Artificial Pancreas Control System in an Inpatient Setting

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Juvenile Diabetes Research Foundation
Information provided by (Responsible Party):
W. Kenneth Ward, Legacy Health System
ClinicalTrials.gov Identifier:
NCT01552603
First received: February 22, 2012
Last updated: May 29, 2013
Last verified: May 2013
  Purpose

The purpose of this study is to verify an automated system of blood glucose control in Type I Diabetics. The automated system consists of the investigational Artificial Pancreas Control software (APC), two blood glucose sensors, and two hormone pumps, one for delivering insulin to lower blood sugar, and the second for delivering glucagon to raise blood sugar. The blood glucose sensors relays information to the Artificial Pancreas software, which uses the Adaptive Proportional Device algorithm to determine the rate of insulin and glucagon infusion by the hormone pumps. In prior studies, the Adaptive Proportional Device algorithm has been verified, but required manual input into the computer and hormone pumps. This study differs in that it uses a fully automated system under the control of the Artificial Pancreas Control software. The importance of this change is that it is the next step to enable outpatient use of automated, closed loop blood glucose control.


Condition Intervention Phase
Type I Diabetes Mellitus
Device: Artificial Pancreas Control Software
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Sensor-controlled Insulin- and Glucagon Delivery in Subjects With Type 1 Diabetes: Testing of an Automated System in a Supervised Inpatient Setting

Resource links provided by NLM:


Further study details as provided by Legacy Health System:

Primary Outcome Measures:
  • Verification of the Automation and Telemetry Components [ Time Frame: all 28 hour studies ] [ Designated as safety issue: Yes ]
    This outcome will verify afferent signal transmittal from the Dexcom sensors to the algorithm and the the efferent signal transmittal from the algorithm to the insulin and glucagon pumps. This will be accomplished by assigning each lapse a grade from 0-6 based on: 1) the type of lapse (insulin or glucagon), and 2) the amount of time of the lapse.


Secondary Outcome Measures:
  • Deviation from Target Blood Glucose [ Time Frame: all 28 hour studies ] [ Designated as safety issue: Yes ]
    Assessment of how accurately the algorithm controls glycemia in the subjects will be carried out using mean BG (mg/dL). Metric will be compared for awake vs sleep hours.


Estimated Enrollment: 12
Study Start Date: March 2012
Estimated Study Completion Date: September 2013
Estimated Primary Completion Date: August 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Artificial Pancreas Control
Type 1 Diabetes Mellitus subjects who fit the inclusion/exclusion criteria will undergo artificial pancreas closed-loop study for 28 hours. For the entire study, the adaptive component of Artificial Pancreas Control Software will be used to control the subject's blood glucose.
Device: Artificial Pancreas Control Software
This master controller software is used in conjunction with two subcutaneous continuous glucose monitoring systems and two Omnipod pumps, one for administering aspart insulin (NovoLog) and one for administering glucagon (GlucaGen), to control blood glucose levels. The insulin and glucagon infusion rates are determined by an automated version of the Adaptive Proportional Derivative (APD) insulin and glucagon control algorithm.

Detailed Description:

The objective of the current human study is to verify the components of the Artificial Pancreas Control system during an inpatient study. This master controller software is designed to be used in conjunction with two subcutaneous continuous glucose monitoring systems to regulate blood glucose levels as well as two Omnipod pumps, one for administering insulin and one for administering glucagon. The sensors communicate wirelessly with two sensor receivers which will be interfaced with the APC by wireless USB connection. The insulin and glucagon pumps will be controlled by the APC through a wireless USB connection. The algorithm included in the APC is an automated version of the Adaptive Proportional Derivative (APD) insulin and glucagon control algorithm, which was previously studied as an investigational device. The APD has been studied in vivo (in 28 experiments, each 33 hr in length, with manual adjustment of pumps) and no serious adverse effects were noted. Manual input of the glucose sensor data and insulin/glucagon infusion rates will no longer be necessary. The APC will be tested in vivo during 28 hour experiments in an inpatient setting in preparation for outpatient testing.

