Efficacy of Closed-loop Insulin Therapy in Prepubertal Child in Free-life (FREELIFE-KID)

University Hospital Center (CHU)

Status: Unknown

Conditions: Type 1 Diabetes Mellitus in Prepubertal Children

Treatments: Device: Closed-loop insulin infusion driven by continuous glucose monitoring through an algorithm, in free-life conditions

Study type: Interventional

Funder types: Other

Identifiers

NCT03739099

UF 7580

Details and patient eligibility

About

The study is a randomized trial preceded by a run-in period and followed by a non-randomized study extension. After 3 weeks of outpatient use of study pump (1 week) and study pump+CGM (2weeks) as run-in period, patient and parents will be admitted for 4-hour training to closed-loop (AP) mode. Following randomization (1:1), patient will be allocated to '24-hour' use of AP or 'dinner and overnight AP mode/day time pump and CGM use' for the next 18-week period. At 18-week visit, a study extension for a further 18-week period will be initiated. AP mode that will be prescribed to all patients will depend from an independent DSMB decision based upon study safety data collected after 6 and 12 weeks from the first 30 included patients. Visits will occur at week 27 (safety follow-up) and 36 (final visit).

Full description

The study is a randomized trial preceded by a run-in period and followed by a non-randomized study extension. After 3 weeks of outpatient use of study pump (1 week) and study pump+CGM (2weeks) as run-in period, patient and parents will be admitted for 4-hour training to closed-loop (AP) mode. Following randomization (1:1), patient will be allocated to '24-hour' use of AP or 'dinner and overnight AP mode/day time pump and CGM use' for the next 18-week period. A hotline phone number will be given to the patient and parents so that they can contact the study staff as needed. A logbook will be provided to collect details about hypoglycemic and hyperglycemic episodes, physical activity and noticeable events. Phone calls will be scheduled between investigator and patient+parents 48 hours, 1 week and 2 weeks after AP mode initiation. Potential misbehaviors will be corrected and all questions answered. If needed, AP parameters may be revised and reconfigured. Hospital visits will be scheduled 6, 12 and 18 weeks after AP mode initiation for the same purposes, plus HbA1c measurement at week 12 and 18. At 18-week visit, a study extension for a further 18-week period will be initiated. AP mode that will be prescribed to all patients will depend from an independent DSMB decision based upon study safety data collected after 6 and 12 weeks from the first 30 included patients. Visits will occur at week 27 (safety follow-up) and 36 (final visit).

Enrollment: 122 patients

Sex: All

Ages: 6 to 12 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Treatment of diabetes by insulin pump since > 6 months
• HbA1c level < 10%

Exclusion criteria

• Unwillingness of one parent or the legally responsible party to participate in insulin treatment
• Any associated chronic disease or therapy (except insulin) affecting glucose metabolism

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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122 participants in 2 patient groups

Closed-loop insulin delivery 24/7, day and night

Active Comparator group

Description:

Closed-loop subcutaneous insulin infusion driven by continuous glucose monitoring through an algorithm

Treatment:

Device: Closed-loop insulin infusion driven by continuous glucose monitoring through an algorithm, in free-life conditions

Closed-loop insulin delivery 7/7, dinner and night

Other group

Description:

Closed-loop subcutaneous insulin infusion driven by continuous glucose monitoring through an algorithm

Treatment:

Device: Closed-loop insulin infusion driven by continuous glucose monitoring through an algorithm, in free-life conditions