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Primary Outcomes: Average decrease in A1c from baseline to end of Study Phase (52 weeks) for subjects in the "722 Group" is greater than that for subjects in the "Control (MDI) Group".
Secondary Outcomes: Incidence and frequency of severe hypoglycemia; Measure of glycemic variability, Area Under the Curve (AUC); Quality of Life; and Health Economic Outcomes (MRU)
Glycemic control remains a significant challenge for adult, adolescent and pediatric Type 1 diabetics. The current first line standard of care continues to be MDI therapy utilizing a long acting analog insulin. Continuous Glucose Monitoring (CGMS) is currently used by clinicians to record continuous, retrospective glucose measurements, which aid in identification of glycemic excursion patterns. This data is then used to make future therapy change recommendations. The MiniMed Paradigm REAL-Time System transmits real-time glucose measurements to the insulin pump every 5 minutes, allowing users to view their current glucose values, as well as to review glycemic excursions and trends over a 24-hour period. Additionally, data can be downloaded from the monitor to a personal computer, using appropriate software, so that the patient and physician can see a complete picture of glucose trends over time. The System will also alert users of high and low glucose levels, and allow subjects and their clinicians to treat to a therapeutic target HbA1c under carefully monitored conditions.
Subjects wearing the MiniMed Paradigm REAL-Time System will be compared to subjects that continue on their current MDI therapy, that includes a long acting analog insulin, over a 12 month period to evaluate changes in glycemic control (HbA1c).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 722 sensor augmented pump | Experimental | 722 arm: MiniMed Paradigm REAL-Time System using NovoLog/NovoRapid for 1 year |
|
| Multiple Daily Injections (MDI) | No Intervention | MDI arm: Continue with current MDI therapy using Lantus and NovoLog/NovoRapid for 1 year |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| MiniMed Paradigm REAL-Time System | Device | Paradigm 722 insulin pump Paradigm REAL-Time Transmitter Sensor ComLink Paradigm Link glucose meter |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in A1c From Baseline to 52 Weeks | Change is defined as A1c at Week 52 minus A1c at Baseline in each study arm. The difference between the change in each group will then be analyzed. A1c measure is defined as the percent of glycated hemoglobin using one standardized assay for all subjects. | Baseline and 52 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Difference in Frequency of Severe Hypoglycemia From Baseline to Week 52; | Severe Hypoglycemia is defined as a hypoglycemic episode absolutely requiring assistance from another person and preferably accompanied by a confirmatory Blood Glucose (BG) by finger stick of less than 50 mg/dL (2.8 mmol/L). The frequency evaluates the total number of events. This will be analyzed and compared between the two study arms from baseline to week 52. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Stephen N Davis, MD | University of Maryland, Baltimore | Principal Investigator |
| William V Tamborlane, MD | Yale University | Principal Investigator |
| Scott W Lee, MD | Medtronic Minimed | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Scripps Institute | La Jolla | California | 92037 | United States | ||
| Children's Hospital of Orange County (CHOC) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25175313 | Derived | Perkins BA, Halpern EM, Orszag A, Weisman A, Houlden RL, Bergenstal RM, Joyce C. Sensor-augmented pump and multiple daily injection therapy in the United States and Canada: post-hoc analysis of a randomized controlled trial. Can J Diabetes. 2015 Feb;39(1):50-4. doi: 10.1016/j.jcjd.2014.03.003. Epub 2014 Aug 29. | |
| 20587585 | Derived |
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| ID | Title | Description |
|---|---|---|
| FG000 | 722 Sensor Augmented Pump | 722 arm: MiniMed Paradigm REAL-Time System using NovoLog/NovoRapid for 1 year |
| FG001 | Multiple Daily Injection (MDI) | MDI arm: Continue with MDI using Lantus and NovoLog/NovoRapid for 1 year |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Baseline and 52 weeks |
