Type1diabetes
Conditions
Brief summary
The study comprises of two segments: a feasibility segment and a Proof of Concept segment. The study is open label, prospective study that will include up to 72 subjects in segment 1 and up to 40 subjects in segment 2. Participants are people with Type 1 or type 2 Diabetes treated with Multiple Daily Injections ( MDI) and Self Monitoring of Blood Glucose (SMBG) or intermittent Continuous Glucose Monitoring (CGM). The study will include screening, a 2-4-week run-in period and 10-12 weeks intervention period. Subjects will be asked to record their insulin delivery during basal/bolus insulin treatment (using dedicated apps ) and their daily activities (meals, physical activity etc.) using electronic log (implemented on Dedicated Apps), for a total period of 12-16 weeks. The goal of this study is to evaluate the safety of a decision support system for adjustment of insulin treatment plan for people with diabetes using multiple daily injections and monitoring glucose by SMBG or intermittent CGM
Interventions
DEVICEDreaMed Advisor Pro DSS-MDI algorithm
The DreaMed Advisor Pro software is a proprietary algorithm, designed to provide a comprehensive analysis of individual diabetes data which consists of glucose levels and insulin delivery history. the Advisor Pro algorithm identifies glucose patterns and their possible causes, which may hamper the patient's glucose control, and recommend on adjustment to the patient-specific insulin treatment profiles as well as suggestions for personalized diabetes management tips (such as timing of meal boluses, bolus delivery compliance and personalized glucose targets).
Sponsors
The Leona M. and Harry B. Helmsley Charitable Trust
DreaMed Diabetes
Rabin Medical Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
14 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Documented Type 1 or Type 2 Diabetes for at least 1 year prior to study enrolment * Aged ≥ 14 years * HbA1c of 6.5 ≤ A1c ≤ 10% * Using basal-bolus MDI therapy: 1. Basal insulin: Glargine, Degludec, or detemir and up to sum of 72 units of basal insulin 2. Bolus insulin: regular insulin, rapid analogues or ultra-rapid analogues * Subjects willing to follow study instructions: 1. For SMBG users (only for segment 1): measure capillary blood glucose at least 4 times a day . Document blood glucose level, insulin delivery, meals and daily activities. Wear CGM. 2. For CGM users (FGM with a reader or real-time CGM): Use CGM according to manufacture instructions, document insulin delivery, meals and daily activities. * Subjects using CGM or SMBG that are compatible with data transmission to the study diabetes management system (i.e. for CGM, FGM with a reader). * Fasting glucose target is \< = 180 mg/dl (T2D) * Subjects have home computer connected to the internet. * Subjects have a smart phone compatible with study requirements. * Subjects willing and able to sign a written informed consent form.
Exclusion criteria
* An episode of diabetic keto-acidosis within the month prior to study entry and/or severe hypoglycemia resulting in seizure or loss of consciousness in the month prior to enrolment. * Concomitant diseases/ treatment that influence metabolic control or any significant diseases /conditions including psychiatric disorders and substance abuse that in the opinion of the investigator is likely to affect the subject's ability to complete the study or compromise patients' safety * Relevant severe organ disorders (diabetic nephropathy, diabetic retinopathy, diabetic foot syndrome) or any secondary disease or complication of diabetes mellitus, such as: * Subject has unstable or rapidly progressive renal disease or is receiving dialysis * Subject has active proliferative retinopathy * Active gastroparesis * Subject has loss of kidney function as measured by estimated Glomerular Filtration Rate (eGFR) \<45 in the previous 3 months 4. Participation in any other interventional study 5. Female subject who is pregnant or planning to become pregnant within the planned study duration * Subject is in the honeymoon phase - i.e. less than 0.5 insulin units/kg per day. * Drug or alcohol abuse.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Sensor glucose percentage of time in hypoglycemia below 54 mg/dl | 12-16 weeks |
| Sensor glucose percentage of time in hyperglycemia above 250 mg/dl | 12-16 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Percentage of readings within range of 70-180 mg/dl | 12-16 weeks |
| Change in HbA1C post study treatment | 12-16 weeks |
| Number of Serious Adverse Events | 12-16 weeks |
Other
| Measure | Time frame |
|---|---|
| Number of recommendations for changes in the treatment plan per iteration | 12-16 weeks |
| Number of physician overrides of the study system recommendations segment 1 only | 12-16 weeks |
| Number of physician overrides of the study system recommendations | 12-16 weeks |
| Percentage of readings above 180 mg/dl | 12-16 weeks |
| The amount of basal insulin dose | 12-16 weeks |
| The amount of bolus insulin dose | 12-16 weeks |
| Total insulin dose | 12-16 weeks |
| Percentage of readings below 70 mg/dl | 12-16 weeks |
| Mean sensor glucose | 11 weeks |
| Glucose variability | 12-16 weeks |
| Number of recommendations for changes in the treatment plan per patient | 12-16 weeks |
Countries
Israel
Contacts
Primary ContactMoshe Phillip, MD
Backup ContactAlona Hamou, MSc
Outcome results
None listed