Research Study to Look at Fast-acting Insulin Aspart With the Insulin Pump System 'iLet™' in Adults With Type 1 Diabetes

Sponsor
Novo Nordisk A/S (Industry)
Overall Status
Completed
CT.gov ID
NCT03816761
Collaborator
(none)
24
1
2
3.4
7

Study Details

Study Description

Brief Summary

The iLet™ is a new insulin pump that is programmed to work with a Continuous Glucose Monitoring (CGM) device. This is to give participants insulin automatically. The CGM device is already available for sale. The iLet™ is not yet approved for use. Fast-acting insulin aspart is a type of insulin that doctors can already prescribe for use with insulin pens, but not for use in an insulin pump. This study is to test how safe fast acting insulin aspart is when used with different insulin delivery settings in the iLet™ in people with type 1 diabetes. Participants will get fast-acting insulin aspart as participants' insulin and use the iLet™ as participants' insulin pump with a CGM device. Participants' iLet™ will be set to 2 different insulin delivery settings for 7 days on each setting. The setting participants get first is decided by chance. The study will last for about 5 to 9 weeks. Participants will have 4 visits and 1 phone contact with the study or staff.

Condition or Disease Intervention/Treatment Phase
  • Drug: Fast-acting insulin aspart
  • Device: iLet™
Phase 2

Study Design

Study Type:
Interventional
Actual Enrollment :
24 participants
Allocation:
Randomized
Intervention Model:
Crossover Assignment
Masking:
Double (Participant, Outcomes Assessor)
Masking Description:
Sponsor staff involved in the clinical trial is masked according to company standard procedures.
Primary Purpose:
Treatment
Official Title:
An Exploratory Trial Investigating the Safety and Efficacy of Fast-acting Insulin Aspart in a Closed-loop Insulin Delivery System (Bionic Pancreas) in Adults With Type 1 Diabetes
Actual Study Start Date :
Feb 25, 2019
Actual Primary Completion Date :
May 31, 2019
Actual Study Completion Date :
Jun 10, 2019

Arms and Interventions

Arm Intervention/Treatment
Experimental: Fast-acting insulin aspart, default tmax setting

Participants will receive fast-acting insulin aspart using the iLet™ with default tmax setting (t65 = 65 minutes) in two different treatment periods in a cross-over manner. There will be 3 different cohorts with 2 treatment periods in each cohort.

Drug: Fast-acting insulin aspart
In each cohort, participants will receive fast-acting insulin aspart using the iLet™ in a cross-over manner for 14 days (7days per period). Dose modification will be handled autonomously by the iLet™ based on the CGM sensor readings and the user interaction with the iLet™ e.g. meal announcements.

Device: iLet™
The bionic pancreas including pigtail adapters, used in insulin-only configuration

Experimental: Fast-acting insulin aspart, non-default tmax setting

Participants will receive fast-acting insulin aspart using the iLet™ with non-default tmax setting (t50 = 50 minutes, t40 = 40 minutes or t30 = 30 minutes) in two different treatment periods in a cross-over manner. There will be 3 different cohorts with 2 treatment periods in each cohort.

Drug: Fast-acting insulin aspart
In each cohort, participants will receive fast-acting insulin aspart using the iLet™ in a cross-over manner for 14 days (7days per period). Dose modification will be handled autonomously by the iLet™ based on the CGM sensor readings and the user interaction with the iLet™ e.g. meal announcements.

Device: iLet™
The bionic pancreas including pigtail adapters, used in insulin-only configuration

Outcome Measures

Primary Outcome Measures

  1. Time in Low Interstitial Glucose (Defined as Below 54 mg/dL [3 mmol/L]) From Initiation of Treatment (Day 1) to End of Treatment (Day 7) (Percentage) [Day 1 to day 7]

    Interstitial glucose: glucose measured in interstitial fluid. Time in low interstitial glucose (defined as below 54 mg/dL [3 mmol/L]) from initiation of treatment (day 1) to end of treatment (day 7). Time spent in low interstitial glucose is calculated as the percentage of available interstitial glucose values below the threshold.

  2. Time in Low Interstitial Glucose (Defined as Below 54 mg/dL [3 mmol/L]) From Initiation of Treatment (Day 1) to End of Treatment (Day 7) (Percentage) - Median [Day 1 to day 7]

    Interstitial glucose: glucose measured in interstitial fluid. Time in low interstitial glucose (defined as below 54 mg/dL [3 mmol/L]) from initiation of treatment (day 1) to end of treatment (day 7). Time spent in low interstitial glucose is calculated as the percentage of available interstitial glucose values below the threshold.

