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The iLet Introduction Study: A Feasibility Study of the iLet, a Fully Integrated Bihormonal Bionic Pancreas

The iLet Introduction Study: A Feasibility Study of the iLet, a Fully Integrated Bihormonal Bionic Pancreas

Status
Terminated
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02701257
Enrollment
20
Registered
2016-03-08
Start date
2016-03-31
Completion date
2018-05-31
Last updated
2019-11-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diabetes Mellitus Type 1

Keywords

Bionic Pancreas, Insulin, Glucagon, Continuous Glucose Monitor

Brief summary

This study will compare two different models of a wearable bionic pancreas device (the iPhone-based bionic pancreas vs. the iLet bionic pancreas) in adult participant with type 1 diabetes. Both bionic pancreas devices measure glucose levels every five minutes and then give insulin and/or glucagon automatically to regulate the blood glucose (BG).

Detailed description

The iPhone bionic pancreas has been used in earlier studies, during which volunteers used the system for up to 11 days at a time while living their normal lives at home and work. The iLet bionic pancreas has never been tested in humans. In this new study, volunteers will participate in a training visit to learn how both devices work. They will then use the iPhone-based BP for 1 day and the iLet BP for 1 day in random order using Lilly glucagon. They will then use the iLet BP for one additional day using Xeris Xerisol glucagon (a stable formulation of human glucagon). A custom infusion set is required for this bihormonal system, to prevent future consumers from being able to accidentally swap their insulin and glucagon reservoirs and infusion sets, which could be potentially fatal. Previous experiments have demonstrated flaws in the infusion set design, requiring human experiments to be suspended and modifications to the infusion set be made. We believe the current infusion set has addressed these flaws by incorporating an anti-coring heel and a tri-beveled needle, and the infusion set sub-study is designed to isolate and study the infusion set function before further experiments using the iLet BP are conducted.

Interventions

DEVICEiPhone bionic pancreas

An experimental device composed of three parts: a continuous glucose monitor, control algorithms running on an iPhone, and drug delivery using Tandem insulin pumps

DEVICEiLet bionic pancreas

An experimental device that combines the functions of the iPhone-based bionic pancreas into one device.

DRUGXeris Xerisol glucagon

A stabilized formulation of human glucagon in a solvent based primarily composed of dimethyl sulfoxide (DMSO) that has prolonged stability and can be used for multiple days in a pump

An aqueous formulation of human glucagon with limited stability that must be changed daily

DEVICEiLet infusion set

The infusion set sub-study will be studying the experimental iLet infusion set in a cross-over with the Contact Detach infusion set. These visits will be conducted separately from the iPhone and iLet BP visits.

DEVICEContact Detach infusion set

The infusion set sub-study will be studying the experimental iLet infusion set in a cross-over with the Contact Detach infusion set. These visits will be conducted separately from the iPhone and iLet BP visits.

Sponsors

Boston University
CollaboratorOTHER
Massachusetts General Hospital
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

iPhone and iLet BP experiments * Age ≥ 18 years and have had clinical type 1 diabetes for at least one year * Diabetes managed using an insulin pump for ≥ 6 months * Prescription medication regimen stable for \> 1 month (except for medications that will not affect the safety of the study and are not expected to affect any outcome of the study, in the judgment of the principal investigator) iLet Infusion Set Sub-Study * Age ≥ 18 years and have had clinical type 1 diabetes for at least one year * Diabetes managed using an insulin pump for ≥ 6 months