| Overall Difference in Rate of Severe Hypoglycemia Events Between Study Arms From Baseline to Week 52 | Severe Hypoglycemia is defined as a hypoglycemic episode absolutely requiring assistance from another person and preferably accompanied by a confirmatory BG by finger stick of less than 50 mg/dL (2.8 mmol/L). The rate evaluates the number of participants that experienced at least one severe hypoglycemia event and compares this number between the two study arms from Baseline to week 52. This measure identifies the rate or frequency of unique participant events. | Baseline and 52 weeks |
| Changes in Hypoglycemia Area Under the Curve (AUC) From Baseline to Week 52; | Hypoglycemia is defined as a recorded blood glucose event <70mg/dL. The amount of time spent below this parameter will be analyzed and compared between groups from Baseline to Week 52. | Baseline and 52 weeks |
| Changes From Baseline in Hyperglycemia Area Under the Curve (AUC) From Baseline to Week 52 | Hyperglycemia is defined as a recorded blood glucose event > 180 mg/dL. The amount of time spent above this parameter will be analyzed and compared between groups from Baseline to Week 52. | Baseline and 52 weeks |
| Quality of Life - Hypoglycemia Fear Scale (HFS), Overall Score | Difference of Baseline and 52 Weeks in Hypoglycemia Fear Scale (HFS) Overall Score between the two study arms (adult subjects only) is presented. Both baseline and 52 weeks scores range from 0-100, with lower scores suggest higher satisfaction. Therefore, a negative number in the difference suggests higher satisfaction at 52 Weeks than Baseline. | Baseline and 52 weeks |
| Health Economic Outcome | Health Economic Outcome was a cost-effectiveness analysis combining estimates from the trial and the literature to populate the previously validated Center for Outcomes Research (CORE) Diabetes Model. Results represent the use of 3-day sensors. This analysis was restricted to only adult subjects (Age 19 to 70), therefore the number of participant analyzed is different. The goal was to estimate the long term cost effectiveness of Sensor Augmented Pump therapy from the perspective of the US health care system. The unit of measurement was cost in $ per year for sensor augmented pump group and MDI group. No formal statistical analysis was planned or performed | Baseline and 52 weeks |
| Quality of Life - Short Form-36 (SF-36v2™), General Health | Difference of Baseline and 52 Weeks in Short Form-36 (SF-36v2™), General Health, between the two study arms (adult subjects only) is presented. Both baseline and 52 weeks scores range from 0-100, with higher scores suggest higher satisfaction. Therefore, a positive number in the difference suggests higher satisfaction at 52 Weeks than Baseline. | Baseline and 52 Weeks |
| Quality of Life - Insulin Delivery System Rating Questionnaire (IDSRQ) for Subject Satisfaction With Type of Insulin Therapy | Difference of Baseline and 52 Weeks in Insulin Delivery System Rating Questionnaire (IDSRQ) for Subject Satisfaction with Type of Insulin Therapy, between the two study arms is presented. Both baseline and 52 weeks scores range from 0-100, with higher scores suggest higher satisfaction. Therefore, a positive number in the difference suggests higher satisfaction at 52 Weeks than Baseline. | Baseline and 52 Weeks |
| Orange |
| California |
| 92864-3874 |
| United States |
| Barbara Davis Center, University of Colorado | Boulder | Colorado | 80045 | United States |
| Yale University | New Haven | Connecticut | 06522 | United States |
| Diabetes Research Institute (DRI) | Miami | Florida | 33136 | United States |
| Endocrine Research Solutions, Inc. | Roswell | Georgia | 30076 | United States |
| Rocky Mountain Diabetes and Osteoporosis Center | Idaho Falls | Idaho | 83404 | United States |
| Mid-America Diabetes Associates | Wichita | Kansas | 67211 | United States |
| Kentucky Diabetes Endocrinology Center | Lexington | Kentucky | 40503 | United States |
| Joslin Clinic | Boston | Massachusetts | 02215 | United States |
| DeVos Children's Hospital | Grand Rapids | Michigan | 49503 | United States |
| Mayo Clinic | Rochester | Minnesota | 55905 | United States |
| Minnesota International Diabetes Center | Saint Louis Park | Minnesota | 55416 | United States |
| Children's Hospital of St. Paul | Saint Paul | Minnesota | 55102 | United States |
| Washington University | St Louis | Missouri | 63110 | United States |
