ClinicalTrials.gg
CompletedNCT03303196Updated Oct 27, 2020Results posted

Bionic Pancreas in Children With Hyperinsulinism and Post-Pancreatectomy Diabetes

An interventional study of Bihormonal Bionic Pancreas in Hyperinsulinism, Diabetes and Pancreatic Diseases, sponsored by Children's Hospital of Philadelphia. Completed at 1 site in United States. Open to participants aged 6 Years to 30 Years. Per ClinicalTrials.gov, last updated 2020-10-27.

Sponsored by Children's Hospital of Philadelphia · Not applicable, Interventional, and Treatment

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Phase
Not applicable
Study type
Interventional
Enrollment
10
Allocation
Randomized
Ages
6 Years to 30 Years
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 56 studies in Hyperinsulinism with a site in United States — 14 open to participants now, 17 under way, 2 of them phase 3. Hyperinsulinism · United States.

Enrollment
38th of 46
10 · median 23
Started
2018
with 2 others
No phase
14 of 56
2 open now
Registered
27th of 56
by date
Lead sponsor
6 of 56
Children's Hospital of Philadelphia

Among the 56 studies in Hyperinsulinism with a site in United States, this one is the 38th largest by enrollment of the 46 interventional ones that give a count, is one of 3 that started in 2018, is one of 14 with no phase, and was the 27th registered.

Hyperinsulinism

112 studies on the registry are indexed under Hyperinsulinism; 24 are open to participants now.

Browse Hyperinsulinism studies →

Open to participants now

14 of the 56 studies in Hyperinsulinism with a site in United States are open now. Recruiting first, the newest first:

9 more — sign in →

All 14 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 18 Hyperinsulinism studies recruiting now, 5 (28%) set no upper age limit and 11 (61%) stop at 75 or younger; 5 take children under 18; 8 take healthy volunteers.

This study: 6 Years to 30 Years · all sexes · no healthy volunteers.

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02

Study summary

This is a pilot study designed to determine if the bihormonal bionic pancreas provides improved blood glucose control, compared to the current standard of care, in individuals with hyperinsulinism who developed diabetes after having a pancreatectomy.

Read the detailed description

The management of diabetes following pancreatectomy for hyperinsulinism (HI) generally consists of the same approaches that are used for individuals with type 1 diabetes (T1D). However, there are significant differences in individuals with HI and post-pancreatectomy diabetes that increases the risk of hypoglycemia in these individuals and prevent achieving tight glycemic control. Individuals with HI have glucagon deficiency and unlike T1D, those with HI and post-pancreatectomy diabetes have residual dysregulated insulin secretion that results in marked hypo- and hyper-glycemia. Furthermore, pancreatic insufficiency can result in disturbances in nutrient absorption and fluctuations in glucose concentrations.

Current treatment approaches with intermittent subcutaneous insulin administration or insulin pump therapy offer inadequate glycemic control in these individuals. We propose a novel approach to the management of these individuals with the bihormonal bionic pancreas to replace both hormones, insulin and glucagon, through an automated glycemic management system.

03

Conditions studied

  • Hyperinsulinism
  • Diabetes
  • Pancreatic Diseases
  • Pancreatectomy; Hyperglycemia

Keywords

  • Post-Pancreatectomy Diabetes
  • Insulin Therapy
04

Who can participate

Ages eligible
6 Years to 30 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Males or females age 6 to 30 years.
  2. Diagnosis of hyperinsulinism.
  3. Previous pancreatectomy.
  4. Diabetes confirmed by one or more of the following:

    • Glycosylated A1c > 6.4%.
    • Fasting glucose > 125 mg/dL.
    • 2-hour post-prandial glucose > 200 mg/dL.
    • Random glucose > 200 mg/dL with symptomatic hyperglycemia.
  5. On insulin therapy with a regimen of at least 11 units/kg/day.
  6. Treatment with subcutaneous insulin by pump at the time of recruitment.
  7. Prescription medication regimen stable for > 1 month (except for medications that will not affect the safety of the study and are not expected to affect any outcome of the study, in the judgment of the site PI).
  8. Females > 11 years of age must have a negative urine/serum pregnancy test and must use an acceptable method of , including abstinence, a barrier method (diaphragm or condom), Depo-Provera, or an oral contraceptive, for the duration of the study.
  9. , parental/guardian permission (informed consent) and if appropriate, child assent.

