NCT06046417

Brief Summary

The aim of this clinical trial is to investigate whether a fully automated Lyumjev-and-pramlintide delivery system improves glycemic outcomes in adults with type 1 diabetes. The main question we aim to answer is whether a Lyumjev-pramlintide fully closed loop system improves time in range compared to a hybrid closed loop system with carbohydrate counting. We also aim to find the optimal insulin to pramlintide ratio for glycemic control in the fully automated system. In this cross-over study, patients will undergo the following three interventions in a random order: (i) fully automated Lyumjev insulin-and-pramlintide (8 μg/u) (ii) fully automated Lyumjev insulin-and-pramlintide (10 μg/u) (iii) rapid automated Lyumjev insulin-and-placebo with carbohydrate-matched boluses For all interventions, participants will be required to wear two Ypsomed pumps programmed by our developed EuGlide system.

Trial Health

57
Monitor

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
30

participants targeted

Target at P25-P50 for phase_2

Timeline
Completed

Started Nov 2023

Shorter than P25 for phase_2

Geographic Reach
1 country

1 active site

Status
recruiting

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

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 12, 2023

Completed
9 days until next milestone

First Posted

Study publicly available on registry

September 21, 2023

Completed
2 months until next milestone

Study Start

First participant enrolled

November 30, 2023

Completed
1.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 1, 2025

Completed
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2025

Completed
Last Updated

April 18, 2024

Status Verified

April 1, 2024

Enrollment Period

1.3 years

First QC Date

September 12, 2023

Last Update Submit

April 16, 2024

Conditions

Keywords

Pramlintidefully automated delivery systemartificial pancreasInsulinLyumjevfully closed loopadjunctive

Outcome Measures

Primary Outcomes (1)

  • Percentage of time of glucose levels spent in the target range (3.9-10.0 mmol/L).

    18 days

Secondary Outcomes (14)

  • Percentage of time of glucose levels spent between 3.9-7.8 mmol/L.

    18 days

  • Percentage of time of glucose levels spent between 3.0-3.9 mmol/L.

    18 days

  • Percentage of time of glucose levels spent between 10.0-13.9 mmol/L.

    18 days

  • Mean glucose levels.

    18 days

  • Standard deviation of glucose levels.

    18 days

  • +9 more secondary outcomes

Other Outcomes (1)

  • Safety Endpoints

    18 days

Study Arms (3)

Fully automated Lyumjev-and-pramlintide delivery system (8 μg/u)

EXPERIMENTAL

Lyumjev and pramlintide fully automated delivery system with no meal announcement. Ratio of 1 unit of insulin for 8 μg of pramlintide.

Drug: PramlintideDrug: LyumjevDevice: Automated Insulin Delivery (AID) system

Fully automated Lyumjev-and-pramlintide delivery system (10 μg/u)

EXPERIMENTAL

Lyumjev and pramlintide fully automated delivery system with no meal announcement. Ratio of 1 unit of insulin for 10 μg of pramlintide.

Drug: PramlintideDrug: LyumjevDevice: Automated Insulin Delivery (AID) system

Hybrid automated Lyumjev-and-placebo delivery system with carbohydrate-matched boluses

ACTIVE COMPARATOR

Lyumjev and saline placebo hybrid automated delivery system with meal announcement. Participants must input the carbohydrate content of their meals to inform the insulin bolus doses based on their pre-programmed insulin-to-carbohydrate ratios.

Drug: Lyumjev

Interventions

Pramlintide delivered in a basal-bolus manner.

Fully automated Lyumjev-and-pramlintide delivery system (10 μg/u)Fully automated Lyumjev-and-pramlintide delivery system (8 μg/u)

Lyumjev delivered in a basal-bolus manner.

Fully automated Lyumjev-and-pramlintide delivery system (10 μg/u)Fully automated Lyumjev-and-pramlintide delivery system (8 μg/u)Hybrid automated Lyumjev-and-placebo delivery system with carbohydrate-matched boluses

The AID system consists of a set of devices that work inter-connectedly to automate insulin (and pramlintide) delivery in response to an individual's glucose levels. It consists of a (i) Dexcom G6 glucose sensor, (ii) a smartphone-based algorithm, (iii) an insulin YpsoPump, and (iv) a pramlintide/placebo YpsoPump in a dual hormone configuration.