| University of Rochester | Rochester | New York | 14644 | United States |
| Mountain Diabetes & Endocrine Center | Asheville | North Carolina | 28801 | United States |
| University of North Carolina at Chapel Hill | Chapel Hill | North Carolina | 27599 | United States |
| Duke University Medical Center Diabetes Research Clinic | Durham | North Carolina | 27710 | United States |
| Diabetes and Obesity Center, East Carolina University | Greenville | North Carolina | 27834 | United States |
| Ohio State University | Columbus | Ohio | 43210 | United States |
| Oregon Health and Science University | Portland | Oregon | 97239 | United States |
| Children's Hospital of Philadelphia | Philadelphia | Pennsylvania | 19104 | United States |
| Vanderbilt University | Nashville | Tennessee | 37232 | United States |
| Utah Diabetes Center | Salt Lake City | Utah | 84108 | United States |
| University of Wisconsin Health West | Madison | Wisconsin | 53717 | United States |
| Endocrine Research, Inc. | Vancouver | British Columbia | V6E1M7 | Canada |
| Health Science Center Memorial Hospital of Newfoundland | St. John's | Newfoundland and Labrador | A1B3V6 | Canada |
| Kingston General Hospital | Kingston | Ontario | K7M5L2 | Canada |
| Toronto General Hospital - UHN | Toronto | Ontario | M5G 2C4 | Canada |
| Bergenstal RM, Tamborlane WV, Ahmann A, Buse JB, Dailey G, Davis SN, Joyce C, Peoples T, Perkins BA, Welsh JB, Willi SM, Wood MA; STAR 3 Study Group. Effectiveness of sensor-augmented insulin-pump therapy in type 1 diabetes. N Engl J Med. 2010 Jul 22;363(4):311-20. doi: 10.1056/NEJMoa1002853. Epub 2010 Jun 29. |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | 722 Sensor Augmented Pump | 722 arm: MiniMed Paradigm REAL-Time System using NovoLog/NovoRapid for 1 year |
| BG001 | Multiple Daily Injection (MDI) | MDI arm: Continue with MDI using Lantus and NovoLog/NovoRapid for 1 year |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
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| Age, Customized | Number | participants |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change in A1c From Baseline to 52 Weeks | Change is defined as A1c at Week 52 minus A1c at Baseline in each study arm. The difference between the change in each group will then be analyzed. A1c measure is defined as the percent of glycated hemoglobin using one standardized assay for all subjects. | Posted | Mean | Standard Deviation | Percent glycated hemoglobin | Baseline and 52 weeks |
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| Secondary | Difference in Frequency of Severe Hypoglycemia From Baseline to Week 52; | Severe Hypoglycemia is defined as a hypoglycemic episode absolutely requiring assistance from another person and preferably accompanied by a confirmatory Blood Glucose (BG) by finger stick of less than 50 mg/dL (2.8 mmol/L). The frequency evaluates the total number of events. This will be analyzed and compared between the two study arms from baseline to week 52. | Posted | Number | number of events | Baseline and 52 weeks |
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| Secondary | Overall Difference in Rate of Severe Hypoglycemia Events Between Study Arms From Baseline to Week 52 | Severe Hypoglycemia is defined as a hypoglycemic episode absolutely requiring assistance from another person and preferably accompanied by a confirmatory BG by finger stick of less than 50 mg/dL (2.8 mmol/L). The rate evaluates the number of participants that experienced at least one severe hypoglycemia event and compares this number between the two study arms from Baseline to week 52. This measure identifies the rate or frequency of unique participant events. | Posted | Number | participants | Baseline and 52 weeks |
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| Secondary | Changes in Hypoglycemia Area Under the Curve (AUC) From Baseline to Week 52; | Hypoglycemia is defined as a recorded blood glucose event <70mg/dL. The amount of time spent below this parameter will be analyzed and compared between groups from Baseline to Week 52. | Posted | Mean | Standard Deviation | mmol/dl*min | Baseline and 52 weeks |
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| Secondary | Changes From Baseline in Hyperglycemia Area Under the Curve (AUC) From Baseline to Week 52 | Hyperglycemia is defined as a recorded blood glucose event > 180 mg/dL. The amount of time spent above this parameter will be analyzed and compared between groups from Baseline to Week 52. | Posted | Mean | Standard Deviation | mmol/dl*min | Baseline and 52 weeks |