Secondary Outcome Measures

  1. Number of Treatment Emergent Severe Hypoglycaemic Episodes [Day 1 to day 7]

    Number of treatment emergent severe hypoglycaemic episodes from initiation of treatment (day 1) to end of treatment (day 7). Treatment emergent is defined as an episode that has onset in the period from initiation of treatment to end of treatment. Severe hypoglycaemia: An episode requiring assistance of another person to actively administer carbohydrate, glucagon or take other corrective actions. Plasma glucose (PG) concentrations may not be available during an event, but neurological recovery following the return of PG to normal is considered sufficient evidence that the event was induced by a low PG concentration.

  2. Number of Self-manageable (Able to Self-treat) Treatment Emergent Hypoglycaemic Episodes That Require Oral Carbohydrate Intervention Per Day [Day 1 to day 7]

    Mean number of self-manageable (able to self-treat) treatment emergent hypoglycaemic episodes that require oral carbohydrate intervention per day. Self-manageable (able to self-treat) hypoglycaemic episodes that require oral carbohydrate intervention per day is calculated as the sum of all hypoglycaemic episodes where the subject is able to self-treat and that require oral carbohydrate intervention divided by the actual duration of the treatment period in days. Treatment emergent is defined as an episode that has onset in the period from initiation of treatment to end of treatment.

  3. Number of Treatment Emergent Overall Hypoglycaemic Episodes Classified According to the American Diabetes Association (ADA) Definition [Day 1 to day 7]

    ADA classification of hypoglycaemia: Severe hypoglycaemia: An episode requiring assistance of another person to actively administer carbohydrate, glucagon or take other corrective actions. Asymptomatic hypoglycaemia: An episode not accompanied by typical symptoms of hypoglycaemia, but with a measured PG concentration ≤3.9 mmol/L (70 mg/dL). Documented symptomatic hypoglycaemia: An episode during which typical symptoms of hypoglycaemia are accompanied by a measured PG concentration ≤ 3.9 mmol/L (70 mg/dL). Pseudo-hypoglycaemia: An episode during which the person with diabetes reports any of the typical symptoms of hypoglycaemia with a measured PG concentration > 3.9 mmol/L (70 mg/dL) but approaching that level. Probable symptomatic hypoglycaemia: An episode during which symptoms of hypoglycaemia are not accompanied by a PG determination but that was presumably caused by a PG concentration ≤ 3.9 mmol/L (70 mg/dL).

  4. Number of Treatment Emergent Overall Hypoglycaemic Episodes Classified According to the Novo Nordisk Classification [Day 1 to day 7]

    Overall hypoglycaemia count according to Novo Nordisk classification. Novo Nordisk classification of hypoglycaemia: Severe hypoglycaemia according to the ADA classification. Symptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) with symptoms consistent with hypoglycaemia. Asymptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) without symptoms consistent with hypoglycaemia. BG confirmed hypoglycaemia: The union of 2. and 3. Severe or BG confirmed symptomatic hypoglycaemia: The union of 1. and 2. Severe or BG confirmed hypoglycaemia: The union of 1., 2. and 3.

  5. Number of Treatment Emergent Daytime Hypoglycaemic Episodes Classified According to the American Diabetes Association (ADA) Definition [Day 1 to day 7 (in both the treatment periods)]

    ADA classification of hypoglycaemia: Severe hypoglycaemia: An episode requiring assistance of another person to actively administer carbohydrate, glucagon or take other corrective actions. Asymptomatic hypoglycaemia: An episode not accompanied by typical symptoms of hypoglycaemia, but with a measured PG concentration ≤3.9 mmol/L (70 mg/dL). Documented symptomatic hypoglycaemia: An episode during which typical symptoms of hypoglycaemia are accompanied by a measured PG concentration ≤ 3.9 mmol/L (70 mg/dL). Pseudo-hypoglycaemia: An episode during which the person with diabetes reports any of the typical symptoms of hypoglycaemia with a measured PG concentration > 3.9 mmol/L (70 mg/dL) but approaching that level. Probable symptomatic hypoglycaemia: An episode during which symptoms of hypoglycaemia are not accompanied by a PG determination but that was presumably caused by a PG concentration ≤ 3.9 mmol/L (70 mg/dL).

  6. Number of Treatment Emergent Daytime Hypoglycaemic Episodes Classified According to the Novo Nordisk Classification [Day 1 to day 7]

    Number of daytime hypoglycaemic episodes according to Novo Nordisk classification. Novo Nordisk classification of hypoglycaemia: Severe hypoglycaemia according to the ADA classification. Symptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) with symptoms consistent with hypoglycaemia. Asymptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) without symptoms consistent with hypoglycaemia. BG confirmed hypoglycaemia: The union of 2. and 3. Severe or BG confirmed symptomatic hypoglycaemia: The union of 1. and 2. Severe or BG confirmed hypoglycaemia: The union of 1., 2. and 3.