Exclusion criteria

iPhone and iLet BP experiments * Unable to provide informed consent (e.g. impaired cognition or judgment) * Unable to safely comply with study procedures and reporting requirements (e.g. impairment of vision or dexterity that prevents safe operation of the bionic pancreas, impaired memory, unable to speak and read English) * Current participation in another diabetes-related clinical trial that, in the judgment of the principal investigator, will compromise the results of this study or the safety of the subject * Pregnancy (positive urine HCG), breast feeding, plan to become pregnant in the immediate future, or sexually active without use of contraception * Current alcohol abuse (intake averaging \> 3 drinks daily in last 30 days), use of marijuana within 1 month of enrollment, or other substance abuse (use within the last 6 months of controlled substances other than marijuana without a prescription) * Unwilling or unable to refrain on the study days from:acetaminophen in any form, use of marijuana, use of drugs that may dull the sensorium, reduce sensitivity to symptoms of hypoglycemia, or hinder decision making during the period of participation in the study (use of beta blockers will be allowed as long as the dose is stable and the subject does not meet the criteria for hypoglycemia unawareness while taking that stable dose, but use of benzodiazepines or narcotics, even if by prescription, may be excluded according to the judgment of the principal investigator) * History of liver disease that is expected to interfere with the anti-hypoglycemia action of glucagon (e.g. liver failure or cirrhosis). Other liver disease (i.e. active hepatitis, steatosis, active biliary disease, any tumor of the liver, hemochromatosis, glycogen storage disease) may exclude the subject if it causes significant compromise to liver function or may do so in an unpredictable fashion. * Renal failure on dialysis * Personal history of cystic fibrosis, pancreatitis, pancreatic tumor, or any other pancreatic disease besides type 1 diabetes * Any known history of coronary artery disease including, but not limited to, history of myocardial infarction, stress test showing ischemia, history of angina, or history of intervention such as coronary artery bypass grafting, percutaneous coronary intervention, or enzymatic lysis of a presumed coronary occlusion) * Congestive heart failure (established history of CHF, lower extremity edema, paroxysmal nocturnal dyspnea, or orthopnea) * History of TIA or stroke * Seizure disorder, history of any non-hypoglycemic seizure within the last two years, or ongoing treatment with anticonvulsants * History of hypoglycemic seizures (grand-mal) or coma in the last year * History of pheochromocytoma: fractionated metanephrines will be tested in patients with history increasing the risk for a catecholamine secreting tumor: Episodic or treatment refractory (requiring 4 or more medications to achieve normotension) hypertension, Paroxysms of tachycardia, pallor, or headache, Personal or family history of MEN 2A, MEN 2B, neurofibromatosis, or von Hippel-Lindau disease * History of adrenal disease or tumor * Hypertension with systolic BP ≥160 mm Hg or diastolic BP ≥100 despite treatment * Untreated or inadequately treated mental illness (indicators would include symptoms such as psychosis, hallucinations, mania, and any psychiatric hospitalization in the last year), or treatment with anti-psychotic medications that are known to affect glucose regulation. * Electrically powered implants (e.g. cochlear implants, neurostimulators) that might be susceptible to RF interference * History of adverse reaction to glucagon (including allergy) besides nausea and vomiting * Established history of allergy or severe reaction to adhesive or tape that must be used in the study * Use of oral (e.g. thiazolidinediones, biguanides, sulfonylureas, glitinides, DPP-4 inhibitors, SGLT-2 inhibitors) anti-diabetic medications * Hemoglobin \< 12 g/dl * Any factors that, in the opinion of the principal investigator would interfere with the safe completion of the study iLet Infusion Set Sub-Study * Unable to provide informed consent (e.g. impaired cognition or judgment) * Unable to safely comply with study procedures and reporting requirements (e.g. impairment of vision or dexterity that prevents safe operation of their insulin pump, impaired memory, unable to speak and read English) * Pregnancy (positive urine HCG), breast feeding, plan to become pregnant in the immediate future, or sexually active without use of contraception * Hemoglobin \< 11 g/dl * Unable to establish IV access, or subject reports difficult IV access in the past * History of allergy or severe reaction to adhesive or tape that must be used in the study

Design outcomes

Primary

MeasureTime frameDescription
Average Percent Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump (Aggregate of Both Insulin and Glucagon Doses)8 hoursAverage percent dose amounts calculated by the bionic pancreas control algorithm that are successfully delivered by the pump (aggregate of both insulin and glucagon doses) - primary outcome for iPhone-based BP using Lilly glucagon vs. iLet BP using Lilly glucagon
Average Percent Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump (Glucagon Doses).8 hoursAverage percent dose amounts calculated by the bionic pancreas control algorithm that are successfully delivered by the pump (glucagon doses) - - primary outcome for iLet BP using Lilly glucagon vs. iLet BP using Xeris Xerisol glucagon
Insulin Area Under the Curve in the 3.5 Hours Following the Insulin Bolus3.5 hours following insulin bolusThis applies only to the infusion set sub-study