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| Secondary | Quality of Life - Hypoglycemia Fear Scale (HFS), Overall Score | Difference of Baseline and 52 Weeks in Hypoglycemia Fear Scale (HFS) Overall Score between the two study arms (adult subjects only) is presented. Both baseline and 52 weeks scores range from 0-100, with lower scores suggest higher satisfaction. Therefore, a negative number in the difference suggests higher satisfaction at 52 Weeks than Baseline. | Adult population (18 and older) only | Posted | Jul 2011 | Mean | Standard Deviation | participants | Baseline and 52 weeks |
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| Secondary | Health Economic Outcome | Health Economic Outcome was a cost-effectiveness analysis combining estimates from the trial and the literature to populate the previously validated Center for Outcomes Research (CORE) Diabetes Model. Results represent the use of 3-day sensors. This analysis was restricted to only adult subjects (Age 19 to 70), therefore the number of participant analyzed is different. The goal was to estimate the long term cost effectiveness of Sensor Augmented Pump therapy from the perspective of the US health care system. The unit of measurement was cost in $ per year for sensor augmented pump group and MDI group. No formal statistical analysis was planned or performed | Posted | Number | $ | Baseline and 52 weeks |
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| Secondary | Quality of Life - Short Form-36 (SF-36v2™), General Health | Difference of Baseline and 52 Weeks in Short Form-36 (SF-36v2™), General Health, between the two study arms (adult subjects only) is presented. Both baseline and 52 weeks scores range from 0-100, with higher scores suggest higher satisfaction. Therefore, a positive number in the difference suggests higher satisfaction at 52 Weeks than Baseline. | Adult population (18 and older) only | Posted | Mean | Standard Deviation | Participants | Baseline and 52 Weeks |
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| Secondary | Quality of Life - Insulin Delivery System Rating Questionnaire (IDSRQ) for Subject Satisfaction With Type of Insulin Therapy | Difference of Baseline and 52 Weeks in Insulin Delivery System Rating Questionnaire (IDSRQ) for Subject Satisfaction with Type of Insulin Therapy, between the two study arms is presented. Both baseline and 52 weeks scores range from 0-100, with higher scores suggest higher satisfaction. Therefore, a positive number in the difference suggests higher satisfaction at 52 Weeks than Baseline. | Posted | Mean | Standard Deviation | participants | Baseline and 52 Weeks |
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | 722 Sensor Augmented Pump | 722 arm: MiniMed Paradigm REAL-Time System using NovoLog/NovoRapid for 1 year | 0 | 244 | 32 | 244 | 96 | 244 |
| EG001 | Multiple Daily Injection (MDI) | MDI arm: Continue with MDI using Lantus and NovoLog/NovoRapid for 1 year | 0 | 241 | 30 | 241 | 49 | 241 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Retinal Haemorrhage | Eye disorders | MedDRA 8.0 | Systematic Assessment |
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| Coronary Artery Disease | Cardiac disorders | MedDRA (8.0) | Systematic Assessment |
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| Hypoglycemia | Metabolism and nutrition disorders | MedDRA (8.0) | Non-systematic Assessment |
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| Hypoglycemia (Severe Hypoglycemia) | Metabolism and nutrition disorders | MedDRA (8.0) | Non-systematic Assessment |
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| Cardiac Arrest | Cardiac disorders | MedDRA (8.0) | Systematic Assessment |
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| Hypoglycemia | Metabolism and nutrition disorders | MedDRA (8.0) | Systematic Assessment |
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| Hypoglycemia (Severe Hypoglycemia) | Metabolism and nutrition disorders | MedDRA (8.0) | Systematic Assessment |
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| Pneumonia | Infections and infestations | MedDRA (8.0) | Systematic Assessment |
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| Diabetic Ketoacidosis (Ketoacidosis) | Metabolism and nutrition disorders | MedDRA (8.0) | Systematic Assessment |