  7. Number of Treatment Emergent Nocturnal Hypoglycaemic Episodes Classified According to the American Diabetes Association (ADA) Definition [Day 1 to day 7]

    ADA classification of hypoglycaemia: Severe hypoglycaemia: An episode requiring assistance of another person to actively administer carbohydrate, glucagon or take other corrective actions. Asymptomatic hypoglycaemia: An episode not accompanied by typical symptoms of hypoglycaemia, but with a measured PG concentration ≤3.9 mmol/L (70 mg/dL). Documented symptomatic hypoglycaemia: An episode during which typical symptoms of hypoglycaemia are accompanied by a measured PG concentration ≤ 3.9 mmol/L (70 mg/dL). Pseudo-hypoglycaemia: An episode during which the person with diabetes reports any of the typical symptoms of hypoglycaemia with a measured PG concentration > 3.9 mmol/L (70 mg/dL) but approaching that level. Probable symptomatic hypoglycaemia: An episode during which symptoms of hypoglycaemia are not accompanied by a PG determination but that was presumably caused by a PG concentration ≤ 3.9 mmol/L (70 mg/dL).

  8. Number of Treatment Emergent Nocturnal Hypoglycaemic Episodes Classified According to the Novo Nordisk Classification [Day 1 to day 7 (in both the treatment periods)]

    Number of nocturnal (from time 00:01-05:59 both inclusive) hypoglycaemic episodes according to Novo Nordisk classification. Novo Nordisk classification of hypoglycaemia: Severe hypoglycaemia according to the ADA classification. Symptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) with symptoms consistent with hypoglycaemia. Asymptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) without symptoms consistent with hypoglycaemia. BG confirmed hypoglycaemia: The union of 2. and 3. Severe or BG confirmed symptomatic hypoglycaemia: The union of 1. and 2. Severe or BG confirmed hypoglycaemia: The union of 1., 2. and 3.

  9. Time in Interstitial Glucose Range Was Defined as 70-180 mg/dL (3.9-10 mmol/L) From Initiation of Treatment (Day 1) to End of Treatment (Day 7) (Percentages) [Day 1 to day 7]

    Time in interstitial glucose range defined as 70-180 mg/dL (3.9-10 mmol/L) from initiation of treatment (day 1) to end of treatment (day 7). Time spent in interstitial glucose range is calculated as the percentage of available interstitial glucose values above or equal to the low threshold and below or equal to the high threshold.

  10. Mean Interstitial-glucose Level [Day 1 to day 7]

    Mean interstitial glucose level is calculated as the average of the available interstitial glucose values.

  11. Number of Treatment Emergent Adverse Events [Day 1 to day 7]

    Number of treatment emergent adverse events from initiation of treatment (day 1) to end of treatment (day 7). Treatment emergent is defined as an event that has onset in the period from initiation of treatment to end of treatment.

  12. Number of Treatment Emergent Infusion Site Reactions [Day 1 to day 7]

    Number of treatment-emergent infusion site reactions from initiation of treatment (day 1) to end of treatment (day 7). Treatment emergent is defined as an event that has onset in the period from initiation of treatment to end of treatment.

  13. Total Insulin Dose Per Day [Day 1 to day 7]

    Total insulin dose (U/kg) per day from initiation of treatment (day 1) to end of treatment (day 7). Total daily insulin dose is calculated as the sum of all insulin doses delivered by the iLet™ divided by the actual duration of the treatment period in days.

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 75 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Inclusion Criteria:
  • Informed consent obtained before any trial-related activities. Trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial

  • Male or female, age more than or equal to 18 years and less than or equal to 75 years at the time of signing informed consent

  • Diagnosed with type 1 diabetes mellitus more than or equal to 1 year prior to the day of screening

  • Treated with continuous subcutaneous insulin infusion more than or equal to 1 year prior to the day of screening

  • Have a mean total daily dose of insulin more than or equal to 20 units

  • Familiar with continuous glucose monitoring as judged by the investigator

  • Has someone over 18 years of age who (i) lives with them, (ii) has access to where they sleep, (iii) is willing to be in the house when the subject is sleeping, and (iv) is willing to receive calls from the study staff and check the welfare of the study subject

  • Body mass index (BMI) less than or equal to 35.0 kg/m^2 at screening

  • Glycated haemoglobin (HbA1c) more than or equal to 6.5% (47 mmol/mol) and less than or equal to 9% (75 mmol/mol) at screening

  • Able and willing to remain in a designated place for the specified duration of the 'in-patient' periods

  • Lives within a 120-minute drive away from the central monitoring location (site)

Exclusion Criteria:
  • Known or suspected hypersensitivity to trial product(s) or related products

  • Previous participation in this trial. Participation is defined as signed informed consent

  • Female who is pregnant, breast-feeding or intends to become pregnant or is of child-bearing potential and not using an adequate contraceptive method (adequate contraceptive measures as required by local regulation or practice)