  Eligibility

Ages Eligible for Study:   21 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Diagnosis of type 1 diabetes mellitus for at least 1 year.
  • Male or female subjects 21 to 65 years of age.
  • Current use of an insulin pump.
  • Willingness to follow all study procedures, including attending all clinic visits.
  • Willingness to sign informed consent and HIPAA documents.

Exclusion Criteria:

  • Pregnancy or Lactation: For women of childbearing potential: there is a requirement for a negative urine pregnancy test and for agreement to use contraception during the study and for at least 1 month after participating in the study. Acceptable contraception includes birth control pill / patch / vaginal ring, Depo-Provera, Norplant, an IUD, the double barrier method (the woman uses a diaphragm and spermicide and the man uses a condom), or abstinence.
  • Renal insufficiency (serum creatinine of 2.0 mg/dL or greater).
  • Serum ALT or AST equal to or greater than 3 times the upper limit of normal; hepatic synthetic insufficiency as defined as a serum albumin of less than 3.3 g/dL; or serum bilirubin of over 2.
  • Adrenal insufficiency
  • Hematocrit of less than or equal to 34%.
  • A history of cerebrovascular disease or coronary artery disease regardless of the time since occurrence.
  • Congestive heart failure, NYHA class III or IV.
  • Diagnosis of 2nd or 3rd degree heart block or any arrhythmia judged by the investigator to be exclusionary.
  • Any active infection.
  • Visual impairment preventing reading of glucose meter values or continuous glucose monitoring device.
  • Physical impairment impeding the ability to use a glucose meter or glucose monitoring device.
  • Active foot ulceration.
  • Severe peripheral arterial disease characterized by ischemic rest pain or severe claudication.
  • Active alcohol abuse, substance abuse, or severe mental illness (as judged by the principal investigator).
  • Active malignancy, except basal cell or squamous cell skin cancers.
  • Major surgical operation within 30 days prior to screening.
  • Seizure disorder.
  • Chronic usage of any immunosuppressive medication (such as cyclosporine, azathioprine, sirolimus, or tacrolimus).
  • Current administration of oral or parenteral corticosteroids.
  • Use of an investigational drug within 30 days prior to screening.
  • Bleeding disorder, treatment with warfarin, or platelet count below 50,000.
  • Allergy to aspart insulin.
  • Allergy to glucagon.
  • Past history of pheochromocytoma or a family history of MEN 2, neurofibromatosis, or von Hippel-Lindau disease.
  • Insulin resistance requiring more than 200 units per day.
  • Need for uninterrupted treatment of acetaminophen.
  • Intolerance of mild hypoglycemia (glucose 60-70 mg/dl).
  • History of hypoglycemic unawareness.
  • Insulin antibody level of ≥ 100 µUnits/ml.
  • C peptide level of ≥0.5 ng/ml.
  • Any concurrent illness, other than diabetes, that is not controlled by a stable therapeutic regimen.
  • Any reason the principal investigator deems exclusionary
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01552603

Locations
United States, Oregon
Legacy Good Samaritan Hospital
Portland, Oregon, United States, 97210
Oregon Health and Science University
Portland, Oregon, United States, 97239
Sponsors and Collaborators
Legacy Health System
Juvenile Diabetes Research Foundation
Investigators
Principal Investigator: W K Ward, MD Legacy Health Research
  More Information

No publications provided

Responsible Party: W. Kenneth Ward, Senior Scientist, Legacy Health System
ClinicalTrials.gov Identifier: NCT01552603     History of Changes
Other Study ID Numbers: 2011.11
Study First Received: February 22, 2012
Last Updated: May 29, 2013
Health Authority: United States: Food and Drug Administration

Keywords provided by Legacy Health System:
glucose sensors
artificial pancreas
Diabetes Mellitus

Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 1
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Autoimmune Diseases
Immune System Diseases
Pancreatin
Pancrelipase
Gastrointestinal Agents
Therapeutic Uses
Pharmacologic Actions

ClinicalTrials.gov processed this record on July 26, 2014