Trial Outcomes & Findings for Two Way Crossover Closed Loop Study Insulin vs Insulin and Pramlintide (NCT NCT06422325)

NCT ID: NCT06422325

Last Updated: 2026-03-05

Results Overview

Incremental area under the curve (iAUC) of postprandial glucose (mg/dL\*min) calculated using a trapezoidal method, which sums all continuous glucose monitoring (CGM) values above the starting glucose for the obseration period. Values shown are (mg/dL\*min)/1000.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

33 participants

Primary outcome timeframe

6 hours following first meal

Results posted on

2026-03-05

Participant Flow

A total of 35 people (19 females and 16 males) with type 1 diabetes mellitus have completed screening visits for the study from July-December 2024.

Participants were randomized immediately after screening.

Participant milestones

Participant milestones
Measure
Insulin Only Arm
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Overall Study
STARTED
16
17
Overall Study
COMPLETED
16
15
Overall Study
NOT COMPLETED
0
2

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Insulin-only to Insulin+Pramlintide
n=16 Participants
Participants will use the closed loop system with insulin-only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Then they will return after washout period to use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. For both arms, sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin+Pramlintide to Insulin-only
n=15 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Then they will return after washout period to use the closed loop system with insulin-only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. For both arms, sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Total
n=31 Participants
Total of all reporting groups
Age, Continuous
34.8 Years
STANDARD_DEVIATION 10.6 • n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
35.9 Years
STANDARD_DEVIATION 11.0 • n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
35.4 Years
STANDARD_DEVIATION 10.6 • n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Sex: Female, Male
Female
11 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
7 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
18 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Sex: Female, Male
Male
5 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
8 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
13 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
2 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
2 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Race (NIH/OMB)
Asian
0 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
0 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
0 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
0 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
0 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Race (NIH/OMB)
Black or African American
1 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
1 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
2 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Race (NIH/OMB)
White
14 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
10 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
24 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Race (NIH/OMB)
More than one race
1 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
2 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
3 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
0 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
0 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
3 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
3 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Ethnicity (NIH/OMB)
Not Hispanic or Latino
16 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
12 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
28 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
0 Participants
n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
0 Participants
n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Weight in kg
83.1 kg
STANDARD_DEVIATION 19.8 • n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
90.3 kg
STANDARD_DEVIATION 14.2 • n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
86.6 kg
STANDARD_DEVIATION 17.4 • n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Hemoglobin A1c
7.6 percentage of glycosylated hemoglobin
STANDARD_DEVIATION 0.7 • n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
7.0 percentage of glycosylated hemoglobin
STANDARD_DEVIATION 0.8 • n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
7.3 percentage of glycosylated hemoglobin
STANDARD_DEVIATION 0.8 • n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Duration of diabetes
15.5 years
STANDARD_DEVIATION 8.8 • n=41 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
18.9 years
STANDARD_DEVIATION 8.3 • n=35 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
17.2 years
STANDARD_DEVIATION 8.6 • n=76 Participants • A total of 33 subjects were randomized into the study. Two participants withdrew from the study before study treatment began, one due to scheduling conflicts and the other was lost to follow-up.
Glucose at start of pramlintide arm
128.4 mg/dl
STANDARD_DEVIATION 44.2 • n=41 Participants
130.5 mg/dl
STANDARD_DEVIATION 36.8 • n=35 Participants
129.4 mg/dl
STANDARD_DEVIATION 40.1 • n=76 Participants
Glucose at start of insulin-only arm
114.3 mg/dl
STANDARD_DEVIATION 25.9 • n=41 Participants
128.5 mg/dl
STANDARD_DEVIATION 38.7 • n=35 Participants
121.2 mg/dl
STANDARD_DEVIATION 33.0 • n=76 Participants

PRIMARY outcome

Timeframe: 6 hours following first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Incremental area under the curve (iAUC) of postprandial glucose (mg/dL\*min) calculated using a trapezoidal method, which sums all continuous glucose monitoring (CGM) values above the starting glucose for the obseration period. Values shown are (mg/dL\*min)/1000.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Incremental Area Under the Curve of Postprandial Glucose Following the First Meal
20.9 (mg/dl*min)/1000
Standard Deviation 13.0
18.1 (mg/dl*min)/1000
Standard Deviation 13.6