  • Participation in any clinical trial of an approved or non-approved investigational medicinal product within 30 days before screening

  • Any disorder, except for conditions associated with diabetes mellitus, which in the investigator's opinion might jeopardise subject's safety or compliance with the protocol

  • Anticipated initiation or change in concomitant medications known to affect weight or glucose metabolism during the trial

  • Impaired liver function, defined as Alanine Aminotransferase (ALT) more than or equal to 2.5 times or Bilirubin more than 1.5 times upper normal limit at screening

  • Renal impairment measured as estimated Glomerular Filtration Rate (eGFR) value of eGFR less than 60 ml/min/1.73 m^2

  • Any episodes of diabetic ketoacidosis within the past 90 days prior to the day of screening

  • Known hypoglycaemic unawareness as indicated by the Investigator according to Clarke's questionnaire question 8

  • Recurrent severe hypoglycaemic episodes within the last year as judged by the Investigator

  • Any of the following: myocardial infarction, stroke, hospitalization for unstable angina pectoris or transient ischaemic attack within the past 180 days prior to the day of screening

  • Subjects presently classified as being in New York Heart Association (NYHA) Class IV

  • Planned coronary, carotid or peripheral artery revascularisation known on the day of screening

  • Inadequately treated blood pressure defined as Grade 3 hypertension or higher (systolic more than or equal to 180 mmHg or diastolic more than or equal to 110 mmHg) at screening

  • Unwilling or unable to avoid acetaminophen throughout the trial

Contacts and Locations

Locations

Site City State Country Postal Code
1 Novo Nordisk Investigational Site Boston Massachusetts United States 02114

Sponsors and Collaborators

  • Novo Nordisk A/S

Investigators

  • Study Director: Clinical Reporting Anchor and Disclosure (1452), Novo Nordisk A/S

Study Documents (Full-Text)

More Information

Publications

None provided.
Responsible Party:
Novo Nordisk A/S
ClinicalTrials.gov Identifier:
NCT03816761
Other Study ID Numbers:
  • NN1218-4360
  • U1111-1205-1788
First Posted:
Jan 25, 2019
Last Update Posted:
Jun 11, 2020
Last Verified:
May 1, 2020
Individual Participant Data (IPD) Sharing Statement:
Yes
Plan to Share IPD:
Yes
Studies a U.S. FDA-regulated Drug Product:
Yes
Studies a U.S. FDA-regulated Device Product:
Yes
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details The trial was conducted at one site in the United States.
Pre-assignment Detail
Arm/Group Title Cohort 1: t65 First, Then t50 Cohort 1: t50 First, Then t65 Cohort 2: t65 First, Then t40 Cohort 2: t40 First, Then t65 Cohort 3: t65 First, Then t30 Cohort 3: t30 First, Then t65
Arm/Group Description iLet™ is a new insulin pump that is programmed to work with a Continuous Glucose Monitoring (CGM) device. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) for 7 days. The total treatment duration for each cohort was 14 days. iLet™ is a new insulin pump that is programmed to work with a Continuous Glucose Monitoring (CGM) device. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. The total treatment duration for each cohort was 14 days. iLet™ is a new insulin pump that is programmed to work with a Continuous Glucose Monitoring (CGM) device. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) for 7 days. The total treatment duration for each cohort was 14 days. iLet™ is a new insulin pump that is programmed to work with a Continuous Glucose Monitoring (CGM) device. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. The total treatment duration for each cohort was 14 days. iLet™ is a new insulin pump that is programmed to work with a Continuous Glucose Monitoring (CGM) device. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) for 7 days. The total treatment duration for each cohort was 14 days. iLet™ is a new insulin pump that is programmed to work with a Continuous Glucose Monitoring (CGM) device. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. The total treatment duration for each cohort was 14 days.
Period Title: First Treatment Period (7 Days)
STARTED 4 4 4 4 4 4
COMPLETED 4 4 4 4 4 3
NOT COMPLETED 0 0 0 0 0 1
Period Title: First Treatment Period (7 Days)
STARTED 4 4 4 4 4 3
COMPLETED 4 4 4 3 4 3
NOT COMPLETED 0 0 0 1 0 0

