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type1diabetesPhase 2/3FCLNCT06046417

A Fully Automated Lyumjev and Pramlintide Delivery System for Adults With Type 1 Diabetes

A Phase 2/3 study testing Pramlintide, Lyumjev and Automated Insulin Delivery (AID) system in people with type1diabetes and Diabetes Mellitus, Type 1, run by McGill University Health Centre/Research Institute of the McGill University Health Centre at 1 site in Canada.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial 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… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
type1diabetes, Diabetes Mellitus, Type 1
What is being tested?
Pramlintide, Lyumjev and Automated Insulin Delivery (AID) system
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteCanada
Study dates
30 Nov 2023to Jun 2025
Phase
Phase 2/3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 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.

Who cannot join

  • 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.
Show all 13Show fewer
  • 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.

Trial locations and contacts

1 site in 1 country.

Joelle Doumat, BSc. contact

832-798-3648

joelle.doumat@mail.mcgill.ca

Ahmad Haidar, PhD. contact

Canada1 site, 1 recruiting
  • Research Institute of the McGill University Health Center

    Montreal, Quebec, H4A 3J1

    Joelle Doumat, BSc., 832-798-3648, joelle.doumat@mail.mcgill.ca

    Michael Tsoukas, M.D

    Recruiting

Other trials in Canada

About this study

Official title: A Randomized, Controlled, Crossover Trial to Assess a Fully Automated, Dual-hormone (Insulin-and-pramlintide) Delivery System Without Carbohydrate Counting in Regulating Glucose Levels in Adults With Type 1 Diabetes.

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:

Read more

(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.

Read the detailed description

The aim of this study is to conduct an outpatient, randomized, crossover clinical trial to compare the glycemic outcomes of a fully automated Lyumjev-pramlintide delivery system to a hybrid automated Lyumjev-placebo delivery system with carbohydrate counting in 26 adults with type 1 diabetes.

Design-

All participants will undergo three interventions in a random order:

(i) Fully automated Lyumjev insulin-pramlintide delivery system. Ratio of 1 unit of inulin for 8μg of pramlintide.

(ii) Fully automated Lyumjev insulin-pramlintide delivery system. Ratio of 1 unit of insulin for 10μg of pramlintide.

(iii) Hybrid automated Lyumjev insulin-placebo delivery system with carbohydrate-matched boluses.

Study drugs-

Lyumjev is a Health Canada insulin for treatment of type 1 diabetes. Participants who do not currently use Lyumjev will be switched to it for the duration of the study.

Pramlintide is an FDA-approved drug used in the treatment of type 1 diabetes. It contributes to regulating glucose levels by delaying gastric emptying, suppressing nutrient-stimulated glucagon secretion and increasing satiety. It is not approved for commercial use by Health Canada, but has been approved for the purpose of the study.

Study Devices-

For the duration of the study, participants will use a Dexcom G6 Continuous Glucose Monitor (GCM), two YpsoPumps (for insulin and pramlintide) as well as a study smartphone with the Euglide application installed. The automated insulin delivery (AID) system will integrate these sets of devices to automate insulin (and pramlintide) delivery in response to an individual's glucose levels.

Treatment Period-

Each intervention will last three weeks and be preceded by a 5-day at-home run-in period. After both the second and third interventions, there will be a 14-45 day washout period. Participants will be followed-up with remotely on days 2 (+/-1) and 5 of each run-in and on days 2(+/-1), 3(+/-1) and 7(+/-2) of each intervention. Remote contact can be performed via phone, email, text message or another reasonable communication channel. After each intervention, participants will be interviewed and asked to complete questionnaires assessing diabetes control and quality of life. Participants will need approximately 15-30 weeks to complete the study.

The study will enroll up to 4 pilot participants, as well as 26 main study participants who meet the eligibility criteria.

Being tested
Pramlintide, Lyumjev, Automated Insulin Delivery (AID) system
Keywords
Pramlintide, fully automated delivery system, artificial pancreas, Insulin, Lyumjev, fully closed loop, adjunctive
Medical subject headings
Diabetes Mellitus, Type 1, Insulin Resistance

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PramlintideDrug

    Pramlintide delivered in a basal-bolus manner.