Secondary

MeasureTime frameDescription
Number of Severe Hypoglycemic Events (Subject Unable to Self-treat, Requiring the Assistance of Another Person)8 hoursThe number of severe hypoglycemic events subjects experience. This applies only to the iPhone vs iLet BP experiments.
Average Percent Insulin Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.8 hoursThe average percentage of successfully delivered insulin doses. This applies only to the iPhone vs iLet BP experiments.
Average Percent Glucagon Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.8 hoursThe average percentage of successfully delivered glucagon doses. This applies only to the iPhone vs iLet BP experiments.
Average Percent Insulin Dose Amounts Successfully Issued to the Pump by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.8 hoursThe average percentage of successfully issued insulin doses that are then delivered successfully by the pump. This applies only to the iPhone vs iLet BP experiments.
Average Percent Glucagon Dose Amounts Successfully Issued to the Pump by the Bionic Pancreas Control Algorithm That a Successfully Delivered by the Pump.8 hoursThe average percentage of successfully issued glucagon doses that are then delivered successfully by the pump. This applies only to the iPhone vs iLet BP experiments.
Average Percent of 5 Minute Steps During Which the Bionic Pancreas is Functioning Nominally in All Respects Based on Real-time CGM Data (New CGM Glucose Reading Captured, Dose Calculated, Dose Issued to Pumps8 hoursThe percentage of time (measured in 5 minute steps) that the bionic pancreas is working, indicated by the presence of a CGM reading, a successful dose calculation and successful issuing of a dose. This applies only to the iPhone vs iLet BP experiments.
Average Percent of 5 Minute Steps During Which the Bionic Pancreas is Functioning Nominally With or Without a New CGM Glucose Reading Captured (Dose Calculated, Dose Issued to Pumps).8 hoursThe percentage of time (measured in 5 minute steps) that the bionic pancreas is working even without a CGM reading being present, indicated by a successful dose calculation and successful issuing of a dose. This applies only to the iPhone vs iLet BP experiments.
CGM Reliability Index, Calculated as Percent of Possible Values Actually Recorded by CGM.8 hoursA measure of CGM reliability, indicating the percentage of values the CGM displayed out of the total values it should have displayed in that time. This applies only to the iPhone vs iLet BP experiments.
Glucagon Total Delivery Per kg of Body Mass.8 hoursThe average total glucagon delivered by the bionic pancreas. This applies only to the iPhone vs iLet BP experiments.
Insulin Total Delivery Per kg of Body Mass.8 hoursThe average total insulin delivered by the bionic pancreas. This applies only to the iPhone vs iLet BP experiments.
Number of Episodes of Symptomatic Hypoglycemia.8 hoursNumber of time subjects experienced symptoms of hypoglycemia and reported that to study staff. This applies only to the iPhone vs iLet BP experiments.
Total Grams of Carbohydrate Taken for Hypoglycemia.8 hoursThe total grams of carbohydrates given to subjects for treatment of hypoglycemia. This applies only to the iPhone vs iLet BP experiments.
Difference in Mean Nausea From VAS During the Study8 hoursThis applies only the iPhone vs. iLet BP experiments. Subjects were given a visual analog scale measuring 100 mm and asked to draw a line to indicate their level of nausea at timepoints during the study with 100 being the worst possible nausea and 0 being no nausea.
Average Insulin Infusion Site Pain From VAS8 hoursThis applies to the iPhone vs. iLet BP experiments and the infusion set sub-study experiments. Subjects were given a visual analog scale measuring 100 mm and asked to draw a line to indicate their level of pain at timepoints during the study with 100 being the worst possible pain and 0 being no pain.
Difference in Local Erythema and Edema According to the Draize Scale8 hoursThis applies to the iPhone vs. iLet BP experiments and the infusion set sub-study experiments. The draize scale assess erythema, eschar and edema using a score from 0-4, with 4 meaning a worse outcome.
Average Continuous Glucose Monitor (CGM) Glucose8 hoursThe average glucose according to continuous glucose monitor readings. This only applies to the iPhone vs. iLet BP experiments.
Number of Unscheduled CGM Sensor Changes.8 hoursThis applies only to the iPhone vs. iLet BP experiments
Insulin Area Under the Curve During the Initial 90 Minute Fasted Period8 hoursThis applies only to the infusion set sub-study
Mean Insulin Levels During the Initial 90 Minute Fasted Period8 hoursThis applies only to the infusion set sub-study
Difference Between Insulin Levels at Baseline and at 90 Minutes8 hoursThis applies only to the infusion set sub-study
Tmax After the Insulin Dose8 hoursThis applies only to the infusion set sub-study
T 1/2 Max After the Insulin Dose8 hoursThis applies only to the infusion set sub-study
C Max After the Insulin Dose8 hoursThis applies only to the infusion set sub-study
AUC in the First 30 Minutes After the Insulin Dose8 hoursThis applies only to the infusion set sub-study
AUC in the First 60 Minutes After the Insulin Dose8 hoursThis applies only to the infusion set sub-study
AUC in the First 90 Minutes After the Insulin Dose8 hoursThis applies only to the infusion set sub-study
Terminal Half Life After the Insulin Dose8 hoursThis applies only to the infusion set sub-study
Difference Between the Fasted PG Value and the PG Value at 90 MinutesBaseline Fasted State and 90 MinutesThis applies only to the infusion set sub-study
Difference in the PG Prior to the Meal and Peak Post-prandial GlucosePre-meal PG value and peak PG value during the 3.5 hours following the meal.This applies only to the infusion set sub-study
PG AUC in the 3.5 Hours Following the Meal3.5 hours following the mealThis applies only to the infusion set sub-study
Number of Unscheduled Infusion Set Replacements.8 hoursThis applies to the iPhone vs. iLet BP experiments and the infusion set sub-study experiments.
Percentage of Time in Each of the Following Ranges: < 50 mg/dl, < 60 mg/dl, <70 mg/dl, 70-120 mg/dl, 70-180 mg/dl, >180 mg/dl, >250 mg/dl8 hoursPercentage of time subjects spent in each of these ranges based on continuous glucose monitor readings. This only applies to the iPhone vs iLet BP visits.
Number of Subjects With Mean CGM Glucose < 154 mg/dl8 hoursThe number of subjects who achieved a mean CGM glucose \< 154 mg/dl, which correlates to an estimated hemoglobin a1c of 7%, which is the ADA goal for therapy. This applies only to the iPhone vs iLet BP experiments