Exclusion criteria

Exclusion Criteria:

  1. Unable to provide (e.g. impaired cognition or judgment).
  2. Evidence of a medical condition that might alter results or compromise the interpretation of results, including active infection, kidney failure, severe liver dysfunction, severe respiratory or cardiac failure.
  3. Evidence of severe hematologic abnormality including severe anemia and/or thrombocytopenia.
  4. Electrically powered implants (e.g. cochlear implants, neurostimulators) that might be susceptible to radio frequency interference.
  5. Unable to completely avoid acetaminophen for duration of study.
  6. History of adverse reaction to glucagon (including allergy) besides nausea and vomiting.
  7. Established history of allergy or severe reaction to adhesive or tape that must be used in the study.
  8. Use oral (e.g. thiazolidinediones, biguanides, sulfonylureas, glitinides, dipeptidyl peptidase-4 (DPP-4) inhibitors, Sodium-glucose Cotransporter-2 (SGLT-2) inhibitors anti-diabetic medications.
  9. Any drug use within 30 days prior to enrollment.
  10. Pregnant or lactating females.
  11. Parents/guardians or subjects who, in the opinion of the Investigator, may be non-compliant with study schedules or procedures.
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
10 participants (actual)

Study arms

  • Experimental
    Bihormonal bionic pancreas admission

    Four day inpatient admission where participants will have blood sugar managed by the Bihormonal Bionic Pancreas. Blood sugars will be monitored for safety by study staff.

    Device: Bihormonal Bionic Pancreas

  • No intervention
    Standard care admission

    Four day inpatient admission where participants will have blood sugar managed by the participant's home-glucose control regimen. Blood sugars will be monitored for safety by study staff.

Interventions

  • DeviceBihormonal Bionic Pancreas

    A 4-day inpatient admission in which subjects will wear the bihormonal pancreas. The bihormonal pancreas will be placed upon admission and there will be 1 day of run-in. This will be followed by 3 days of data collection for comparison with the data obtained from the standard of care during the control admission.

06

What researchers measure

Primary outcomes

  1. Mean Plasma Glucose Level.

    Mean plasma glucose concentration, as measured by the Continuous glucose monitoring system (CGMS), during the final 2 days of the Bihormonal Bionic Pancreas Admission compared to the Standard Care Admission.

    Time frame: Days 2-3 of each admission

07

Results

Posted Oct 27, 2020

Participant flow

Participant flow — Overall Study
MilestoneBihormonal Bionic Pancreas AdmissionStandard Care Admission
Started55
Washout55
Completed55
Not completed00

Outcome measures

PrimaryMean Plasma Glucose Level.

Mean plasma glucose concentration, as measured by the Continuous glucose monitoring system (CGMS), during the final 2 days of the Bihormonal Bionic Pancreas Admission compared to the Standard Care Admission.

Time frame:
Days 2-3 of each admission
Reported as:
Mean · mg/dL
Mean Plasma Glucose Level.
mg/dLSequential Admissions
Bihormonal Bionic Pancreas Admission149.666118 ± 12.7998623
Standard Care Admision162.574753 ± 32.2642656

Adverse events

Collected over Adverse event data was collected from the start of screening until the end of the last day of the subject's second admission. This time period ranged from 16 to 38 days, depending on how many days in between admissions they had.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Bihormonal Bionic Pancreas Admission0/5 (0%)0/5 (0%)2/5 (40%)
Standard Care Admission0/5 (0%)0/5 (0%)5/5 (100%)
Most frequent other events
Most frequent other events
EventBihormonal Bionic Pancreas AdmissionStandard Care Admission
Intermittent nasueaGastrointestinal disorders2/53/5
HeadacheNervous system disorders0/53/5
HyperglycemiaMetabolism and nutrition disorders0/51/5
Upper respiratory infectionInfections and infestations0/51/5

Baseline characteristics

Age, Continuous
Age, Continuous(years)Sequential Admissions
Mean15.1 (7 to 25)
Sex: Female, Male
Sex: Female, Male(Participants)Sequential Admissions
Female5
Male5
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Sequential Admissions
Hispanic or Latino0
Not Hispanic or Latino10
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Sequential Admissions
American Indian or Alaska Native0
Asian1
Native Hawaiian or Other Pacific Islander0
Black or African American0
White9
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Sequential Admissions
United States10
Mean Plasma Glucose Level
Mean Plasma Glucose Level(mmmol/L)Sequential Admissions
Bionic Pancreas Admission8.3 ± 0.7
Standard Care Admission9.0 ± 1.8
08

Study locations

1 site
  • Children's Hospital of Philadelphia
    Philadelphia, Pennsylvania 19104, United States
09