Baseline Characteristics

Arm/Group Title Cohort 1 Cohort 2 Cohort 3 Total
Arm/Group Description Participants were randomised in a 1:1 manner to one of two treatment sequences. First sequence: Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) for 7 days. Second sequence: Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. The total treatment duration for the cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants were randomised in a 1:1 manner to one of two treatment sequences. First sequence: Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) for 7 days. Second sequence: Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. The total treatment duration for the cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants were randomised in a 1:1 manner to one of two treatment sequences. First sequence: Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) for 7 days. Second sequence: Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) for 7 days. After 7 days they received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) for 7 days. The total treatment duration for the cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Total of all reporting groups
Overall Participants 8 8 8 24
Age (Years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [Years]
45.5
(13.5)
36.3
(14.8)
47.1
(10.7)
43.0
(13.4)
Sex: Female, Male (Count of Participants)
Female
6
75%
7
87.5%
5
62.5%
18
75%
Male
2
25%
1
12.5%
3
37.5%
6
25%
Race (NIH/OMB) (Count of Participants)
American Indian or Alaska Native
0
0%
0
0%
0
0%
0
0%
Asian
0
0%
0
0%
0
0%
0
0%
Native Hawaiian or Other Pacific Islander
0
0%
0
0%
0
0%
0
0%
Black or African American
0
0%
0
0%
0
0%
0
0%
White
7
87.5%
8
100%
8
100%
23
95.8%
More than one race
0
0%
0
0%
0
0%
0
0%
Unknown or Not Reported
1
12.5%
0
0%
0
0%
1
4.2%

Outcome Measures

1. Primary Outcome
Title Time in Low Interstitial Glucose (Defined as Below 54 mg/dL [3 mmol/L]) From Initiation of Treatment (Day 1) to End of Treatment (Day 7) (Percentage)
Description Interstitial glucose: glucose measured in interstitial fluid. Time in low interstitial glucose (defined as below 54 mg/dL [3 mmol/L]) from initiation of treatment (day 1) to end of treatment (day 7). Time spent in low interstitial glucose is calculated as the percentage of available interstitial glucose values below the threshold.
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Full analysis set: included all randomised subjects receiving treatment.Number of participants analysed=participants with available data.
Arm/Group Title t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 8 7
Mean (Standard Deviation) [Percentage]
0.98
(0.72)
0.89
(1.16)
0.69
(0.50)
0.50
(0.79)
0.61
(0.56)
0.37
(0.41)
2. Primary Outcome
Title Time in Low Interstitial Glucose (Defined as Below 54 mg/dL [3 mmol/L]) From Initiation of Treatment (Day 1) to End of Treatment (Day 7) (Percentage) - Median
Description Interstitial glucose: glucose measured in interstitial fluid. Time in low interstitial glucose (defined as below 54 mg/dL [3 mmol/L]) from initiation of treatment (day 1) to end of treatment (day 7). Time spent in low interstitial glucose is calculated as the percentage of available interstitial glucose values below the threshold.
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Full analysis set: included all randomised subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 8 7
Median (Full Range) [Percentage]
0.93
0.42
0.75
0.20
0.58
0.29
3. Secondary Outcome
Title Number of Treatment Emergent Severe Hypoglycaemic Episodes
Description Number of treatment emergent severe hypoglycaemic episodes from initiation of treatment (day 1) to end of treatment (day 7). Treatment emergent is defined as an episode that has onset in the period from initiation of treatment to end of treatment. Severe hypoglycaemia: An episode requiring assistance of another person to actively administer carbohydrate, glucagon or take other corrective actions. Plasma glucose (PG) concentrations may not be available during an event, but neurological recovery following the return of PG to normal is considered sufficient evidence that the event was induced by a low PG concentration.
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Safety analysis set (SAS): included all subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t50 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 8 7
Number [Episodes]
0
0
0
0
0
0
4. Secondary Outcome
Title Number of Self-manageable (Able to Self-treat) Treatment Emergent Hypoglycaemic Episodes That Require Oral Carbohydrate Intervention Per Day