PRIMARY outcome

Timeframe: 6 hours following first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. Percent of time in range can take values between 0 and 100 and uses the six hours following the meal as the denominator.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose Between 70 - 180 mg/dl Following First Meal
44.3 Percent time in range
Standard Deviation 23.6
50.5 Percent time in range
Standard Deviation 29.5

SECONDARY outcome

Timeframe: 6 hours following second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Incremental area under the curve (iAUC) of postprandial glucose (mg/dL\*min) calculated using a trapezoidal method, which sums all continuous glucose monitoring (CGM) values above the starting glucose for the obseration period. Values shown are iAUC/1000.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Incremental Area Under the Curve of Postprandial Glucose Following the Second Meal
23.4 (mg/dl*min)/1000
Standard Deviation 12.1
11.0 (mg/dl*min)/1000
Standard Deviation 9.8

SECONDARY outcome

Timeframe: 6 hours following second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. Percent of time in range can take values between 0 and 100 and uses the six hours following the meal as the denominator.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose Between 70 - 180 mg/dl Following Second Meal
49.3 Percent time in range
Standard Deviation 20.1
74.4 Percent time in range
Standard Deviation 24.1

SECONDARY outcome

Timeframe: 6 hours following first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Net area under the curve (netAUC) of postprandial glucose (mg/dL\*min) calculated using a trapezoidal method, which sums all continuous glucose monitoring (CGM) values above the starting glucose and subtracts CGM values below the starting glucose for the observation period. Values shown are (mg/dL\*min)/1000.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Net Area Under the Curve of Postprandial Glucose Following the First Meal
15.0 (mg/dL*min)/1000
Standard Deviation 18.1
14.9 (mg/dL*min)/1000
Standard Deviation 16.6

SECONDARY outcome

Timeframe: 6 hours following second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Net area under the curve (netAUC) of postprandial glucose (mg/dL\*min) calculated using a trapezoidal method, which sums all continuous glucose monitoring (CGM) values above the starting glucose and subtracts CGM values below the starting glucose for the observation period. Values shown are (mg/dl \*min)/1000

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Net Area Under the Curve of Postprandial Glucose Following the Second Meal
22.2 (mg/dl *min)/1000
Standard Deviation 13.3
6.4 (mg/dl *min)/1000
Standard Deviation 14.4

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Net area under the curve (netAUC) of postprandial glucose (mg/dL\*min) calculated using a trapezoidal method, which sums all continuous glucose monitoring (CGM) values above the starting glucose and subtracts CGM values below the starting glucose for the observation period. Values shown are (mg/dL\*min)/1000.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Net Area Under the Curve of Postprandial Glucose
22.2 (mg/dL*min)/1000
Standard Deviation 13.3
6.6 (mg/dL*min)/1000
Standard Deviation 14.2

SECONDARY outcome

Timeframe: 6 hours following first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Assess the percent of time that the Dexcom G6 reported sensor glucose values less than 70 mg/dl using Dexcom sensor in the 6 hours following the start of the first meal. Because so few participants had any sensed glucose values \<70 mg/dL, this summary shows the count of participants with any time (\>0) with sensed glucose \<70 mg/dL

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose <70 mg/dL Following First Meal
6 Participants
2.5
5 Participants
2.4

SECONDARY outcome

Timeframe: 6 hours following second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Because so few participants had any sensed glucose values \<70 mg/dL, this summary shows the count of participants with any time (\>0) with sensed glucose \<70 mg/dL

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose <70 mg/dL Following Second Meal
6 Participants
5.1
10 Participants
4.5

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Because so few participants had any sensed glucose values \<70 mg/dL, this summary shows the count of participants with any time (\>0) with sensed glucose \<70 mg/dL

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose <70 mg/dL
11 Participants
14 Participants