Countries

United States

Participant flow

Participants by arm

ArmCount
iPhone Bionic Pancreas - Lilly Glucagon
iPhone based bionic pancreas using insulin lispro and Lilly glucagon. These visits will be conducted separately from the infusion set sub-study visits. iPhone bionic pancreas: An experimental device composed of three parts: a continuous glucose monitor, control algorithms running on an iPhone, and drug delivery using Tandem insulin pumps Lilly glucagon: An aqueous formulation of human glucagon with limited stability that must be changed dailyy
6
iLet Bionic Pancreas - Lilly Glucagon
iLet Bionic Pancreas using using insulin lispro and Lilly glucagon. These visits will be conducted separately from the infusion set sub-study visits. iLet bionic pancreas: An experimental device that combines the functions of the iPhone-based bionic pancreas into one device. Lilly glucagon: An aqueous formulation of human glucagon with limited stability that must be changed daily
6
iLet Bionic Pancreas - Xerisol Glucagon
iLet Bionic Pancreas using using insulin lispro and Xeris Xerisol glucagon. These visits will be conducted separately from the infusion set sub-study visits. iLet bionic pancreas: An experimental device that combines the functions of the iPhone-based bionic pancreas into one device. Xeris Xerisol glucagon: A stabilized formulation of human glucagon in a solvent based primarily composed of dimethyl sulfoxide (DMSO) that has prolonged stability and can be used for multiple days in a pump
0
iLet Infusion Set First, Then Contact Detach
The infusion set sub-study will be testing just the experimental iLet infusion set in a crossover with the contact detach infusion set. These visits will be conducted separately from the iPhone and iLet bionic pancreas visits. iLet infusion set: The infusion set sub-study will be studying the experimental iLet infusion set in a cross-over with the Contact Detach infusion set. These visits will be conducted separately from the iPhone and iLet BP visits. Contact Detach infusion set: The infusion set sub-study will be studying the experimental iLet infusion set in a cross-over with the Contact Detach infusion set. These visits will be conducted separately from the iPhone and iLet BP visits.
4
Contact Detach First, Then iLet Infusion Set
The infusion set sub-study will be testing just the experimental iLet infusion set in a crossover with the contact detach infusion set. These visits will be conducted separately from the iPhone and iLet bionic pancreas visits. Contact Detach infusion set: The infusion set sub-study will be studying the experimental iLet infusion set in a cross-over with the Contact Detach infusion set. These visits will be conducted separately from the iPhone and iLet BP visits. iLet infusion set: The infusion set sub-study will be studying the experimental iLet infusion set in a cross-over with the Contact Detach infusion set. These visits will be conducted separately from the iPhone and iLet BP visits.
4
Total20

Baseline characteristics

CharacteristiciPhone Bionic Pancreas - Lilly GlucagoniLet Bionic Pancreas - Lilly GlucagoniLet Infusion Set First, Then Contact DetachContact Detach First, Then iLet Infusion SetTotal
Age, Continuous38.6 years
STANDARD_DEVIATION 22.3
32.6 years
STANDARD_DEVIATION 17.9
48.8 years
STANDARD_DEVIATION 14.7
44.7 years
STANDARD_DEVIATION 17.7
39.7 years
STANDARD_DEVIATION 17.5
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
6 Participants6 Participants3 Participants4 Participants19 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants1 Participants0 Participants1 Participants
Hemoglobin A1c8.3 percent
STANDARD_DEVIATION 0.7
7.6 percent
STANDARD_DEVIATION 1.8
6.9 percent
STANDARD_DEVIATION 1.2
8.1 percent
STANDARD_DEVIATION 1.8
7.8 percent
STANDARD_DEVIATION 1.2
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
6 Participants6 Participants4 Participants4 Participants20 Participants
Region of Enrollment
United States
6 participants6 participants4 participants4 participants20 participants
Sex: Female, Male
Female
5 Participants4 Participants3 Participants2 Participants14 Participants
Sex: Female, Male
Male
1 Participants2 Participants1 Participants2 Participants6 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
deaths
Total, all-cause mortality
0 / 90 / 120 / 00 / 50 / 7
other
Total, other adverse events
0 / 97 / 120 / 00 / 50 / 7
serious
Total, serious adverse events
0 / 90 / 120 / 00 / 50 / 7

Outcome results

Primary

Average Percent Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump (Aggregate of Both Insulin and Glucagon Doses)

Average percent dose amounts calculated by the bionic pancreas control algorithm that are successfully delivered by the pump (aggregate of both insulin and glucagon doses) - primary outcome for iPhone-based BP using Lilly glucagon vs. iLet BP using Lilly glucagon

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonAverage Percent Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump (Aggregate of Both Insulin and Glucagon Doses)94.6 percentage of doses deliveredStandard Deviation 9.2
iLet Bionic Pancreas - Lilly GlucagonAverage Percent Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump (Aggregate of Both Insulin and Glucagon Doses)95.0 percentage of doses deliveredStandard Deviation 12.3
Primary

Average Percent Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump (Glucagon Doses).