Description Mean number of self-manageable (able to self-treat) treatment emergent hypoglycaemic episodes that require oral carbohydrate intervention per day. Self-manageable (able to self-treat) hypoglycaemic episodes that require oral carbohydrate intervention per day is calculated as the sum of all hypoglycaemic episodes where the subject is able to self-treat and that require oral carbohydrate intervention divided by the actual duration of the treatment period in days. Treatment emergent is defined as an episode that has onset in the period from initiation of treatment to end of treatment.
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Safety analysis set (SAS): included all subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t50 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 8 7
Mean (Standard Deviation) [Episodes]
1.01
(0.44)
0.87
(0.49)
1.06
(0.57)
0.68
(0.43)
0.86
(0.55)
0.51
(0.36)
5. Secondary Outcome
Title Number of Treatment Emergent Overall Hypoglycaemic Episodes Classified According to the American Diabetes Association (ADA) Definition
Description ADA classification of hypoglycaemia: Severe hypoglycaemia: An episode requiring assistance of another person to actively administer carbohydrate, glucagon or take other corrective actions. Asymptomatic hypoglycaemia: An episode not accompanied by typical symptoms of hypoglycaemia, but with a measured PG concentration ≤3.9 mmol/L (70 mg/dL). Documented symptomatic hypoglycaemia: An episode during which typical symptoms of hypoglycaemia are accompanied by a measured PG concentration ≤ 3.9 mmol/L (70 mg/dL). Pseudo-hypoglycaemia: An episode during which the person with diabetes reports any of the typical symptoms of hypoglycaemia with a measured PG concentration > 3.9 mmol/L (70 mg/dL) but approaching that level. Probable symptomatic hypoglycaemia: An episode during which symptoms of hypoglycaemia are not accompanied by a PG determination but that was presumably caused by a PG concentration ≤ 3.9 mmol/L (70 mg/dL).
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Safety analysis set (SAS): included all subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t65 Faster Aspart Cohort 1 t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 2 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 3 t30 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 7 8
Severe hypoglycaemia
0
0
0
0
0
0
Documented symptomatic hypoglycaemia
36
38
24
42
17
25
Asymptomatic hypoglycaemia
9
15
8
6
4
9
Probable symptomatic hypoglycaemia
4
2
3
3
1
5
Pseudo-hypoglycaemia
3
8
3
6
3
6
6. Secondary Outcome
Title Number of Treatment Emergent Overall Hypoglycaemic Episodes Classified According to the Novo Nordisk Classification
Description Overall hypoglycaemia count according to Novo Nordisk classification. Novo Nordisk classification of hypoglycaemia: Severe hypoglycaemia according to the ADA classification. Symptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) with symptoms consistent with hypoglycaemia. Asymptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) without symptoms consistent with hypoglycaemia. BG confirmed hypoglycaemia: The union of 2. and 3. Severe or BG confirmed symptomatic hypoglycaemia: The union of 1. and 2. Severe or BG confirmed hypoglycaemia: The union of 1., 2. and 3.
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Safety analysis set (SAS): included all subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t65 Faster Aspart Cohort 1 t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 2 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 3 t30 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 7 8
Severe hypoglycaemia
0
0
0
0
0
0
Symptomatic BG confirmed hypoglycaemia
13
12
4
13
6
10
Asymptomatic BG confirmed hypoglycaemia
3
3
3
1
1
2
BG confirmed hypoglycaemia
16
15
7
14
7
12
Severe or BG confirmed symptomatic hypoglycaemia
13
12
4
13
6
10
Severe or BG confirmed hypoglycaemia
16
15
7
14
7
12
7. Secondary Outcome
Title Number of Treatment Emergent Daytime Hypoglycaemic Episodes Classified According to the American Diabetes Association (ADA) Definition
Description ADA classification of hypoglycaemia: Severe hypoglycaemia: An episode requiring assistance of another person to actively administer carbohydrate, glucagon or take other corrective actions. Asymptomatic hypoglycaemia: An episode not accompanied by typical symptoms of hypoglycaemia, but with a measured PG concentration ≤3.9 mmol/L (70 mg/dL). Documented symptomatic hypoglycaemia: An episode during which typical symptoms of hypoglycaemia are accompanied by a measured PG concentration ≤ 3.9 mmol/L (70 mg/dL). Pseudo-hypoglycaemia: An episode during which the person with diabetes reports any of the typical symptoms of hypoglycaemia with a measured PG concentration > 3.9 mmol/L (70 mg/dL) but approaching that level. Probable symptomatic hypoglycaemia: An episode during which symptoms of hypoglycaemia are not accompanied by a PG determination but that was presumably caused by a PG concentration ≤ 3.9 mmol/L (70 mg/dL).
Time Frame Day 1 to day 7 (in both the treatment periods)

