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CompletedNCT03414320POC-IDENTITY-1Updated Aug 2, 2018

Proof of Concept - Identification of Patient-specific Parameters for Bolus Calculators for Type 1 Diabetes

An interventional study of Gathering data in Type1 Diabetes Mellitus, sponsored by Universitaire Ziekenhuizen KU Leuven. Completed at 1 site in Belgium. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2018-08-02.

Sponsored by Universitaire Ziekenhuizen KU Leuven · Not applicable, Interventional, and Other

Phase
Not applicable
Study type
Interventional
Enrollment
21
Allocation
Not applicable
Ages
18 Years to 65 Years
Sex
All
01

Study summary

The adoption of bolus calculators has been limited by the slow speed of the current trial and error approach. The goal of this project is to automate the determination of patient specific insulin pump parameters based on current automatic electronic logbooks of glucose measurements, carbohydrate intake, and insulin usage, by means of a mathematical model. More specifically, the investigators are interested in computing the carbohydrate to insulin ratio (CIR) and insulin sensitivity factor (ISF), which are the main parameters of bolus calculators.

The present study is a proof-of-concept, open label, single arm clinical trial to validate the new method and refine both the mathematical model and the numerical techniques in well-regulated and disciplined type 1 diabetic subject.

The study is a "trial" of the selected underlying mathematical model and the associated algorithms to simulate the glucose values of a patient with uncertain meal-data.

Read the detailed description

After signing informed consent and checking eligibility criteria participants will receive uniform education related to self-monitoring of blood glucose and continuous glucose monitoring (CGM) using the CGM sensor as well as on the bolus calculator (BC). The study will take three weeks (or three sensors) per patient.

Patients should live a close to normal life and should participate in their normal daily activities. During the study, patients must consequently keep using the BC of their insulin pump, record in the insulin pump when they eat extra food outside their regular meals and when they inject extra insulin without the use of their insulin pump. Faulty 'meal markers' have to be noted in a booklet and patients will also have to take pictures of their plate for each meal or record their meals in detail in a booklet. Patients should also consequently shut off insulin delivery when they disconnect their insulin pump and write it down in a booklet. The patients will be asked to wear an activity tracker (i.e. Fitbit), this data will help in the refinement of the model and will be used for research later in the same project.

During the study, patients must skip a total of three meals: breakfast, lunch and dinner (not on the same day, but within the three weeks). This gives the investigators a period of measurements in which they know that there are no significant amounts of unpredictable carbohydrates in the blood. Patients can give correction insulin or take extra fast carbohydrates to correct the glycaemia when needed and record this in the insulin pump or in a booklet. The fast rescue carbohydrates should be in the form of Dextro energy tablets (provided by the study team).

After the three weeks, patients will come back to the hospital where the study team will download data from the insulin pump, CGM sensor, and activity tracker. The booklet and photographs of the meals will be handed over to the study team. This is the end of the study for the patient. The collected patient data will further be used to assess the model fit of the chosen mathematical model as in, i.e. the investigators evaluate how well the model is able to reproduce the collected data.

02

Conditions studied

  • Type1 Diabetes Mellitus

Keywords

  • type 1 diabetes
  • insulin pump
  • bolus calculator
  • continuous glucose monitoring
  • carbohydrate to insulin ratio
  • insulin sensitivity factor
03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Signed informed consent
  • Patient followed at the endocrinology department of UZ Leuven
  • Type 1 diabetes
  • Treated with subcutaneous insulin pump (CSII) for more than 12 weeks
  • Using a continuous glucose monitor (CGM) for more than 12 weeks
  • No known diabetic gastroparesis
  • C-peptide negative
  • HbA1c between 6-10%
  • Using, or willing to use, the bolus calculator

Exclusion criteria

Exclusion Criteria:

  • Type 2 diabetes, patients with secondary diabetes
  • Patients treated with multiple daily insulin injections or begin of treatment with CSII less than 12 weeks before inclusion
  • Known diabetic gastroparesis
  • C-peptide positive
  • HbA1c \< 6% or > 10%
  • Not using or not willing to use the bolus calculator
04

Study design

Phase
Not applicable
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
21 participants (actual)

Study arms

  • Experimental
    Study Arm

    We will gather data from this group of patients.

    Other: Gathering data

Interventions

  • OtherGathering data

    Gathering data about sleep, heart rate, carbohydrate intake, insulin pump, continuous glucose sensor, meals.

05

What researchers measure

Primary outcomes

  1. Accepting mathematical model

    The primary outcome measure will be to accept or reject the mathematical model by calculating mean-squared error differences with the data.

    Time frame: three weeks

06

Study locations

1 site
  • UZ Leuven
    Leuven, 3000, Belgium
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03414320
Lead sponsor
Universitaire Ziekenhuizen KU Leuven
Collaborators
KU Leuven
Responsible party
prof dr Pieter Gillard (Principal Investigator, Universitaire Ziekenhuizen KU Leuven) — Principal investigator
First posted
Jan 29, 2018
Start date
Jan 11, 2018
Primary completion
Jul 12, 2018
Completion
Jul 12, 2018
Last update
Aug 2, 2018

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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