Average percent dose amounts calculated by the bionic pancreas control algorithm that are successfully delivered by the pump (glucagon doses) - - primary outcome for iLet BP using Lilly glucagon vs. iLet BP using Xeris Xerisol glucagon

Time frame: 8 hours

Population: This analysis only applies to the iLet BP using Lilly glucagon vs the iLet BP using Xerisol glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. Data for this outcome is reported for the iPhone BP and iLet BP arms using Lilly glucagon. This analysis does not apply to the infusion set sub study.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonAverage Percent Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump (Glucagon Doses).96.6 percentage of dosesStandard Deviation 6.8
iLet Bionic Pancreas - Lilly GlucagonAverage Percent Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump (Glucagon Doses).100.0 percentage of dosesStandard Deviation 0.5
Primary

Insulin Area Under the Curve in the 3.5 Hours Following the Insulin Bolus

This applies only to the infusion set sub-study

Time frame: 3.5 hours following insulin bolus

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The infusion set sub study was terminated and the insulin assays were not completed.

Secondary

AUC in the First 30 Minutes After the Insulin Dose

This applies only to the infusion set sub-study

Time frame: 8 hours

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The infusion set sub study was terminated and the insulin assays were not completed.

Secondary

AUC in the First 60 Minutes After the Insulin Dose

This applies only to the infusion set sub-study

Time frame: 8 hours

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The infusion set sub study was terminated and the insulin assays were not completed.

Secondary

AUC in the First 90 Minutes After the Insulin Dose

This applies only to the infusion set sub-study

Time frame: 8 hours

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed.The infusion set sub study was terminated and the insulin assays were not completed.

Secondary

Average Continuous Glucose Monitor (CGM) Glucose

The average glucose according to continuous glucose monitor readings. This only applies to the iPhone vs. iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonAverage Continuous Glucose Monitor (CGM) Glucose179.2 mg/dlStandard Deviation 37.5
iLet Bionic Pancreas - Lilly GlucagonAverage Continuous Glucose Monitor (CGM) Glucose251.2 mg/dlStandard Deviation 80
Secondary

Average Insulin Infusion Site Pain From VAS

This applies to the iPhone vs. iLet BP experiments and the infusion set sub-study experiments. Subjects were given a visual analog scale measuring 100 mm and asked to draw a line to indicate their level of pain at timepoints during the study with 100 being the worst possible pain and 0 being no pain.

Time frame: 8 hours

Population: The experimental arm with the iLet BP using Xeris glucagon was never conducted. Analysis includes 9 subjects that completed both the BP visits and 4 subjects that completed both infusion set sub study visits.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonAverage Insulin Infusion Site Pain From VAS1.49 score on a scaleStandard Deviation 3.06
iLet Bionic Pancreas - Lilly GlucagonAverage Insulin Infusion Site Pain From VAS6.61 score on a scaleStandard Deviation 13.04
iLet Infusion SetAverage Insulin Infusion Site Pain From VAS0.54 score on a scaleStandard Deviation 2.61
Contact Detach Infusion SetAverage Insulin Infusion Site Pain From VAS2.42 score on a scaleStandard Deviation 9.98
Secondary

Average Percent Glucagon Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.

The average percentage of successfully delivered glucagon doses. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonAverage Percent Glucagon Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.96.6 percentage of dosesStandard Deviation 6.8
iLet Bionic Pancreas - Lilly GlucagonAverage Percent Glucagon Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.100.0 percentage of dosesStandard Deviation 0.5
Secondary

Average Percent Glucagon Dose Amounts Successfully Issued to the Pump by the Bionic Pancreas Control Algorithm That a Successfully Delivered by the Pump.

The average percentage of successfully issued glucagon doses that are then delivered successfully by the pump. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonAverage Percent Glucagon Dose Amounts Successfully Issued to the Pump by the Bionic Pancreas Control Algorithm That a Successfully Delivered by the Pump.96.6 percentage of dosesStandard Deviation 6.8
iLet Bionic Pancreas - Lilly GlucagonAverage Percent Glucagon Dose Amounts Successfully Issued to the Pump by the Bionic Pancreas Control Algorithm That a Successfully Delivered by the Pump.100.0 percentage of dosesStandard Deviation 0.5
Secondary

Average Percent Insulin Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.