Outcome Measure Data

Analysis Population Description
Safety analysis set (SAS): included all subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t65 Faster Aspart Cohort 1 t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 2 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 3 t30 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 7 8
Severe hypoglycaemia
0
0
0
0
0
0
Documented symptomatic hypoglycaemia
30
31
21
35
14
22
Asymptomatic hypoglycaemia
5
11
5
4
4
7
Probable symptomatic hypoglycaemia
3
2
3
2
0
4
Pseudo-hypoglycaemia
2
5
3
6
2
6
8. Secondary Outcome
Title Number of Treatment Emergent Daytime Hypoglycaemic Episodes Classified According to the Novo Nordisk Classification
Description Number of daytime hypoglycaemic episodes according to Novo Nordisk classification. Novo Nordisk classification of hypoglycaemia: Severe hypoglycaemia according to the ADA classification. Symptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) with symptoms consistent with hypoglycaemia. Asymptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) without symptoms consistent with hypoglycaemia. BG confirmed hypoglycaemia: The union of 2. and 3. Severe or BG confirmed symptomatic hypoglycaemia: The union of 1. and 2. Severe or BG confirmed hypoglycaemia: The union of 1., 2. and 3.
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Safety analysis set (SAS): included all subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t65 Faster Aspart Cohort 1 t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 2 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 3 t30 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 7 8
Severe hypoglycaemia
0
0
0
0
0
0
Symptomatic BG confirmed hypoglycaemia
12
9
3
9
3
9
Asymptomatic BG confirmed hypoglycaemia
2
1
2
0
1
2
BG confirmed hypoglycaemia
14
10
5
9
4
11
Severe or BG confirmed symptomatic hypoglycaemia
12
9
3
9
3
9
Severe or BG confirmed hypoglycaemia
14
10
5
9
4
11
9. Secondary Outcome
Title Number of Treatment Emergent Nocturnal Hypoglycaemic Episodes Classified According to the American Diabetes Association (ADA) Definition
Description ADA classification of hypoglycaemia: Severe hypoglycaemia: An episode requiring assistance of another person to actively administer carbohydrate, glucagon or take other corrective actions. Asymptomatic hypoglycaemia: An episode not accompanied by typical symptoms of hypoglycaemia, but with a measured PG concentration ≤3.9 mmol/L (70 mg/dL). Documented symptomatic hypoglycaemia: An episode during which typical symptoms of hypoglycaemia are accompanied by a measured PG concentration ≤ 3.9 mmol/L (70 mg/dL). Pseudo-hypoglycaemia: An episode during which the person with diabetes reports any of the typical symptoms of hypoglycaemia with a measured PG concentration > 3.9 mmol/L (70 mg/dL) but approaching that level. Probable symptomatic hypoglycaemia: An episode during which symptoms of hypoglycaemia are not accompanied by a PG determination but that was presumably caused by a PG concentration ≤ 3.9 mmol/L (70 mg/dL).
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Safety analysis set (SAS): included all subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t65 Faster Aspart Cohort 1 t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 2 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 3 t30 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 7 8
Severe hypoglycaemia
0
0
0
0
0
0
Documented symptomatic hypoglycaemia
6
7
3
7
3
3
Asymptomatic hypoglycaemia
4
4
3
2
0
2
Probable symptomatic hypoglycaemia
1
0
0
1
1
1
Pseudo-hypoglycaemia
1
3
0
0
1
0
10. Secondary Outcome
Title Number of Treatment Emergent Nocturnal Hypoglycaemic Episodes Classified According to the Novo Nordisk Classification
Description Number of nocturnal (from time 00:01-05:59 both inclusive) hypoglycaemic episodes according to Novo Nordisk classification. Novo Nordisk classification of hypoglycaemia: Severe hypoglycaemia according to the ADA classification. Symptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) with symptoms consistent with hypoglycaemia. Asymptomatic BG confirmed hypoglycaemia: An episode that is BG confirmed by PG value <3.1 mmol/L (56 mg/dL) without symptoms consistent with hypoglycaemia. BG confirmed hypoglycaemia: The union of 2. and 3. Severe or BG confirmed symptomatic hypoglycaemia: The union of 1. and 2. Severe or BG confirmed hypoglycaemia: The union of 1., 2. and 3.
Time Frame Day 1 to day 7 (in both the treatment periods)

Outcome Measure Data

Analysis Population Description
Safety analysis set (SAS): included all subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t65 Faster Aspart Cohort 1 t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 2 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 3 t30 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 7 8
Severe hypoglycaemia
0
0
0
0
0
0
Symptomatic BG confirmed hypoglycaemia
1
3
1
4
3
1
Asymptomatic BG confirmed hypoglycaemia
1
2
1
1
0
0
BG confirmed hypoglycaemia
2
5
2
5
3
1
Severe or BG confirmed symptomatic hypoglycaemia
1
3
1
4
3
1
Severe or BG confirmed hypoglycaemia
2
5
2
5
3
1
11. Secondary Outcome
Title Time in Interstitial Glucose Range Was Defined as 70-180 mg/dL (3.9-10 mmol/L) From Initiation of Treatment (Day 1) to End of Treatment (Day 7) (Percentages)
Description Time in interstitial glucose range defined as 70-180 mg/dL (3.9-10 mmol/L) from initiation of treatment (day 1) to end of treatment (day 7). Time spent in interstitial glucose range is calculated as the percentage of available interstitial glucose values above or equal to the low threshold and below or equal to the high threshold.
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Full analysis set: Included all randomised subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 8 7
Mean (Standard Deviation) [Percentage]
70.87
(9.35)
66.79
(10.39)
73.93
(6.14)
70.44
(8.49)
78.32
(6.96)
73.82
(11.79)
12. Secondary Outcome
Title Mean Interstitial-glucose Level
Description Mean interstitial glucose level is calculated as the average of the available interstitial glucose values.
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Full analysis set: Included all randomised subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 8 7
Mean (Standard Deviation) [mg/dL]
150.3
(7.8)
157.7
(11.0)
150.1
(8.5)
157.6
(11.5)
144.1
(7.1)
152.5
(11.4)
13. Secondary Outcome
Title Number of Treatment Emergent Adverse Events
Description Number of treatment emergent adverse events from initiation of treatment (day 1) to end of treatment (day 7). Treatment emergent is defined as an event that has onset in the period from initiation of treatment to end of treatment.
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Safety analysis set (SAS): included all subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 8 7
Number [Events]
2
2
2
0
0
1
14. Secondary Outcome
Title Number of Treatment Emergent Infusion Site Reactions
Description Number of treatment-emergent infusion site reactions from initiation of treatment (day 1) to end of treatment (day 7). Treatment emergent is defined as an event that has onset in the period from initiation of treatment to end of treatment.
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Safety analysis set (SAS): included all subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 8 7
Number [Infusion site reaction]
0
0
0
0
0
1
15. Secondary Outcome
Title Total Insulin Dose Per Day
Description Total insulin dose (U/kg) per day from initiation of treatment (day 1) to end of treatment (day 7). Total daily insulin dose is calculated as the sum of all insulin doses delivered by the iLet™ divided by the actual duration of the treatment period in days.
Time Frame Day 1 to day 7