References and documents

Publications

  • Russell SJ, El-Khatib FH, Nathan DM, Magyar KL, Jiang J, Damiano ER. Blood glucose control in type 1 diabetes with a bihormonal bionic endocrine pancreas. Diabetes Care. 2012 Nov;35(11):2148-55. doi: 10.2337/dc12-0071. Epub 2012 Aug 24. PubMed 22923666 ↗
  • El-Khatib FH, Russell SJ, Magyar KL, Sinha M, McKeon K, Nathan DM, Damiano ER. Autonomous and continuous adaptation of a bihormonal bionic pancreas in adults and adolescents with type 1 diabetes. J Clin Endocrinol Metab. 2014 May;99(5):1701-11. doi: 10.1210/jc.2013-4151. Epub 2014 Jan 31. PubMed 24483160 ↗
  • Russell SJ, Hillard MA, Balliro C, Magyar KL, Selagamsetty R, Sinha M, Grennan K, Mondesir D, Ekhlaspour L, Zheng H, Damiano ER, El-Khatib FH. Day and night glycaemic control with a bionic pancreas versus conventional insulin pump therapy in preadolescent children with type 1 diabetes: a randomised crossover trial. Lancet Diabetes Endocrinol. 2016 Mar;4(3):233-243. doi: 10.1016/S2213-8587(15)00489-1. Epub 2016 Feb 3. Erratum In: Lancet Diabetes Endocrinol. 2018 Mar;6(3):e3. doi: 10.1016/S2213-8587(18)30053-6. PubMed 26850709 ↗
  • El-Khatib FH, Balliro C, Hillard MA, Magyar KL, Ekhlaspour L, Sinha M, Mondesir D, Esmaeili A, Hartigan C, Thompson MJ, Malkani S, Lock JP, Harlan DM, Clinton P, Frank E, Wilson DM, DeSalvo D, Norlander L, Ly T, Buckingham BA, Diner J, Dezube M, Young LA, Goley A, Kirkman MS, Buse JB, Zheng H, Selagamsetty RR, Damiano ER, Russell SJ. Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes: a multicentre randomised crossover trial. Lancet. 2017 Jan 28;389(10067):369-380. doi: 10.1016/S0140-6736(16)32567-3. Epub 2016 Dec 20. Erratum In: Lancet. 2017 Jan 28;389(10067):368. doi: 10.1016/S0140-6736(16)32594-6. Lancet. 2017 Feb 4;389(10068):e2. doi: 10.1016/S0140-6736(17)30228-3. PubMed 28007348 ↗
  • De Leon DD, Stanley CA. Mechanisms of Disease: advances in diagnosis and treatment of hyperinsulinism in neonates. Nat Clin Pract Endocrinol Metab. 2007 Jan;3(1):57-68. doi: 10.1038/ncpendmet0368. PubMed 17179930 ↗
  • Rayannavar A, Mitteer LM, Balliro CA, El-Khatib FH, Lord KL, Hawkes CP, Ballester LS, Damiano ER, Russell SJ, De Leon DD. The Bihormonal Bionic Pancreas Improves Glycemic Control in Individuals With Hyperinsulinism and Postpancreatectomy Diabetes: A Pilot Study. Diabetes Care. 2021 Nov;44(11):2582-2585. doi: 10.2337/dc21-0416. Epub 2021 Sep 13. PubMed 34518377 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Apr 2018 to primary completion in Sep 2019, 17 months.

Results were first posted in Oct 2020, 1 year after primary completion.

Of 24 interventional studies with no phase under Hyperinsulinism, half reached primary completion within 23 months of starting (the median), counting those still running; a quarter within 13 and three quarters within 90. This study's 17 months is below that.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 2, 2017
First posted
Oct 5, 2017
StartActual
Apr 9, 2018
Primary completionActual
Sep 30, 2019
CompletionActual
Sep 30, 2019
Results first posted
Oct 27, 2020
Last update
Oct 27, 2020
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Oct 27, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03303196
Responsible party
Diva De Leon, MD, MSCE (Director, Congenital Hyperinsulinism Center, Children's Hospital of Philadelphia) — Principal investigator
First posted
Oct 5, 2017
Start date
Apr 9, 2018
Primary completion
Sep 30, 2019
Completion
Sep 30, 2019
Results posted
Oct 27, 2020
Last update
Oct 27, 2020

Study contacts

Diva D De Leon, MD, MSCE
principal investigator · Children's Hospital of Philadelphia
Arpana Rayannavar, MD
principal investigator · Children's Hospital of Philadelphia

Oversight

FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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