Fully automated Lyumjev-and-pramlintide delivery system (10 μg/u)Fully automated Lyumjev-and-pramlintide delivery system (8 μg/u)

Eligibility Criteria

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

You may qualify if:

  • Individuals ≥ 18 years of age.
  • A clinical diagnosis of type 1 diabetes for at least 12 months. The diagnosis of type 1 diabetes relies on the investigator's judgment; C peptide level and antibody determinations are unnecessary.
  • Using insulin pump therapy for at least three months.
  • Individuals of childbearing potential using an effective birth-control method. An individual of childbearing potential must agree to use a highly effective method of birth control.

You may not qualify if:

  • Current or recent use of antihyperglycemic agents other than insulin (≤ 2-week use of sodium-glucose cotransporter-2 inhibitor (SGLT2I), Metformin, etc.; ≤ 1-month for glucagon-like peptide-1 receptor agonists (GLP1-RA)).
  • Current use of glucocorticoid medication (except low, stable doses and inhaled steroids).
  • Individuals with confirmed gastroparesis.
  • Use of medication that alters gastrointestinal motility (ex: domperidone).
  • Use of hydroxyurea.
  • Planned or ongoing pregnancy.
  • Breastfeeding individuals.
  • Severe hypoglycemia requiring hospitalization in the past month. Severe hypoglycemia is defined as requiring the assistance of another person, due to altered consciousness, to administer carbohydrates, glucagon, or other resuscitative actions.
  • Diabetic ketoacidosis episode in the past month.
  • Clinically significant nephropathy, neuropathy, or retinopathy as judged by the investigator.
  • Recent (\< 6 months) acute macrovascular event, e.g., acute coronary syndrome.
  • Other serious medical illnesses which are likely to interfere with study participation or the ability to complete the trial by the investigator's judgment.
  • Known hypersensitivity to the study drugs or their excipients.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Research Institute of the McGill University Health Center

Montreal, Quebec, H4A 3J1, Canada

RECRUITING

MeSH Terms

Conditions

Diabetes Mellitus, Type 1Insulin Resistance

Interventions

pramlintideInsemination, Artificial, HeterologousDrug Delivery Systems

Condition Hierarchy (Ancestors)

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

Intervention Hierarchy (Ancestors)

Insemination, ArtificialReproductive Techniques, AssistedReproductive TechniquesTherapeuticsInvestigative TechniquesInseminationReproductionReproductive Physiological PhenomenaReproductive and Urinary Physiological PhenomenaDrug Therapy

Study Officials

  • Michael Tsoukas, M.D.

    Research Institute of the McGill University Health Center

    PRINCIPAL INVESTIGATOR
  • Ahmad Haidar, Ph.D.

    Research Institute of the McGill University Health Center

    STUDY CHAIR
  • Laurent Legault, M.D.

    Montreal's Children's Hospital Division of Endocrinology

    STUDY CHAIR
  • Michael Vallis, Ph.D.

    Dalhousie University Psychologist

    STUDY CHAIR
  • Natasha Garfield, M.D.

    Royal Victoria Hospital Division of Endocrinology

    STUDY CHAIR
  • Melissa-Rosina Pasqua, M.D.

    Research Institute of the McGill University Health Center

    STUDY CHAIR

Central Study Contacts

Ahmad Haidar, PhD.

CONTACT

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor, Endocrinology & Metabolism

Study Record Dates

First Submitted

September 12, 2023

First Posted

September 21, 2023

Study Start

November 30, 2023

Primary Completion

April 1, 2025

Study Completion

June 1, 2025

Last Updated

April 18, 2024

Record last verified: 2024-04

Data Sharing

IPD Sharing
Will share

The raw data (that is, insulin delivery, glucose levels and individual participant data) and informed consent form will be shared by the corresponding author, for academic purposes, subject to a material transfer agreement and approval of the McGill University Health Center's Research Ethics Board. All data shared will be de-identified. Raw data will be shared for non-commercial use upon reasonable request and a material transfer agreement.

Shared Documents
ICF

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