# A Randomized Cross-Over Trial Evaluating Automated Insulin Delivery Technologies on Glycemic Outcomes and Quality of Life in Older Adults with Type 1 Diabetes

> **NIH NIH R01** · JAEB CENTER FOR HEALTH RESEARCH, INC. · 2023 · $239,044

## Abstract

Project Summary/Abstract
 “A Randomized Cross-Over Trial Evaluating Automated Insulin Delivery Technologies
on Glycemic Outcomes and Quality of Life in Older Adults with Type 1 Diabetes” (AIDE)
Reducing hypoglycemia is an important aspect of management of type 1 diabetes in older adults,
many of whom have hypoglycemic unawareness, cognitive impairment, or both. Clinical trials of
existing automated insulin delivery systems have not included older adults in sufficient numbers
to allow for focused evaluation of efficacy and quality of life impacts that may differ from those
observed in younger age groups.
The research entitled “A Randomized Cross-over Trial Evaluating Automated Insulin Delivery
Technologies on Glycemic Outcomes and Quality of Life in Older Adults with Type 1 Diabetes”
aims to evaluate the effectiveness of 1) hybrid closed loop (HCL) technology and 2) predictive
low-glucose suspension (PLGS) on glycemic outcomes, QOL indicators and usability compared
with sensor-augmented pump (SAP) therapy, as well as evaluate the safety of these technologies,
in older adults with T1D. A secondary objective is to directly compare HCL with PLGS on these
same outcomes.
These aims will be achieved via a multi-center, randomized, crossover trial, consisting of three
treatment arms over three 12-week periods, with the HCL treatment arm used during one period,
the PLGS treatment arm used during one period and SAP treatment arm (control) used during
one period. The crossover trial will be preceded by a run-in phase in which participants will receive
training on using the study devices. The randomized trial will include 90 individuals, aged at least
65 years, with T1D for at least one year who have evidence of sensor measured hypoglycemia
during the baseline run-in. The primary outcome is percent of time spent with glucose levels less
than 70 mg/dl during each period. Other glycemic metrics, QOL assessments and system usability
will be secondary outcomes. Occurrences of severe hypoglycemia, diabetic ketoacidosis,
falls/fractures, emergency room visits, and hospitalizations also will be assessed. Following the
cross-over trial, participants will be given the opportunity to use study devices for an additional 12
weeks to assess choice of system use (PLGS vs. HCL), long-term durability and safety in a more
real-world setting with less frequent study contacts.
Thus, it is imperative to assess whether more advanced technologies involving automation of
insulin delivery can be successfully implemented into diabetes management of older adults.
Recruitment was slowed due to the COVID pandemic. As of October 18th, 2022, 70 of the total 90
participants are randomized, 36 of which are still active. Recruitment stalled during the COVID-
19 pandemic; this application is for funding to complete the follow-up of participants until
December 1st, 2023, with 4 months for analysis and closeout afterward.

## Key facts

- **NIH application ID:** 10734496
- **Project number:** 3R01DK122603-04S1
- **Recipient organization:** JAEB CENTER FOR HEALTH RESEARCH, INC.
- **Principal Investigator:** Naomi Sage Chaytor
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $239,044
- **Award type:** 3
- **Project period:** 2022-11-04 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10734496

## Citation

> US National Institutes of Health, RePORTER application 10734496, A Randomized Cross-Over Trial Evaluating Automated Insulin Delivery Technologies on Glycemic Outcomes and Quality of Life in Older Adults with Type 1 Diabetes (3R01DK122603-04S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10734496. Licensed CC0.

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