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This study is a multi-center, single arm and in-clinic study to evaluate the safety of the PLGM System and its algorithm with the Enlite 3 Sensor.
A total of up to 95 subjects with type 1 diabetes (age 14-75 years old) will be enrolled at up to 8 investigational centers in order to reach a minimum of 60 subjects who will complete the study (N=minimum 40 adult subjects, 22-75 years old) and N=minimum 15 pediatric subjects (14-21 years old). Subjects will be evaluated in an in-clinic setting with induction of hypoglycemia by increasing their basal rate using a standardized titration tool referred to in protocol as rate of change basal increase algorithm (Buckingham, Diabetes Care 5, 2010). Total duration of frequent sample testing (FST) using Yellow Springs Instrument (YSI) may be up to 19 hours.
Subjects will undergo in-clinic testing on Sensor Day 1.
All subjects will undergo hypoglycemic induction at Visit 2 with target set to 65 mg/dL using the rate of change basal increase algorithm. Low Limit setting when PLGM ON is 65 mg/dL.
The In-Clinic part of the study consists of hypoglycemic induction and an observation period.
Hypoglycemic induction ends when one of the following 3 criteria is met, whichever comes first:
Observation with YSI ends when:
Enrollment for this study will proceed in phases.
Phase 1 only allows enrollment of adult subjects (22-75 years). Subjects will wear pump system, as shown below:
Progression to Phase 2 may occur after 10 adult subjects have completed Phase 1 and a Data Safety Monitoring Board (DSMB) has approved that it is safe to continue on to Phase 2.
Phase 2 enrollment involves a minimum of 15 pediatric subjects (14-21). Subjects will wear the same pump system as shown for Phase 1.
A total of up to 95 subjects will be enrolled at up to 10 investigational centers in order to reach a minimum of 60 subjects (N=minimum 40 adult subjects and N=minimum 15 pediatric subjects) who will complete the study.
Considering around 15% screen failure rate and approximately 15% drop-out rate, a total of up to 95 subjects will be enrolled in order to have 60 subjects complete the study.
The study is anticipated to last no longer than 12 months from investigational center initiation to completion of all data entry and monitoring procedures including final report. Subjects can expect to participate for approximately 2-3 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Predictive Low Glucose Management (PLGM) | Experimental | To evaluate the safety of the Predictive Low Glucose Management feature in insulin pump algorithm with the Enlite 3 Sensor |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Predictive Low Glucose Management Feature in Insulin pump | Device | All subjects will undergo hypoglycemic induction at Visit 2 with target set to 65 mg/dL using the rate of change basal increase algorithm. Low Limit setting when PLGM ON is 65 mg/dL. |
| Measure | Description | Time Frame |
|---|---|---|
| Serious Adverse Events (SAE) | Evaluation of incidence of SAE during in-clinic procedures | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
| Unanticipated Device Effect (UADE) | Evaluation of incidence of UADE during in-clinic procedures | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
| Severe Hypoglycemia | Evaluation of incidence of severe hypoglycemia during in-clinic procedures | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
| Diabetic Ketoacidosis | Evaluation of DKA during in-clinic procedures | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
| Rescue Events During In-clinic Procedues | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
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| Measure | Description | Time Frame |
|---|---|---|
| PLGM Performance - Hypoglycemia Event Rate at Threshold of YSI <= 65 mg/dL. | Hypoglycemic event rate among 71 subjects who underwent the PLGM experiment. Hypoglycemic events are defined based on: occurrence of 2 or more continuous YSI <= 65 mg/dL during in-clinic procedures. | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
Inclusion Criteria:
Subject is 14-75 years of age at time of screening
Subject has a clinical diagnosis of type 1 diabetes, as determined via medical record or source documentation by an individual qualified to make a medical diagnosis
Inclusion Criteria that are Based on Demands of In-Clinic Study Procedures
On pump therapy at the time of screening with insulin sensitivity and insulin carbohydrate ratio
Adequate venous access as assessed by investigator or appropriate staff
Exclusion Criteria:
Exclusion Criteria that are Based on Demands of In-Clinic Study Procedures
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| Name | Affiliation | Role |
|---|---|---|
| Scott Lee, MD | Medtronic MiniMed, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| AMCR Institute, Inc. | Escondido | California | 92026 | United States | ||