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| Fibula Fracture (Fracture of Left Lower Leg, Fibula at Ankle) | Injury, poisoning and procedural complications | MedDRA (8.0) | Systematic Assessment |
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| Gastroenteritis (Acute Gastroenteritis) | Infections and infestations | MedDRA (8.0) | Systematic Assessment |
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| Urinary Tract Infection | Infections and infestations | MedDRA (8.0) | Systematic Assessment |
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| Non-Cardiac (Atypical) Chest Pain | General disorders | MedDRA (8.0) | Systematic Assessment |
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| Skin Laceration (Traumatic Laceration to Dorsum of the Right Foot with extensor Hallucis Longus Tear | Injury, poisoning and procedural complications | MedDRA (8.0) | Systematic Assessment |
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| Breast Cancer (Left Breast Cancer: Invasive Ductal Adenocarcinoma) | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (8.0) | Systematic Assessment |
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| Urethral Injury (Urethral Tear) | Injury, poisoning and procedural complications | MedDRA (8.0) | Systematic Assessment |
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| Cellulitis (Cellulitis of Left Lower Leg) | Infections and infestations | MedDRA (8.0) | Systematic Assessment |
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| Acute Pancreatitis | Gastrointestinal disorders | MedDRA (8.0) | Systematic Assessment |
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| Pulmonary Hypertension | Respiratory, thoracic and mediastinal disorders | MedDRA (8.0) | Systematic Assessment |
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| Limb Crushing Injury (Crush Injury to Right Lateral Thigh) | Injury, poisoning and procedural complications | MedDRA (8.0) | Systematic Assessment |
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| Syncope Vasovagal (Syncope Vasovagal Response) | Nervous system disorders | MedDRA (8.0) | Systematic Assessment |
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| Nephrolithiasis (Kidney Stones) | Renal and urinary disorders | MedDRA (8.0) | Systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | MedDRA (8.0) | Systematic Assessment |
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| Gastroenteritis | Infections and infestations | MedDRA (8.0) | Systematic Assessment |
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| Supraventricular Tachycardia | Cardiac disorders | MedDRA (8.0) | Systematic Assessment |
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| Ketoacidosis | Metabolism and nutrition disorders | MedDRA (8.0) | Systematic Assessment | Did not meet protocol criteria for DKA |
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| Hypoglycemia | Metabolism and nutrition disorders | MedDRA (8.0) | Systematic Assessment | Did not meet protocol definition of Severe Hypoglycemia |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hypoglycemia | Metabolism and nutrition disorders | MedDRA (8.0) | Non-systematic Assessment |
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| Infusion/application site infection/abscess | Infections and infestations | MedDRA (8.0) | Systematic Assessment |
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| Application site bleeding/bruising/irritation/pain | General disorders | MedDRA (8.0) | Systematic Assessment |
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| Diabetic ketoacidosis | Metabolism and nutrition disorders | MedDRA (8.0) | Non-systematic Assessment |
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| Hyperglycemia | Metabolism and nutrition disorders | MedDRA (8.0) | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Scott Lee, M.D. | Medtronic | 8185764204 | scott.w.lee@medtronic.com |
| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
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| Between 19 and 70 years |
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| Male |
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| Canada |
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Superiority test with margin of 0.35 |
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