SECONDARY outcome

Timeframe: 6 hours following first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. Percent of time in range can take values between 0 and 100 and uses the six hours following the meal as the denominator.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose Between 70-140 mg/dL Following First Meal
21 Percent time in range (mg/dl)
Inter-Quartile Range 23 • Interval 7.0 to 39.0
29 Percent time in range (mg/dl)
Inter-Quartile Range 24 • Interval 8.0 to 46.0

SECONDARY outcome

Timeframe: 6 hours following second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. Percent of time in range can take values between 0 and 100 and uses the six hours following the meal as the denominator.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose Between 70-140 mg/dL Following Second Meal
21 Percent time in range (mg/dl)
Inter-Quartile Range 19 • Interval 10.0 to 38.0
48 Percent time in range (mg/dl)
Inter-Quartile Range 22 • Interval 32.0 to 68.0

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. Percent of time in range can take values between 0 and 100 and uses the twelve hours of the clinic visit as the denominator.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose Between 70-140 mg/dL
23 Percent time in range (mg/dl)
Interval 15.0 to 35.0
39 Percent time in range (mg/dl)
Interval 24.0 to 58.0

SECONDARY outcome

Timeframe: 6 hours following first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. The outcome is calculated as the average of these values for the six hours following the meal.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Mean Sensed Glucose Following First Meal
204 mg/dL
Standard Deviation 45
184 mg/dL
Standard Deviation 44

SECONDARY outcome

Timeframe: 6 hours following second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. The outcome is calculated as the average of these values for the six hours following the meal.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Mean Sensed Glucose Following Second Meal
183 mg/dL
Standard Deviation 36
148 mg/dL
Standard Deviation 32

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. The outcome is calculated as the average of these values for the twelve-hour clinic visit.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Mean Sensed Glucose
194 mg/dL
Standard Deviation 30
166 mg/dL
Standard Deviation 33

SECONDARY outcome

Timeframe: 6 hours following first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Because so few participants had any sensed glucose values \<54 mg/dL, this summary shows the count of participants with any time (\>0) with sensed glucose \<54 mg/dL

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose <54 mg/dL Following First Meal
1 Participants
1 Participants

SECONDARY outcome

Timeframe: 6 hours following second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Because so few participants had any sensed glucose values \<54 mg/dL, this summary shows the count of participants with any time (\>0) with sensed glucose \<54 mg/dL

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose <54 mg/dL Following Second Meal
2 Participants
6.5
3 Participants
10

SECONDARY outcome

Timeframe: 12 hour clinic visit

Because so few participants had any sensed glucose values \<54 mg/dL, this summary shows the count of participants with any time (\>0) with sensed glucose \<54 mg/dL.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose <54 mg/dL
3 Participants
4 Participants

SECONDARY outcome

Timeframe: 6 hours following first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. Percent of time in range can take values between 0 and 100 and uses the six hours following the meal as the denominator.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose >180 mg/dL Following First Meal
55 Percent time in range
Standard Deviation 24
48 Percent time in range
Standard Deviation 31

SECONDARY outcome

Timeframe: 6 hours following second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. Percent of time in range can take values between 0 and 100 and uses the six hours following the meal as the denominator.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose >180 mg/dL Following Second Meal
49 Percent time in range
Standard Deviation 22
23 Percent time in range
Standard Deviation 25

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. Percent of time in range can take values between 0 and 100 and uses the twelve-hour clinic visit as the denominator.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose >180 mg/dL
52 percent of time
Standard Deviation 18
36 percent of time
Standard Deviation 24

SECONDARY outcome

Timeframe: 6 hours following first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. Percent of time in range can take values between 0 and 100 and uses the six hours after the meal as the denominator.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose >250 mg/dL Following First Meal
33 Percent time in range
Inter-Quartile Range 20 • Interval 12.0 to 51.0
7 Percent time in range
Inter-Quartile Range 20 • Interval 0.0 to 38.0

