Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2018 Aug 13;8(8):e020275.
doi: 10.1136/bmjopen-2017-020275.

Effect of 6 months hybrid closed-loop insulin delivery in young people with type 1 diabetes: a randomised controlled trial protocol

Collaborators, Affiliations
Clinical Trial

Effect of 6 months hybrid closed-loop insulin delivery in young people with type 1 diabetes: a randomised controlled trial protocol

Martin de Bock et al. BMJ Open. .

Abstract

Introduction: Automated insulin delivery (also known as closed loop, or artificial pancreas) has shown potential to improve glycaemic control and quality of life in people with type 1 diabetes (T1D). Automated insulin delivery devices incorporate an insulin pump with continuous glucose monitoring(CGM) and an algorithm, and adjust insulin in real time. This study aims to establish the safety and efficacy of a hybrid closed-loop (HCL) system in a long-term outpatient trial in people with T1D aged 12 -<25 years of age, and compare outcomes with standard therapy for T1D as used in the contemporary community.

Methods and analysis: This is an open-label, multicentre, 6-month, randomised controlled home trial to test the MiniMed Medtronic 670G system (HCL) in people with T1D aged 12 -<25 years, and compare it to standard care (multiple daily injections or continuous subcutaneous insulin infusion (CSII), with or without CGM). Following a run-in period including diabetes and carbohydrate counting education, dosage optimisation and baseline glucose control data collection, participants are randomised to either HCL or to continue on their current treatment regimen. The primary aim of the study is to compare the proportion of time spent in target sensor glucose range (3.9-10.0 mmol/L) on HCL versus standard therapy. Secondary aims include a range of glucose control parameters, psychosocial measures, health economic measures, biomarker status, user/technology interactions and healthcare professional expectations. Analysis will be intention to treat. A study in adults with an aligned design is being conducted in parallel to this trial.

Ethics and dissemination: Ethics committee permissions were gained from respective institutional review boards. The findings of the study will provide high-quality evidence on the role of HCL in clinical practice.

Keywords: clinical trials; paediatrics.

PubMed Disclaimer

Conflict of interest statement

Competing interests: MB reports receiving speaker honoraria from Medtronic. DNO reports receiving speaker honoraria and research grants from Medtronic.

Figures

Figure 1
Figure 1
Schematic outline of study. CGM, continuous glucose monitor; CHO, carbohydrate; HbA1c, haemoglobin A1c; HCL, hybrid closed loop; MDI, multiple daily injections; RCT, randomised controlled trial.

References

    1. Steil G, Rebrin K, Mastrototaro JJ. Metabolic modelling and the closed-loop insulin delivery problem. Diabetes Res Clin Pract 2006;74 Suppl 2:S183–S186. 10.1016/S0168-8227(06)70028-6 - DOI - PubMed
    1. Hovorka R, Canonico V, Chassin LJ, et al. Nonlinear model predictive control of glucose concentration in subjects with type 1 diabetes. Physiol Meas 2004;25:905–20. 10.1088/0967-3334/25/4/010 - DOI - PubMed
    1. Mauseth R, Wang Y, Dassau E, et al. Proposed clinical application for tuning fuzzy logic controller of artificial pancreas utilizing a personalization factor. J Diabetes Sci Technol 2010;4:913–22. 10.1177/193229681000400422 - DOI - PMC - PubMed
    1. Steil GM, Rebrin K, Darwin C, et al. Feasibility of automating insulin delivery for the treatment of type 1 diabetes. Diabetes 2006;55:3344–50. 10.2337/db06-0419 - DOI - PubMed
    1. Nordwall M, Abrahamsson M, Dhir M, et al. Impact of HbA1c, followed from onset of type 1 diabetes, on the development of severe retinopathy and nephropathy: the VISS Study (Vascular Diabetic Complications in Southeast Sweden). Diabetes Care 2015;38:308–15. 10.2337/dc14-1203 - DOI - PubMed

Publication types

LinkOut - more resources