  • LyumjevDrug

    Lyumjev delivered in a basal-bolus manner.

  • Automated Insulin Delivery (AID) systemDevice

    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.

Study groups in NCT06046417
Study groupRoleWhat they receive
Fully automated Lyumjev-and-pramlintide delivery system (8 μg/u)ExperimentalLyumjev and pramlintide fully automated delivery system with no meal announcement. Ratio of 1 unit of insulin for 8 μg of pramlintide.
Receives: Drug: Pramlintide; Drug: Lyumjev; Device: Automated Insulin Delivery (AID) system
Fully automated Lyumjev-and-pramlintide delivery system (10 μg/u)ExperimentalLyumjev and pramlintide fully automated delivery system with no meal announcement. Ratio of 1 unit of insulin for 10 μg of pramlintide.
Receives: Drug: Pramlintide; Drug: Lyumjev; Device: Automated Insulin Delivery (AID) system
Hybrid automated Lyumjev-and-placebo delivery system with carbohydrate-matched bolusesActive comparatorLyumjev 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.
Receives: Drug: Lyumjev

What is being measured

The primary outcome is the main question the study is designed to answer.

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

    Measured: 18 days

Secondary outcomes (14)
  1. Percentage of time of glucose levels spent between 3.9-7.8 mmol/L.

    Measured: 18 days

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

    Measured: 18 days

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

    Measured: 18 days

  4. Mean glucose levels.

    Measured: 18 days

  5. Standard deviation of glucose levels.

    Measured: 18 days

  6. Coefficient of variance of glucose levels.

    Measured: 18 days

  7. Total pramlintide delivery (overall, basal, and bolus).

    Measured: 18 days

  8. Total insulin delivery (overall, basal, and bolus).

    Measured: 18 days

  9. Mean score on the Type 1 Diabetes Distress Scale (T1DDS) excluding the physician subscale.

    A scale from 1-6 indicating overall diabetes distress. Higher scores indicate higher levels of diabetes distress. Any total subscale score of >2.0 is considered clinically significant.

    Measured: 18 days

  10. Mean score on the Hypoglycemia Fear Survey - II (Worry Subscale) (HSF2).

    A scale from 1-5 with higher scores indicating a greater fear of hypoglycemia.

    Measured: 18 days

  11. Mean score on the INSPIRE questionnaire for adults (INSPIRE).

    A scale from 1-5 with higher scores reflecting more favorable opinions about using Automated Insulin Delivery (AID).

    Measured: 18 days

  12. Mean score on selected items from The Diabetes Bowel Symptoms Questionnaire (DBSQ).

    A 1-5 scale with higher values reflecting a greater quantity and severity of diabetes bowel symptoms.

    Measured: 18 days

  13. Mean score on a Treatment Satisfaction Questionnaire (TSQ) taken from Marrero et al.

    A 1-6 scale with higher values indicating more satisfaction with treatment.

    Measured: 18 days

  14. Thematic interview analysis

    Semi-structured interviews will be carried out after every intervention. We will analyze their qualitative content.

    Measured: 18 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Sep 2023
  2. Study start30 Nov 2023
  3. Primary completionApr 2025 (estimated)
  4. Study completionJun 2025 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06046417
Sponsor's protocol ID
2023-9373
Acronym
FCL
Status last verified
Apr 2024
First submitted
12 Sep 2023
Last updated
18 Apr 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: 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.

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Pramlintide, Lyumjev and Automated Insulin Delivery (AID) system in people with type1diabetes and Diabetes Mellitus, Type 1, run by McGill University Health Centre/Research Institute of the McGill University Health Centre at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 18 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Joelle Doumat, BSc. (832-798-3648, joelle.doumat@mail.mcgill.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of time of glucose levels spent in the target range (3.9-10.0 mmol/L). (time frame: 18 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Apr 2024.

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