The average percentage of successfully delivered insulin doses. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonAverage Percent Insulin Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.94.0 percentage of dosesStandard Deviation 10.7
iLet Bionic Pancreas - Lilly GlucagonAverage Percent Insulin Dose Amounts Calculated by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.95.8 percentage of dosesStandard Deviation 13.3
Secondary

Average Percent Insulin Dose Amounts Successfully Issued to the Pump by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.

The average percentage of successfully issued insulin doses that are then delivered successfully by the pump. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonAverage Percent Insulin Dose Amounts Successfully Issued to the Pump by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.98.5 percentage of dosesStandard Deviation 5.5
iLet Bionic Pancreas - Lilly GlucagonAverage Percent Insulin Dose Amounts Successfully Issued to the Pump by the Bionic Pancreas Control Algorithm That Are Successfully Delivered by the Pump.96.1 percentage of dosesStandard Deviation 13.1
Secondary

Average Percent of 5 Minute Steps During Which the Bionic Pancreas is Functioning Nominally in All Respects Based on Real-time CGM Data (New CGM Glucose Reading Captured, Dose Calculated, Dose Issued to Pumps

The percentage of time (measured in 5 minute steps) that the bionic pancreas is working, indicated by the presence of a CGM reading, a successful dose calculation and successful issuing of a dose. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonAverage Percent of 5 Minute Steps During Which the Bionic Pancreas is Functioning Nominally in All Respects Based on Real-time CGM Data (New CGM Glucose Reading Captured, Dose Calculated, Dose Issued to Pumps88.9 percentage of 5 minute stepsStandard Deviation 0.073
iLet Bionic Pancreas - Lilly GlucagonAverage Percent of 5 Minute Steps During Which the Bionic Pancreas is Functioning Nominally in All Respects Based on Real-time CGM Data (New CGM Glucose Reading Captured, Dose Calculated, Dose Issued to Pumps75.1 percentage of 5 minute stepsStandard Deviation 0.196
Secondary

Average Percent of 5 Minute Steps During Which the Bionic Pancreas is Functioning Nominally With or Without a New CGM Glucose Reading Captured (Dose Calculated, Dose Issued to Pumps).

The percentage of time (measured in 5 minute steps) that the bionic pancreas is working even without a CGM reading being present, indicated by a successful dose calculation and successful issuing of a dose. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonAverage Percent of 5 Minute Steps During Which the Bionic Pancreas is Functioning Nominally With or Without a New CGM Glucose Reading Captured (Dose Calculated, Dose Issued to Pumps).94.6 percentage of 5 minutes stepsStandard Deviation 0.054
iLet Bionic Pancreas - Lilly GlucagonAverage Percent of 5 Minute Steps During Which the Bionic Pancreas is Functioning Nominally With or Without a New CGM Glucose Reading Captured (Dose Calculated, Dose Issued to Pumps).99.8 percentage of 5 minutes stepsStandard Deviation 0.004
Secondary

CGM Reliability Index, Calculated as Percent of Possible Values Actually Recorded by CGM.

A measure of CGM reliability, indicating the percentage of values the CGM displayed out of the total values it should have displayed in that time. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonCGM Reliability Index, Calculated as Percent of Possible Values Actually Recorded by CGM.94.1 percentage of CGM valuesStandard Deviation 0.06
iLet Bionic Pancreas - Lilly GlucagonCGM Reliability Index, Calculated as Percent of Possible Values Actually Recorded by CGM.75.1 percentage of CGM valuesStandard Deviation 0.19
Secondary

C Max After the Insulin Dose

This applies only to the infusion set sub-study

Time frame: 8 hours

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The infusion set sub study was terminated and the insulin assays were not completed.

Secondary

Difference Between Insulin Levels at Baseline and at 90 Minutes

This applies only to the infusion set sub-study

Time frame: 8 hours

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The infusion set sub study was terminated and the insulin assays were not completed.

Secondary

Difference Between the Fasted PG Value and the PG Value at 90 Minutes

This applies only to the infusion set sub-study

Time frame: Baseline Fasted State and 90 Minutes

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The Overall Number of Participants Analyzed represents all Completed participants that received the intervention

ArmMeasureValue (MEAN)Dispersion
iLet Infusion SetDifference Between the Fasted PG Value and the PG Value at 90 Minutes-3.7 mg/dlStandard Deviation 28.7
Contact Detach Infusion SetDifference Between the Fasted PG Value and the PG Value at 90 Minutes-6.7 mg/dlStandard Deviation 41.8
Secondary

Difference in Local Erythema and Edema According to the Draize Scale

This applies to the iPhone vs. iLet BP experiments and the infusion set sub-study experiments. The draize scale assess erythema, eschar and edema using a score from 0-4, with 4 meaning a worse outcome.

