30 days; Current use of oral/inhaled Glucocorticoids
  • Cystic fibrosis
  • Inpatient psychiatric treatment in the past 6 months for either the subject or the subject's primary care giver (i.e., parent or guardian)
  • Use of non-insulin medications that may affect blood glucose (eg Symlin),
  • Systolic blood pressure >140 on screening; Diastolic blood pressure >90 on screening
  • History of seizure or loss of consciousness in the last 6 months.
  • Adhesive allergies; Active skin condition that would affect sensor placement
  • History of heart disease
  • Active Graves disease;
  • Currently on beta blocker medication;
  • Unwilling or unable to follow the protocol;
  • History of diagnosed medical eating disorder;
  • History of known illicit drug abuse or prescription drug abuse;
  • History of current alcohol abuse;
  • History of visual impairment which would not allow subject to participate
  • Currently participating in an investigational study (drug or device);
  • Other major illness that in the judgment of the investigator might interfere with the completion of the protocol: Adequately treated thyroid disease and celiac disease do not exclude subjects from enrollment

Treatment and study plan

TTR controller (Medtronic)

Device

Subjects will arrive in the morning and the TTR controller (Medtronic) will be initialized, and then they will give their usual premeal insulin bolus for breakfast. At lunch, they will either have a low glycemic index meal or a high glycemic index meal and the meal bolus will be omitted. The device will be turned off before dinner, they will have their usual insulin bolus for dinner, eat dinner, and then be discharged to home. On another admission, they will receive an insulin dose before lunch which will be 120% of their usual insulin bolus.

Primary outcomes

  1. Safety and Feasibility of TTR Closed-loop Control System as Measure by the Count of Successful Hospital Admissions

    Time frame: Day of hospital admission (12 hours)

    A successful hospital admission was defined as requiring no more than 2 TTR closed-loop control system adjustments of algorithm tuning parameters after initial set up, and not meeting any stopping criteria. The system was considered feasible if 75% of hospital admissions were successful.

Sponsors and collaborators

Lead sponsor

Stanford University

Other

Collaborators

  • Medtronic

Registry information

Official study title

Medtronic Treat to Range (TTR) Closed-Loop Control: Tuning a Treat-to-Range Controller for the Effects of High and Low Glycemic Index Meals

Important dates

Study start
2011
Primary completion
2013
Study completion
2013
First posted
Dec 12, 2011
Registry last updated
Sep 29, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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