SECONDARY outcome

Timeframe: 6 hours following second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. Percent of time in range can take values between 0 and 100 and uses the six hours after the meal as the denominator.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose >250 mg/dL Following Second Meal
6 Percent time in range
Inter-Quartile Range 17 • Interval 0.0 to 26.0
0 Percent time in range
Inter-Quartile Range 10 • Interval 0.0 to 0.0

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. Percent of time in range can take values between 0 and 100 and uses the twelve hours of the clinic visit as the denominator.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Percent of Time With Sensed Glucose >250 mg/dL
23 Percent time in range
Interval 15.0 to 31.0
4 Percent time in range
Interval 0.0 to 19.0

SECONDARY outcome

Timeframe: 6 hours following the first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Median and quartiles reported for insulin and pramlintide, rather than mean, because the distribution is right-skewed.

Amount of insulin (units) delivered in the 6 hours following the first meal.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Median Amount of Insulin Delivered Following First Meal
11.1 Units
Interval 7.9 to 15.7
11.1 Units
Interval 7.9 to 16.4

SECONDARY outcome

Timeframe: 6 hours following the second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Amount of insulin (units) delivered. in the 6 hours following the second meal.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Median Amount of Insulin Delivered Following Second Meal
11.8 Units
Interval 7.9 to 14.9
9.1 Units
Interval 6.9 to 13.3

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Amount of insulin (units) delivered

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Median Amount of Insulin Delivered
22.4 Units
Interval 16.1 to 36.2
20.1 Units
Interval 16.6 to 25.7

SECONDARY outcome

Timeframe: 6 hours following the first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Amount of pramlintide (mcg) delivered in the 6 hours following the first meal.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Median Amount of Pramlintide Delivered Following First Meal
65.4 mcg
Interval 46.7 to 96.0

SECONDARY outcome

Timeframe: 6 hours following the second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Amount of pramlintide (mcg) delivered in the 6 hours following the second meal.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Median Amount of Pramlintide Delivered Following Second Meal
51.8 mcg
Interval 41.0 to 78.4

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Amount of pramlintide (mcg) delivered

Outcome measures

Outcome measures
Measure
Insulin Only Arm
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Median Amount of Pramlintide Delivered
117.2 mcg
Interval 97.3 to 149.1

SECONDARY outcome

Timeframe: 6 hours following the first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. The coefficient of variation outcome is calculated as (100 \* \[standard deviation\] / mean) of these values for the six hours following the meal.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Coefficient of Variation Following First Meal
33.0 Unitless
Standard Deviation 9.1
24.8 Unitless
Standard Deviation 6.5

SECONDARY outcome

Timeframe: 6 hours following the second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. The coefficient of variation outcome is calculated as (100 \* \[standard deviation\] / mean) of these values for the six hours following the meal.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Coefficient of Variation Following Second Meal
26.6 Unitless
Standard Deviation 6.9
23.2 Unitless
Standard Deviation 6.4

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Blood glucose values are recorded every 5 minutes using the Dexcom G6 sensor. The coefficient of variation outcome is calculated as (100 \* \[standard deviation\] / mean) of these values for the twelve hours in the clinic.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Coefficient of Variation
33.8 Unitless
Standard Deviation 8.6
28.7 Unitless
Standard Deviation 5.5

SECONDARY outcome

Timeframe: 6 hours following the first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

The Low Blood Glucose Index (LBGI) was calculated and categorized following accepted methods as described in: Clarke W, Kovatchev B. Statistical tools to analyze continuous glucose monitor data. Diabetes Technol Ther. 2009;11(Suppl 1):S-45-S-54. doi:10.1089/dia.2008.0138

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Low Blood Glucose Index (LBGI) Following the First Meal
Minimal risk (<=1.1)
28 Participants
28 Participants
Low Blood Glucose Index (LBGI) Following the First Meal
Low risk (1.1 <LBGI <=2.5)
3 Participants
2 Participants
Low Blood Glucose Index (LBGI) Following the First Meal
Moderate risk (2.5 <LBGI <=5)
0 Participants
1 Participants