| Stanford University Department of Pediatric Endocrinology |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28221823 | Derived | Buckingham BA, Bailey TS, Christiansen M, Garg S, Weinzimer S, Bode B, Anderson SM, Brazg R, Ly TT, Kaufman FR. Evaluation of a Predictive Low-Glucose Management System In-Clinic. Diabetes Technol Ther. 2017 May;19(5):288-292. doi: 10.1089/dia.2016.0319. Epub 2017 Feb 16. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Predictive Low Glucose Management (PLGM) | To evaluate the safety of the Predictive Low Glucose Management feature in insulin pump algorithm with the Enlite 3 Sensor Predictive Low Glucose Management Feature in Insulin pump: All subjects will undergo hypoglycemic induction at Visit 2 with target set to 65 mg/dL using the rate of change basal increase algorithm. Low Limit setting when PLGM ON is 65 mg/dL. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Predictive Low Glucose Management (PLGM) | To evaluate the safety of the Predictive Low Glucose Management feature in insulin pump algorithm with the Enlite 3 Sensor Predictive Low Glucose Management Feature in Insulin pump: All subjects will undergo hypoglycemic induction at Visit 2 with target set to 65 mg/dL using the rate of change basal increase algorithm. Low Limit setting when PLGM ON is 65 mg/dL. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| 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 | Serious Adverse Events (SAE) | Evaluation of incidence of SAE during in-clinic procedures | Posted | Count of Participants | Participants | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
|
|
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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 | Predictive Low Glucose Management (PLGM) | To evaluate the safety of the Predictive Low Glucose Management feature in insulin pump algorithm with the Enlite 3 Sensor Predictive Low Glucose Management Feature in Insulin pump: All subjects will undergo hypoglycemic induction at Visit 2 with target set to 65 mg/dL using the rate of change basal increase algorithm. Low Limit setting when PLGM ON is 65 mg/dL. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Upper respiratory infection | Infections and infestations | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Suiying Huang, Statistician | Medtronic Minimed | 818-576-3319 | suiying.huang@medtronic.com |
Not provided
| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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|
| Sensor Performance: Accuracy | MARD (Mean Absolute Relative Difference) between sensor glucose value and YSI. MARD = Mean of ((Absolute difference of YSI reference and Sensor glucose values / YSI reference glucose values) * 100). | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
| Device Metric/Performance - All Device Deficiencies | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
| Stanford |
| California |
| 94305 |
| United States |
| Diablo Clinical Research | Walnut Creek | California | 94598 | United States |
| Barbara Davis Center of Childhood Diabetes | Denver | Colorado | 80045 | United States |
| Yale University Diabetes Research Program | New Haven | Connecticut | 06519 | United States |
| Atlanta Diabetes Associates | Atlanta | Georgia | 30318 | United States |
| University of Virgina | Charlottesville | Virginia | 22903 | United States |
| Rainier Clinical Research | Renton | Washington | 98057 | United States |
| Subject was screened as backup for study |
|
| Screen Failure |
|
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Counts |
|---|
| Participants |
|
|
| Primary | Unanticipated Device Effect (UADE) | Evaluation of incidence of UADE during in-clinic procedures | Posted | Count of Participants | Participants | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
|
|
|
| Primary | Severe Hypoglycemia | Evaluation of incidence of severe hypoglycemia during in-clinic procedures | Posted | Count of Participants | Participants | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
|
|
|
| Primary | Diabetic Ketoacidosis | Evaluation of DKA during in-clinic procedures | Posted | Count of Participants | Participants | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
|
|
|
| Primary | Rescue Events During In-clinic Procedues | Posted | Count of Participants | Participants | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
|
|
|
| Other Pre-specified | PLGM Performance - Hypoglycemia Event Rate at Threshold of YSI <= 65 mg/dL. | Hypoglycemic event rate among 71 subjects who underwent the PLGM experiment. Hypoglycemic events are defined based on: occurrence of 2 or more continuous YSI <= 65 mg/dL during in-clinic procedures. | Two subjects were excluded from analysis because the site staff did not set the pump up correctly prior to YSI and the PLGM feature was never set to activate. | Posted | Number | percentage of total subjects | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
|
|
|
| Other Pre-specified | Sensor Performance: Accuracy | MARD (Mean Absolute Relative Difference) between sensor glucose value and YSI. MARD = Mean of ((Absolute difference of YSI reference and Sensor glucose values / YSI reference glucose values) * 100). | Total of 71 subjects completed the study. However, two subjects who withdrew also had YSI and Sensor glucose values. Therefore, total of 73 subjects contributed to sensor accuracy analysis | Posted | Mean | Standard Deviation | percentage | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
|
|
|
| Other Pre-specified | Device Metric/Performance - All Device Deficiencies | Posted | Number | device performance issues | From start of in clinic procedures until the end of the study, which may occur up to 48 hours after the start of in-clinic procedures |
|
|
|
| 0 |
| 80 |
| 5 |
| 80 |
| Mild back strain | Injury, poisoning and procedural complications | Systematic Assessment |
|
| emesis | Gastrointestinal disorders | Systematic Assessment |
|
| headache | Nervous system disorders | Systematic Assessment |
|
| pain | General disorders | Systematic Assessment |
|
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| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |