NCT04201496

Brief Summary

The primary purpose of this study is to evaluate the safety and efficacy of combining SGLT2 inhibitors with closed loop control (CLC).

Trial Health

87
On Track

Trial Health Score

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

Enrollment
34

participants targeted

Target at P50-P75 for phase_1

Timeline
Completed

Started Feb 2020

Geographic Reach
1 country

1 active site

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

First Submitted

Initial submission to the registry

November 4, 2019

Completed
1 month until next milestone

First Posted

Study publicly available on registry

December 17, 2019

Completed
2 months until next milestone

Study Start

First participant enrolled

February 24, 2020

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 7, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 7, 2021

Completed
Last Updated

August 11, 2022

Status Verified

August 1, 2022

Enrollment Period

1.5 years

First QC Date

November 4, 2019

Last Update Submit

August 9, 2022

Conditions

Keywords

Artificial Pancreas (AP)Sodium-glucose co-transporter 2 (SGLT2) inhibitorInsulin PumpsContinuous Glucose Monitor (CGM)Closed Loop ControlLow blood glucose index (LBGI)High blood glucose index (HBGI)

Outcome Measures

Primary Outcomes (1)

  • CGM-measured time in the target range 70-180mg/dl (TIR) during the day

    CGM-measured time in the target range 70-180mg/dl (TIR) during the day

    6 weeks

Secondary Outcomes (14)

  • Time below 70 mg/dl

    6 weeks

  • Time above 180 mg/dl

    6 weeks

  • Time between 70-140 mg/dl 5 hours post prandial

    6 weeks

  • Glucose variability index HBGI

    6 weeks

  • Glucose variability index LBGI

    6 weeks

  • +9 more secondary outcomes

Study Arms (4)

Empagliflozin + Control-IQ x 4 wks then Basal-IQ x 2 wks

EXPERIMENTAL

Control-IQ x 4 weeks (CiQ-EMPA) then Basal-IQ x 2 weeks (BiQ-EMPA)

Combination Product: Empagliflozin + Control-IQ x 4 wks then Basal-IQ x 2 wks

Empagliflozin + Basal-IQ x 2 wks then CiQ x 4 wks

EXPERIMENTAL

Basal-IQ x 2 weeks (BiQ-EMPA) then Control-IQ x 4 weeks (CiQ-EMPA)

Combination Product: Empagliflozin + Basal-IQ x 2 wks then Control-IQ x 4 wks

No Empagliflozin + Control-IQ x 4 wks then Basal-IQ x 2 wks

ACTIVE COMPARATOR

Control-IQ x 4 weeks (CiQ-NO EMPA) then Basal-IQ x 2 weeks (BiQ-NO EMPA)

Device: No Empagliflozin + Control-IQ x 4 wks then Basal-IQ x 2 wks

No Empagliflozin + Basal-IQ x 2 wks then Control-IQ x 4 wks

ACTIVE COMPARATOR

Basal-IQ x 2 weeks (BiQ-NO EMPA) then Control-IQ x 4 weeks (CiQ-NO EMPA)

Device: No Empagliflozin + Basal-IQ x 2 wks then Control-IQ x 4 wks

Interventions

Participants with be provided with Empagliflozin to take daily for approximately 10 weeks. Along with the study medication, participants will initially use the Tandem t:slim insulin pump with Control-IQ Technology for 4 weeks. Participants will then transition to using the Tandem t:slim insulin pump with Basal-IQ Technology for 2 weeks.

Empagliflozin + Control-IQ x 4 wks then Basal-IQ x 2 wks

Participants with be provided with Empagliflozin to take daily for approximately 10 weeks. Along with the study medication, participants will initially use the Tandem t:slim insulin pump with Basal-IQ Technology for 2 weeks. Participants will then transition to using the Tandem t:slim insulin pump with Control-IQ Technology for 4 weeks.

Empagliflozin + Basal-IQ x 2 wks then CiQ x 4 wks

Participants will initially use the Tandem t:slim insulin pump with Control-IQ Technology for 4 weeks. Participants will then transition to using the Tandem t:slim insulin pump with Basal-IQ Technology for 2 weeks. Empaglizflozin will not be provided to this group.

No Empagliflozin + Control-IQ x 4 wks then Basal-IQ x 2 wks

Participants will initially use the Tandem t:slim insulin pump with Basal-IQ Technology for 2 weeks. Participants will then transition to using the Tandem t:slim insulin pump with Control-IQ Technology for 4 weeks. Empaglizflozin will not be provided to this group.

No Empagliflozin + Basal-IQ x 2 wks then Control-IQ x 4 wks

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age ≥18.0 and ≤65 years old at time of consent
  • Clinical diagnosis, based on investigator assessment, of type 1 diabetes for at least one year
  • Currently using an insulin pump for at least six months
  • Currently using insulin for at least six months
  • Using insulin parameters such as carbohydrate ratio and correction factors consistently on their pump in order to dose insulin for meals or corrections
  • Access to internet and willingness to upload data during the study as needed
  • For females, not currently known to be pregnant or breastfeeding
  • If female and sexually active, must agree to use a form of contraception to prevent pregnancy while a participant in the study. A negative serum or urine pregnancy test will be required for all females of childbearing potential. Participants who become pregnant will be discontinued from the study. Also, participants who during the study develop and express the intention to become pregnant within the timespan of the study will be discontinued.
  • Willingness to suspend use of any personal CGM for the duration of the clinical trial once the study CGM is in use
  • Willingness to switch to lispro (Humalog) or aspart (Novolog) if not using already, and to use no other insulin besides lispro (Humalog) or aspart (Novolog) during the study
  • Total daily insulin dose (TDD) at least 10 U/day
  • Willingness not to start any new non-insulin glucose-lowering agent during the course of the trial (including metformin, GLP-1 agonists, pramlintide, DPP-4 inhibitors, biguanides, sulfonylureas and naturaceuticals)
  • Willingness to eat at least 100 grams of carbohydrates per day
  • An understanding and willingness to follow the protocol and signed informed consent
  • Pilot Participants: Agree to hotel/research house admission with other Pilot participants on a date selected by the study team.

You may not qualify if:

  • Hemoglobin A1c \>9%
  • History of diabetic ketoacidosis (DKA) in the 12 months prior to enrollment
  • Severe hypoglycemia resulting in seizure or loss of consciousness in the 12 months prior to enrollment
  • Pregnancy or intent to become pregnant during the trial
  • Currently breastfeeding or planning to breastfeed
  • Currently being treated for a seizure disorder
  • Planned surgery during study duration
  • History of cardiac arrhythmia (except for benign premature atrial contractions and benign premature ventricular contractions which are permitted)
  • Clinically significant electrocardiogram (ECG) abnormality at time of Screening, as interpreted by the study medical physician
  • Use of diuretics (e.g. Lasix, Thiazides)
  • History of chronic or recurrent genital infections
  • eGFR lab value below 60 mL/min/1.73 m2
  • Treatment with any non-insulin glucose-lowering agent (including metformin, GLP-1 agonists, pramlintide, DPP-4 inhibitors, SGLT-2 inhibitors, biguanides, sulfonylureas and naturaceuticals)
  • A known medical condition that in the judgment of the investigator might interfere with the completion of the protocol such as the following examples:
  • Severe renal impairment, end-stage renal disease, or dialysis
  • +9 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Virginia, Center for Diabetes Technology

Charlottesville, Virginia, 22903, United States

Location

Related Publications (1)

  • Garcia-Tirado J, Farhy L, Nass R, Kollar L, Clancy-Oliveri M, Basu R, Kovatchev B, Basu A. Automated Insulin Delivery with SGLT2i Combination Therapy in Type 1 Diabetes. Diabetes Technol Ther. 2022 Jul;24(7):461-470. doi: 10.1089/dia.2021.0542. Epub 2022 Mar 14.

MeSH Terms

Conditions

Diabetes Mellitus, Type 1

Interventions

empagliflozin

Condition Hierarchy (Ancestors)

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

Study Officials

  • Ananda Basu, MD

    University of Virginia

    PRINCIPAL INVESTIGATOR
  • Ralf Nass, MD

    University of Virginia

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
phase 1
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
CROSSOVER
Model Details: Participants will be first randomized to taking empagliflozin or not taking this drug. Participants will then be randomized to using the Basal-IQ insulin pump first or the Control-IQ insulin pump first. Participants then transition to using the other pump. With empagliflozin: * Control-IQ x 4 weeks (CiQ-EMPA) then Basal-IQ x 2 weeks (BiQ-EMPA) * Basal-IQ x 2 weeks (BiQ-EMPA) then Control-IQ x 4 weeks (CiQ-EMPA) Without empagliflozin: * Control-IQ x 4 weeks (CiQ-NO EMPA) then Basal-IQ x 2 weeks (BiQ-NO EMPA) * Basal-IQ x 2 weeks (BiQ-NO EMPA) then Control-IQ x 4 weeks (CiQ-NO EMPA)
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

November 4, 2019

First Posted

December 17, 2019

Study Start

February 24, 2020

Primary Completion

September 7, 2021

Study Completion

September 7, 2021

Last Updated

August 11, 2022

Record last verified: 2022-08

Data Sharing

IPD Sharing
Will share

To be determined

Shared Documents
STUDY PROTOCOL
Time Frame
After publication for one year

Locations