Time frame: 8 hours

Population: The experimental arm with the iLet BP using Xeris glucagon was never conducted. Analysis includes 9 subjects that completed both the BP visits and 4 subjects that completed both infusion set sub study visits.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonDifference in Local Erythema and Edema According to the Draize Scale0 score on a scaleStandard Deviation 0
iLet Bionic Pancreas - Lilly GlucagonDifference in Local Erythema and Edema According to the Draize Scale0 score on a scaleStandard Deviation 0
iLet Infusion SetDifference in Local Erythema and Edema According to the Draize Scale0 score on a scaleStandard Deviation 0
Contact Detach Infusion SetDifference in Local Erythema and Edema According to the Draize Scale0 score on a scaleStandard Deviation 0
Secondary

Difference in Mean Nausea From VAS During the Study

This applies only the iPhone vs. iLet BP experiments. Subjects were given a visual analog scale measuring 100 mm and asked to draw a line to indicate their level of nausea at timepoints during the study with 100 being the worst possible nausea and 0 being no nausea.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonDifference in Mean Nausea From VAS During the Study3.47 score on a scaleStandard Deviation 10.47
iLet Bionic Pancreas - Lilly GlucagonDifference in Mean Nausea From VAS During the Study6.93 score on a scaleStandard Deviation 15.29
Secondary

Difference in the PG Prior to the Meal and Peak Post-prandial Glucose

This applies only to the infusion set sub-study

Time frame: Pre-meal PG value and peak PG value during the 3.5 hours following the meal.

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The Overall Number of Participants Analyzed represents all Completed participants that received the intervention

ArmMeasureValue (MEAN)Dispersion
iLet Infusion SetDifference in the PG Prior to the Meal and Peak Post-prandial Glucose176.3 mg/dlStandard Deviation 88.2
Contact Detach Infusion SetDifference in the PG Prior to the Meal and Peak Post-prandial Glucose73.9 mg/dlStandard Deviation 76.8
Secondary

Glucagon Total Delivery Per kg of Body Mass.

The average total glucagon delivered by the bionic pancreas. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonGlucagon Total Delivery Per kg of Body Mass.0.60 mcg/kgStandard Deviation 0.84
iLet Bionic Pancreas - Lilly GlucagonGlucagon Total Delivery Per kg of Body Mass.1.12 mcg/kgStandard Deviation 1.71
Secondary

Insulin Area Under the Curve During the Initial 90 Minute Fasted Period

This applies only to the infusion set sub-study

Time frame: 8 hours

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The infusion set sub study was terminated and the insulin assays were not completed.

Secondary

Insulin Total Delivery Per kg of Body Mass.

The average total insulin delivered by the bionic pancreas. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonInsulin Total Delivery Per kg of Body Mass.0.22 units/kgStandard Deviation 0.07
iLet Bionic Pancreas - Lilly GlucagonInsulin Total Delivery Per kg of Body Mass.0.23 units/kgStandard Deviation 0.07
Secondary

Mean Insulin Levels During the Initial 90 Minute Fasted Period

This applies only to the infusion set sub-study

Time frame: 8 hours

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The infusion set sub study was terminated and the insulin assays were not completed.

Secondary

Number of Episodes of Symptomatic Hypoglycemia.

Number of time subjects experienced symptoms of hypoglycemia and reported that to study staff. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (NUMBER)
iPhone Bionic Pancreas - Lilly GlucagonNumber of Episodes of Symptomatic Hypoglycemia.0 number of episodes
iLet Bionic Pancreas - Lilly GlucagonNumber of Episodes of Symptomatic Hypoglycemia.0 number of episodes
Secondary

Number of Severe Hypoglycemic Events (Subject Unable to Self-treat, Requiring the Assistance of Another Person)

The number of severe hypoglycemic events subjects experience. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (NUMBER)
iPhone Bionic Pancreas - Lilly GlucagonNumber of Severe Hypoglycemic Events (Subject Unable to Self-treat, Requiring the Assistance of Another Person)0 events
iLet Bionic Pancreas - Lilly GlucagonNumber of Severe Hypoglycemic Events (Subject Unable to Self-treat, Requiring the Assistance of Another Person)0 events
Secondary

Number of Subjects With Mean CGM Glucose < 154 mg/dl

The number of subjects who achieved a mean CGM glucose \< 154 mg/dl, which correlates to an estimated hemoglobin a1c of 7%, which is the ADA goal for therapy. This applies only to the iPhone vs iLet BP experiments

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
iPhone Bionic Pancreas - Lilly GlucagonNumber of Subjects With Mean CGM Glucose < 154 mg/dl1 Participants
iLet Bionic Pancreas - Lilly GlucagonNumber of Subjects With Mean CGM Glucose < 154 mg/dl1 Participants
Secondary

Number of Unscheduled CGM Sensor Changes.

This applies only to the iPhone vs. iLet BP experiments

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (NUMBER)
iPhone Bionic Pancreas - Lilly GlucagonNumber of Unscheduled CGM Sensor Changes.0 number of sensor changes
iLet Bionic Pancreas - Lilly GlucagonNumber of Unscheduled CGM Sensor Changes.0 number of sensor changes
Secondary

Number of Unscheduled Infusion Set Replacements.