SECONDARY outcome

Timeframe: 6 hours following the second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

The Low Blood Glucose Index (LBGI) was calculated and categorized following accepted methods as described in: Clarke W, Kovatchev B. Statistical tools to analyze continuous glucose monitor data. Diabetes Technol Ther. 2009;11(Suppl 1):S-45-S-54. doi:10.1089/dia.2008.0138

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Low Blood Glucose Index (LBGI) Following the Second Meal
Minimal risk (<=1.1)
27 Participants
24 Participants
Low Blood Glucose Index (LBGI) Following the Second Meal
Low risk (1.1 <LBGI <=2.5)
3 Participants
5 Participants
Low Blood Glucose Index (LBGI) Following the Second Meal
Moderate risk (2.5 <LBGI <=5)
1 Participants
1 Participants

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

The Low Blood Glucose Index (LBGI) was calculated and categorized following accepted methods as described in: Clarke W, Kovatchev B. Statistical tools to analyze continuous glucose monitor data. Diabetes Technol Ther. 2009;11(Suppl 1):S-45-S-54. doi:10.1089/dia.2008.0138

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Low Blood Glucose Index (LBGI)
Minimal risk (<=1.1)
29 Participants
28 Participants
Low Blood Glucose Index (LBGI)
Low risk (1.1 <LBGI <=2.5)
1 Participants
2 Participants
Low Blood Glucose Index (LBGI)
Moderate risk (2.5 <LBGI <=5)
1 Participants
1 Participants

SECONDARY outcome

Timeframe: 6 hours following the first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

The High Blood Glucose Index (HBGI) was calculated and categorized following accepted methods as described in: Clarke W, Kovatchev B. Statistical tools to analyze continuous glucose monitor data. Diabetes Technol Ther. 2009;11(Suppl 1):S-45-S-54. doi:10.1089/dia.2008.0138

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
High Blood Glucose Index (HBGI) Following the First Meal
Low risk (<4.5)
4 Participants
7 Participants
High Blood Glucose Index (HBGI) Following the First Meal
Moderate risk (4.5 < HBGI <= 9)
4 Participants
10 Participants
High Blood Glucose Index (HBGI) Following the First Meal
High risk (>9)
23 Participants
14 Participants

SECONDARY outcome

Timeframe: 6 hours following the second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

The High Blood Glucose Index (HBGI) was calculated and categorized following accepted methods as described in: Clarke W, Kovatchev B. Statistical tools to analyze continuous glucose monitor data. Diabetes Technol Ther. 2009;11(Suppl 1):S-45-S-54. doi:10.1089/dia.2008.0138

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
High Blood Glucose Index (HBGI) Following the Second Meal
Low risk (<4.5)
4 Participants
20 Participants
High Blood Glucose Index (HBGI) Following the Second Meal
Moderate risk (4.5 < HBGI <= 9)
11 Participants
6 Participants
High Blood Glucose Index (HBGI) Following the Second Meal
High risk (>9)
16 Participants
4 Participants

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

The High Blood Glucose Index (HBGI) was calculated and categorized following accepted methods as described in: Clarke W, Kovatchev B. Statistical tools to analyze continuous glucose monitor data. Diabetes Technol Ther. 2009;11(Suppl 1):S-45-S-54. doi:10.1089/dia.2008.0138

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
High Blood Glucose Index (HBGI)
Low risk (<4.5)
3 Participants
10 Participants
High Blood Glucose Index (HBGI)
Moderate risk (4.5 < HBGI <= 9)
2 Participants
10 Participants
High Blood Glucose Index (HBGI)
High risk (>9)
26 Participants
11 Participants

SECONDARY outcome

Timeframe: 4 days of pramlintide use

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Assess the number of adverse events probably or possibly associated with pramlintide administration.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Adverse Events Related to Pramlintide
16 Number of events
0.5

SECONDARY outcome

Timeframe: 6 hours following first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Six hours after the meal, participants were asked to use the Baxter Retching Faces (BARF) visual analog scale to indicate the worst nausea/vomiting discomfort they felt over the prior 6 hours. The scale ranges from 0 (none) to 10 (most discomfort).

