NCT01497938

Brief Summary

Introduction: The purpose of the pivotal In Home study is to collect clinical data on the safety and efficacy of the Paradigm LGS System in the actual use environment and by the intended use population. ASPIRE is a multi-center, in home, randomized parallel adaptive study design with type 1 diabetes. The study will compare A1C and CGM based nocturnal hypoglycemic events in a treatment arm to a control arm. Arms are defined as:

  • Treatment Arm (LGS ON) using Paradigm® VEO™ Pump
  • Control Arm (NO LGS FEATURE ) using Paradigm® Revel™2.0 Pump The study's objectives are two-fold:
  • The first study objective is to demonstrate that home use of Low Glucose Suspend (LGS) is safe and is not associated with glycemic deterioration, as measured by change in A1C from baseline to end of study participation.
  • The second study objective is to demonstrate that home use of Low Glucose Suspend (LGS) is associated with reduction in nocturnal hypoglycemia when patients fail to respond.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
247

participants targeted

Target at P50-P75 for phase_3

Timeline
Completed

Started Dec 2011

Geographic Reach
1 country

17 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

December 1, 2011

Completed
17 days until next milestone

First Submitted

Initial submission to the registry

December 18, 2011

Completed
5 days until next milestone

First Posted

Study publicly available on registry

December 23, 2011

Completed
1.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2013

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2013

Completed
10 months until next milestone

Results Posted

Study results publicly available

March 17, 2014

Completed
Last Updated

March 17, 2014

Status Verified

January 1, 2014

Enrollment Period

1.5 years

First QC Date

December 18, 2011

Results QC Date

October 24, 2013

Last Update Submit

January 31, 2014

Conditions

Outcome Measures

Primary Outcomes (2)

  • Change in A1C From Baseline to End of Study Participation

    The first study objective is to demonstrate that home use of Low Glucose Suspend (LGS) is safe and is not associated with glycemic deterioration, as measured by change in A1C from baseline to end of study participation.

    5 months

  • The Event Area Under the Curve (AUC) Was Used to Demonstrate the Reduction of Nocturnal Hypoglycemia With the Low Glucose Suspend (LGS) Feature (LGS ON)

    An event is identified as: LGS feature in the correct setting; CGM values \<= 65 mg/dL continuously with starting time between 10pm - 8am; No evidence of patient intervention during the first 20 minutes when CGM value was \<= 65 mg/dL; The rate of change before reaching sensor glucose value of \<= 65 mg/dL was \<= 5 mg/dl/minutes; If the time between two successive events was less than 30 minutes, they will be combined as one event; An evaluable event is defined as any event with CGM value \<= 65 mg/dL of greater than 20 minutes and the LGS feature is on the correct setting; Event AUC analysis was performed based on logarithm of AUC data.

    5 months

Study Arms (2)

Low Glucose Suspend feature (LGS)

EXPERIMENTAL

According to randomization, Low Glucose Suspend (LGS) will be turned ON in the treatment arm of the study

Device: Medtronic MMT-754 Veo Insulin pump testing Low Glucose Suspend (LGS) feature

Control Arm

EXPERIMENTAL

The Low Glucose Suspend feature will not be available to subjects in the control arm

Device: Medtronic (NO LGS FEATURE ) using Paradigm® Revel™2.0 Pump

Interventions

Automatic suspension of insulin delivery when glucose is low.

Low Glucose Suspend feature (LGS)

No Automatic suspension of insulin delivery when glucose is low.

Control Arm

Eligibility Criteria

Age16 Years - 70 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Subjects who are 16-21 years are determined by the investigator to have the appropriate, requisite support (family, caregiver or social network) to successfully participate in this study
  • Subjects who are determined by the investigator to be psychologically sound in order to successfully participate in this study.
  • Subject was \< 40 years at disease onset
  • Subject has been diagnosed with type 1 diabetes ≥ 2 years
  • Subject is willing to perform ≥ 4 finger stick blood glucose measurements daily
  • Subject is willing to perform required sensor calibrations
  • Subject is willing to wear the system continuously throughout the study
  • Subject is willing to keep a log to record at minimum:
  • Sick days
  • Days with exercise and days with symptoms of low glucose
  • Subject has an A1C value 5.8% to 10.0% (as processed by Central Lab) at time of screening visit
  • Subject must be on pump therapy use for \>6 months prior to Screening
  • Subject has been followed by a well trained diabetes health care provider(s) for 6 months prior to screening
  • Subject is willing to upload data weekly from the study pump, must have Internet access and a computer system that meets the requirements for uploading the study pump
  • If subject has celiac disease, it has been adequately treated as determined by the investigator
  • +3 more criteria

You may not qualify if:

  • Subject has a history of 2 or more episodes of severe hypoglycemia, which resulted in any the following during the 6 months prior to screening:
  • Medical assistance (i.e. Paramedics, Emergency room or Hospitalization)
  • Coma
  • Seizures
  • Subject is unable to tolerate tape adhesive in the area of sensor placement
  • Subject has any unresolved adverse skin condition in the area of sensor placement (e.g., psoriasis, rash, Staphylococcus infection)
  • Women of child-bearing potential who have a positive pregnancy test at screening or plan to become pregnant during the course of the study
  • Subject has had any of the following new diagnoses within 1 year of screening: myocardial infarction, unstable angina, coronary artery bypass surgery, coronary artery stenting, transient ischemic attack, cerebrovascular accident, angina, congestive heart failure, ventricular rhythm disturbances or thromboembolic disease
  • Subject is being treated for hyperthyroidism at time of screening
  • Subject has an abnormality (out of upper reference range, as processed by Central Lab) in creatinine at time of screening visit
  • Subject has an abnormality (out of reference range, as processed by Central Lab) in thyroid-stimulating hormone (TSH) at time of screening visit
  • Subject has taken any oral, injectable, or IV steroids within 8 weeks from time of screening visit, or plans to take any oral, injectable, or IV steroids during the course of the study
  • Subject is actively participating in an investigational study (drug or device) wherein he/she has received treatment from an investigational study drug or investigational study device in the last 2 weeks
  • Subject has been hospitalized or has visited the emergency room in the 6 months prior to screening resulting in a primary diagnosis of uncontrolled diabetes
  • Subject is currently abusing illicit drugs
  • +12 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (17)

Arkansas Diabetes Clinic and Research Center

Little Rock, Arkansas, 72205, United States

Location

AMCR Institute, Inc

Escondido, California, 92026, United States

Location

Frank Diabetes Research Institute/ Mills-Peninsula Health Center

San Mateo, California, 94401, United States

Location

University of Colorado Denver/ Barbara Davis Center for Childhood Diabetes

Aurora, Colorado, 80045, United States

Location

Metabolic Research Institute

West Palm Beach, Florida, 33401, United States

Location

Atlanta Diabetes Associates

Atlanta, Georgia, 30309, United States

Location

Physicians Research Associates

Lawrenceville, Georgia, 30046, United States

Location

Endocrine Research Solutions

Roswell, Georgia, 30046, United States

Location

Rocky Mountains Diabetes and Osteoporosis Center

Idaho Falls, Idaho, 83404, United States

Location

Iowa Diabetes and Endocrinology Research Center

Des Moines, Iowa, 50314, United States

Location

International Diabetes Center

Minneapolis, Minnesota, 55416, United States

Location

Naomie Barrie Diabetes Center

New York, New York, 10032, United States

Location

Joslin Diabetes Center

Syracuse, New York, 13210, United States

Location

Ohio University College of Osteopathic Medicine

Athens, Ohio, 45701, United States

Location

Texas Diabetes

Austin, Texas, 78731, United States

Location

Rainier Clinical Research Center

Renton, Washington, 98057, United States

Location

University of Wisconsin - Madison

Madison, Wisconsin, 53717, United States

Location

Related Publications (4)

  • Weiss R, Garg SK, Bode BW, Bailey TS, Ahmann AJ, Schultz KA, Welsh JB, Shin JJ. Hypoglycemia Reduction and Changes in Hemoglobin A1c in the ASPIRE In-Home Study. Diabetes Technol Ther. 2015 Aug;17(8):542-7. doi: 10.1089/dia.2014.0306. Epub 2015 Jun 2.

  • Weiss R, Garg SK, Bergenstal RM, Klonoff DC, Bode BW, Bailey TS, Thrasher J, Schwartz F, Welsh JB, Kaufman FR; ASPIRE In-Home Study Group. Predictors of Hypoglycemia in the ASPIRE In-Home Study and Effects of Automatic Suspension of Insulin Delivery. J Diabetes Sci Technol. 2015 May 18;9(5):1016-20. doi: 10.1177/1932296815586014.

  • Klonoff DC, Bergenstal RM, Garg SK, Bode BW, Meredith M, Slover RH, Ahmann A, Welsh JB, Lee SW. ASPIRE In-Home: rationale, design, and methods of a study to evaluate the safety and efficacy of automatic insulin suspension for nocturnal hypoglycemia. J Diabetes Sci Technol. 2013 Jul 1;7(4):1005-10. doi: 10.1177/193229681300700424.

  • Bergenstal RM, Klonoff DC, Garg SK, Bode BW, Meredith M, Slover RH, Ahmann AJ, Welsh JB, Lee SW, Kaufman FR; ASPIRE In-Home Study Group. Threshold-based insulin-pump interruption for reduction of hypoglycemia. N Engl J Med. 2013 Jul 18;369(3):224-32. doi: 10.1056/NEJMoa1303576. Epub 2013 Jun 22.

MeSH Terms

Conditions

Diabetes Mellitus, Type 1

Condition Hierarchy (Ancestors)

Diabetes MellitusGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesAutoimmune DiseasesImmune System Diseases

Results Point of Contact

Title
Thomas Troub
Organization
Medtronic

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

December 18, 2011

First Posted

December 23, 2011

Study Start

December 1, 2011

Primary Completion

June 1, 2013

Study Completion

June 1, 2013

Last Updated

March 17, 2014

Results First Posted

March 17, 2014

Record last verified: 2014-01

Locations