This applies to the iPhone vs. iLet BP experiments and the infusion set sub-study experiments.

Time frame: 8 hours

Population: The experimental arm with the iLet BP using Xeris glucagon was never conducted. Analysis includes 9 subjects that completed both the BP visits and 4 subjects that completed both infusion set sub study visits.

ArmMeasureValue (NUMBER)
iPhone Bionic Pancreas - Lilly GlucagonNumber of Unscheduled Infusion Set Replacements.1 number of infusion set changes
iLet Bionic Pancreas - Lilly GlucagonNumber of Unscheduled Infusion Set Replacements.0 number of infusion set changes
iLet Infusion SetNumber of Unscheduled Infusion Set Replacements.0 number of infusion set changes
Contact Detach Infusion SetNumber of Unscheduled Infusion Set Replacements.0 number of infusion set changes
Secondary

Percentage of Time in Each of the Following Ranges: < 50 mg/dl, < 60 mg/dl, <70 mg/dl, 70-120 mg/dl, 70-180 mg/dl, >180 mg/dl, >250 mg/dl

Percentage of time subjects spent in each of these ranges based on continuous glucose monitor readings. This only applies to the iPhone vs iLet BP visits.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureGroupValue (MEAN)Dispersion
iPhone Bionic Pancreas - Lilly GlucagonPercentage of Time in Each of the Following Ranges: < 50 mg/dl, < 60 mg/dl, <70 mg/dl, 70-120 mg/dl, 70-180 mg/dl, >180 mg/dl, >250 mg/dlCGM glucose < 600.0 percentage of timeStandard Deviation 0
iPhone Bionic Pancreas - Lilly GlucagonPercentage of Time in Each of the Following Ranges: < 50 mg/dl, < 60 mg/dl, <70 mg/dl, 70-120 mg/dl, 70-180 mg/dl, >180 mg/dl, >250 mg/dlCGM glucose > 18039.0 percentage of timeStandard Deviation 24.5
iLet Bionic Pancreas - Lilly GlucagonPercentage of Time in Each of the Following Ranges: < 50 mg/dl, < 60 mg/dl, <70 mg/dl, 70-120 mg/dl, 70-180 mg/dl, >180 mg/dl, >250 mg/dlCGM glucose < 600.36 percentage of timeStandard Deviation 1.07
iLet Bionic Pancreas - Lilly GlucagonPercentage of Time in Each of the Following Ranges: < 50 mg/dl, < 60 mg/dl, <70 mg/dl, 70-120 mg/dl, 70-180 mg/dl, >180 mg/dl, >250 mg/dlCGM glucose > 18067.5 percentage of timeStandard Deviation 21.3
Secondary

PG AUC in the 3.5 Hours Following the Meal

This applies only to the infusion set sub-study

Time frame: 3.5 hours following the meal

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The Overall Number of Participants Analyzed represents all Completed participants that received the intervention

ArmMeasureValue (MEAN)Dispersion
iLet Infusion SetPG AUC in the 3.5 Hours Following the Meal15512740 mg*min/dlStandard Deviation 10050495
Contact Detach Infusion SetPG AUC in the 3.5 Hours Following the Meal8359871 mg*min/dlStandard Deviation 5458714
Secondary

T 1/2 Max After the Insulin Dose

This applies only to the infusion set sub-study

Time frame: 8 hours

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The infusion set sub study was terminated and the insulin assays were not completed.

Secondary

Terminal Half Life After the Insulin Dose

This applies only to the infusion set sub-study

Time frame: 8 hours

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The infusion set sub study was terminated and the insulin assays were not completed.

Secondary

Tmax After the Insulin Dose

This applies only to the infusion set sub-study

Time frame: 8 hours

Population: This outcome only applies to the infusion set sub study, the other arms were not analyzed. The infusion set sub study was terminated and the insulin assays were not completed.

Secondary

Total Grams of Carbohydrate Taken for Hypoglycemia.

The total grams of carbohydrates given to subjects for treatment of hypoglycemia. This applies only to the iPhone vs iLet BP experiments.

Time frame: 8 hours

Population: This analysis only applies to the iPhone BP vs iLet BP using Lilly glucagon arms. The experimental arm with the iLet BP using Xeris glucagon was never conducted. This analysis does not apply to the infusion set sub study. Analysis includes 9 subjects that completed both the BP visits.

ArmMeasureValue (NUMBER)
iPhone Bionic Pancreas - Lilly GlucagonTotal Grams of Carbohydrate Taken for Hypoglycemia.0 number of grams of carbohydrates
iLet Bionic Pancreas - Lilly GlucagonTotal Grams of Carbohydrate Taken for Hypoglycemia.0 number of grams of carbohydrates

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026