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Baxter Retching Faces (BARF) Visual Analog Scale for Gastrointestinal Issues After the First Meal
0.0 score on the scale
Interval 0.0 to 1.0
0.0 score on the scale
Interval 0.0 to 7.2

SECONDARY outcome

Timeframe: 6 hours following second meal

Six hours after the meal, participants were asked to use the Baxter Retching Faces (BARF) visual analog scale to indicate the worst nausea/vomiting discomfort they felt over the prior 6 hours. The scale ranges from 0 (none) to 10 (most discomfort).

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Baxter Retching Faces (BARF) Visual Analog Scale for Gastrointestinal Issues After the Second Meal
0.0 score on the scale
Interval 0.0 to 3.0
0.0 score on the scale
Interval 0.0 to 8.2

SECONDARY outcome

Timeframe: 6 hours following first meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Six hours after the meal, participants were asked to report the approximate number of minutes they felt nausea during the prior 6 hours.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Mean Duration of Gastrointestinal Issues After the First Meal
1 Minutes
Interval 0.0 to 30.0
45 Minutes
Interval 0.0 to 360.0

SECONDARY outcome

Timeframe: 6 hours following second meal

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design. Unequal sample sizes reflect one missing meal for one participant.

Six hours after the meal, participants were asked to report the approximate number of minutes they felt nausea during the prior 6 hours.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=30 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Mean Duration of Gastrointestinal Issues After the Second Meal
4 Minutes
Interval 0.0 to 120.0
41 Minutes
Interval 0.0 to 360.0

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Counts of the number of episodes when the continuous glucose monitoring (CGM) values were \<70 mg/dL for 10 minutes or more.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Episodes of Hypoglycemia
3
1 Participants
0 Participants
Episodes of Hypoglycemia
0
21 Participants
19 Participants
Episodes of Hypoglycemia
1
7 Participants
12 Participants
Episodes of Hypoglycemia
2
2 Participants
0 Participants

SECONDARY outcome

Timeframe: 12 hour clinic visit

Population: All participants who completed at least one six-hour observation period. Participants completed both arms in a crossover design.

Assess the number of rescue carbohydrate treatments (defined as 15 grams of carbohydrate intake) needed to treat hypoglycemia.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Episodes of Carbohydrate Intake to Treat Hypoglycemia
0.5 number of events
Standard Deviation 0.9
0.7 number of events
Standard Deviation 1.0

SECONDARY outcome

Timeframe: 12 hour clinic visit

Assess the number of provider-administered insulin injections due to hyperglycemia.

Outcome measures

Outcome measures
Measure
Insulin Only Arm
n=31 Participants
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 Participants
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Number of Provider-administered Insulin Injections
0 count of injections
Standard Deviation 0
0 count of injections
Standard Deviation 0

Adverse Events

Insulin Only Arm

Serious events: 0 serious events
Other events: 17 other events
Deaths: 0 deaths

Insulin and Pramlintide Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Insulin Only Arm
n=31 participants at risk
Participants will use the closed loop system with insulin only for managing blood sugar during the 12.5 hour study. Insulin will be administered by an Omnipod. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Insulin and Pramlintide Arm
n=31 participants at risk
Participants will use the closed loop system with insulin and pramlintide for managing blood sugar during the 12.5 hour study. Insulin and pramlintide will be administered by two Omnipods. Sensor glucose will be measured by a Dexcom G6 CGM. Participants will eat two meals while in clinic.
Gastrointestinal disorders
Nausea
54.8%
17/31 • Up to seven weeks from study enrollment to study completion. This includes two clinic visits and time in between.
All the participants that started the first treatment period after randomization are included in the adverse events.
0.00%
0/31 • Up to seven weeks from study enrollment to study completion. This includes two clinic visits and time in between.
All the participants that started the first treatment period after randomization are included in the adverse events.

Additional Information

Leah Wilson

Oregon Health & Science University

Phone: 5034943273

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place