Outcome Measure Data

Analysis Population Description
Full analysis set: Included all randomised subjects receiving treatment. Number of participants analysed=participants with available data.
Arm/Group Title t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
Measure Participants 8 8 8 8 8 7
Mean (Standard Deviation) [U/Kg/day]
0.60
(0.12)
0.63
(0.12)
0.65
(0.13)
0.67
(0.16)
0.63
(0.12)
0.64
(0.18)

Adverse Events

Time Frame From the first trial-related activity (screening, day -14) after obtaining informed consent and until the follow up visit (treatment days 7 in both periiods+7 days follow-up)
Adverse Event Reporting Description All adverse events listed are treatment emergent. Treatment emergent is defined as an event that has onset in the period from initiation of treatment to end of treatment.
Arm/Group Title t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Arm/Group Description Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t50 = 50 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 1. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t40 = 40 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 2. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having non-default tmax in the algorithm settings (t30 = 30 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days. Participants received fast-acting insulin aspart with the iLet™ having default tmax in the algorithm settings (t65 = 65 minutes) in cohort 3. The total treatment duration for each cohort was 14 days with each cross-over period of the 2 tmax settings being 7 days.
All Cause Mortality
t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/8 (0%) 0/8 (0%) 0/8 (0%) 0/8 (0%) 0/8 (0%) 0/7 (0%)
Serious Adverse Events
t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/8 (0%) 0/8 (0%) 0/8 (0%) 0/8 (0%) 0/8 (0%) 0/7 (0%)
Other (Not Including Serious) Adverse Events
t50 Faster Aspart Cohort 1 t65 Faster Aspart Cohort 1 t40 Faster Aspart Cohort 2 t65 Faster Aspart Cohort 2 t30 Faster Aspart Cohort 3 t65 Faster Aspart Cohort 3
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 2/8 (25%) 1/8 (12.5%) 1/8 (12.5%) 0/8 (0%) 0/8 (0%) 1/7 (14.3%)
Gastrointestinal disorders
Vomiting 0/8 (0%) 0 0/8 (0%) 0 1/8 (12.5%) 1 0/8 (0%) 0 0/8 (0%) 0 0/7 (0%) 0
General disorders
Infusion site reaction 0/8 (0%) 0 0/8 (0%) 0 0/8 (0%) 0 0/8 (0%) 0 0/8 (0%) 0 1/7 (14.3%) 1
Pyrexia 0/8 (0%) 0 0/8 (0%) 0 1/8 (12.5%) 1 0/8 (0%) 0 0/8 (0%) 0 0/7 (0%) 0
Infections and infestations
Viral upper respiratory tract infection 1/8 (12.5%) 1 0/8 (0%) 0 0/8 (0%) 0 0/8 (0%) 0 0/8 (0%) 0 0/7 (0%) 0
Metabolism and nutrition disorders
Hyperglycaemia 1/8 (12.5%) 1 1/8 (12.5%) 2 0/8 (0%) 0 0/8 (0%) 0 0/8 (0%) 0 0/7 (0%) 0

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

At the end of the trial, one or more scientific publications may be prepared collaboratively by the investigator(s) and Novo Nordisk. Novo Nordisk reserves the right to postpone publication and/or communication for up to 60 days to protect intellectual property.

Results Point of Contact

Name/Title Clinical Reporting Anchor and Disclosure (1452)
Organization Novo Nordisk A/S
Phone (+1) 866-867-7178
Email clinicaltrials@novonordisk.com
Responsible Party:
Novo Nordisk A/S
ClinicalTrials.gov Identifier:
NCT03816761
Other Study ID Numbers:
  • NN1218-4360
  • U1111-1205-1788
First Posted:
Jan 25, 2019
Last Update Posted:
Jun 11, 2020
Last Verified:
May 1, 2020