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NCT Number: NCT06453928

Starting Technology in At Risk Type 1 Diabetes Study

Diabetes technology has revolutionized T1D management, disparities in technology access are evident among racial-ethnic minorities, patients with lower socioeconomic status and those with poorly controlled T1D (A1c>8.5%). In order to examine whether diabetes technology can reduce diabetes care burdens and enhance outcomes among some of highest need patients, diabetes technology clinical trials must be expanded beyond the very select populations included in studies thus far (ie., mostly White, higher SES). Therefore, the investigators propose to perform a pilot RCT of hybrid closed-loop insulin pump therapy (HCL) in 40 diverse adult patients with poorly controlled T1D (HbA1c >8.5%) from the largest academic and safety net health systems in the Los Angeles region to determine the feasibility of a RCT in this population and identify facilitators and barriers of effective use of closed loop insulin pump therapy in patients with poorly controlled T1D.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

UCLA, Santa Monica, California, United States

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Type 1 Diabetes
  • A1c >8.5%
  • Not insulin pump user
  • Primary language of English or Spanish
  • Have medical insurance coverage

Exclusion criteria

  • No measured A1c in the past year
  • Have comorbidities that can result in inaccurate hemoglobin A1c
  • Have cognitive, physical or mental impairment precluding diabetes technology use
  • Limited life expectancy (<1 year)
  • Pregnancy

Treatment and study plan

Hybrid Closed Loop Insulin Pump System

Device

Patients will be started on an automated insulin delivery system.

Primary outcomes

  1. Proportion of screened participants that are eligible

    Time frame: 6 months

    Eligible among screened, enrolled among eligible, excluded among screened (and why) based on screening, recruitment and enrollment data.

  2. Proportion of enrolled participants that are randomized

    Time frame: 6 months

    Randomized among enrolled, and receiving allocated intervention among randomized.

  3. Proportion of average time delay to enrollment

    Time frame: 6 months

    Average time delay from screening to enrollment.

  4. Proportion of retention among participants randomized to the Intervention Group

    Time frame: 6 months

    Retention among participants receiving allocated intervention after being randomized and discontinued intervention among randomized.

  5. Proportion of retention among participants randomized

    Time frame: 6 months

    Participants lost to follow-up among those initially randomized.

  6. Proportion of retention among participants randomized

    Time frame: 6 months

    Retention rates by participants completing all research assessments among randomized.

  7. Number of participants who adhere to assigned treatment

    Time frame: 6 months

    Treatment-specific adherence, Adherence to study protocol and Proportion of planned assessments that are completed.

    Fidelity, which pertains to guaranteeing that the intervention is delivered in accordance with the established protocol, will be summarized by study arms, and differences between arms will be examined using t-tests or two-sample tests of proportions as appropriate.

    Adherence, which relates to the extent to which participants follow the treatment and study protocol, as well as the proportion of planned assessments completed, will be summarized by study arms, and differences between arms will be examined using t-tests or two-sample tests of proportions as appropriate.

Secondary outcomes

  1. Change in A1c

    Time frame: 6 months

    Serum Hemoglobin A1c laboratory measurement

  2. Episodes and % of time with severe hypoglycemia ( BG <54 mg/dl)

    Time frame: 6 months

    Hypoglycemia will be measure by combining CGM metrics and glucometer to report severe hypoglycemia in mg/dl.

  3. Mean Diabetes Ketoacidosis Episodes Incidence

    Time frame: 6 months

    Assess instances of diabetic ketoacidosis through participant surveys and comprehensive chart reviews.

  4. ED visits/Hospitalizations Number of diabetes related ED visits or hospitalizations

    Time frame: 6 months

    Number of diabetes related ED visits or hospitalizations

  5. Treatment Burden and Satisfaction: Diabetes Distress

    Time frame: 6 months

    Assessing treatment burden through the Type 1 Diabetes Distress Assessment System T1DDAS, which comprises eight questions and evaluates ten prevalent sources of diabetes distress in adults with type 1 diabetes. The score indicates the level of diabetes distress reported by the respondent, with higher scores indicating greater intensity. The core scale scoring ranges 1 to 5. This scale assesses each of ten common Sources of diabetes distress for adults with type 1 diabetes: Financial Worries, Interpersonal Challenges, Management Difficulties, Shame, Hypoglycemia Concerns, Healthcare Quality, Lack Of Diabetes Resources, Technology Challenges, Burden To Others, Worries About Complications. The higher the score, the more impactful that Source is likely to be in contributing to diabetes distress for this individual with the minimum value being 1 and maximum value being 5.

  6. Treatment Burden and Satisfaction: Insulin Treatment Satisfaction

    Time frame: 6 months

    Assessed treatment burden and satisfaction using the Insulin Treatment Satisfaction Questionnaire (ITSQ), consisting of 22 questions among 5 content clusters with a score from 0 to 100% where a higher score indicates greater satisfaction with insulin treatment. The scale explores perceptions of current insulin treatment and its impact on daily life.

  7. Treatment Burden and Satisfaction: Glucose Monitoring System Satisfaction (GMSS)

    Time frame: 6 months

    Examined treatment burden and satisfaction employing the Glucose Monitoring System Satisfaction Survey (GMSS), comprising 15 questions divided into four subcategories: openness, emotional burden, behavioral burden and trust. Higher scores within each subcategory denote either greater satisfaction or burden, depending on the specific aspect assessed with the minimum value being 1 and maximum value being 5. The total scare has a minimum value of 1 and maximum value of 15 with higher scores indicating greater satisfaction. The scores are obtained by calculating the mean for each.

  8. Treatment Burden and Satisfaction: Motivation and Attitudes Towards Changing Health (MATCH)

    Time frame: 6 months

    Assessed treatment burden and satisfaction using the Motivation and Attitudes towards Health Scale (MATCH), consisting of nine questions categorized into four subgroups: willingness to make changes, perceived ability to make or maintain changes, feeling changes are worthwhile, and overall mean/average of willingness, able, and worthwhile. Scores are calculated by determining the mean or average response within each category with higher scores meaning a better outcome.

    WILLINGNESS: minimum value is 1 and maximum value is 5. ABLE: minimum value is 1 and maximum value is 5. WORTHWHILE: minimum value is 1 and maximum value is 5. TOTAL SCALE: minimum value is 1 and maximum value is 9.

Study contacts

Contact information is provided by the study sponsor or research team.

Estelle M Everett, MD, MHS

CONTACT

[email protected]

310-267-0625

Sponsors and collaborators

Lead sponsor

University of California, Los Angeles

Other

Collaborators

  • Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
  • Olive View-UCLA Education & Research Institute

Registry information

Official study title

Starting Technology in At Risk Type 1 Diabetes (STAR-T1D) Study

Acronym: STAR-T1D

Important dates

Study start
2024
Primary completion
2027
Study completion
2027
First posted
Jun 12, 2024
Registry last updated
Feb 13, 2026

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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