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Trial registered on ANZCTR
Registration number
ACTRN12624000448549
Ethics application status
Approved
Date submitted
12/03/2024
Date registered
12/04/2024
Date last updated
12/04/2024
Date data sharing statement initially provided
12/04/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluating Glucose Levels and Risk of Ketoacidosis in People with Type 1 Diabetes Receiving SGLT1/2 inhibitor Therapy Using a Novel Continuous Ketone Sensor
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Scientific title
Evaluating Glucose Levels and Risk of Ketoacidosis in People with Type 1 Diabetes Receiving SGLT1/2 inhibitor Therapy Using a Novel Continuous Ketone Sensor (PARTNER)
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Secondary ID [1]
311659
0
None
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Universal Trial Number (UTN)
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Trial acronym
PARTNER
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 1 Diabetes
333117
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Condition category
Condition code
Metabolic and Endocrine
329808
329808
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
After screening, participants will undergo a 2-week run-in period where they will wear a continuous glucose monitor and ketone sensor and receive education about management of sustained hyperglycemia/ketosis.
After run-in, participants will be randomized to either the intervention or placebo.
The intervention will be Sotagliflozin 200 mg oral tablet daily for three months.
Adherence to intervention will be monitored by counting number of study drugs returned at the end of intervention.
Wash-out period is 2 weeks between interventions.
Arm 1: Sotagliflozin for 12 weeks, then cross-over to Placebo for 12 weeks after washout
Arm 2: Placebo for 12 weeks, then cross-over to Sotagliflozin for 12 weeks after washout
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Intervention code [1]
328122
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Treatment: Drugs
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Intervention code [2]
328123
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Prevention
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Comparator / control treatment
The control group will be a placebo control group. The placebo tablet will contain the same excipients without the active drug, comprising of croscarmellose sodium, colloidal silicondioxide, microcrystalline cellulose, magnesium stearate, and talc.
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Control group
Placebo
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Outcomes
Primary outcome [1]
337579
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Percentage time in range (3.9-10.0 mmol/L) on continuous glucose monitor (measured over 2 weeks)
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Assessment method [1]
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Abbott Libre-2 Intermittently Scanned-Continuous Glucose Monitor
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Timepoint [1]
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Daily during the final two weeks of each study arm (week 10 to 12 and week 24 to 26)
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Primary outcome [2]
337580
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Number of episodes of diabetic ketoacidosis
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Assessment method [2]
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Presentations to hospital with glucose concentration of >11.1mmol/L at the time of presentation and plasma beta-hydroxybutyrate concentrations of greater than or equal to 3.0mmol/l or urine ketones of more than 2+ on a standard urine ketone stick and pH <7.3 or a serum bicarbonate of <15.0mmol/L
Presentations to hospital will be collected from patient history and from hospital medical records
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Timepoint [2]
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Daily throughout the study until week 26
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Secondary outcome [1]
432367
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Mean glucose on continuous glucose monitor across entire day, daytime, nighttime and post-prandial
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Assessment method [1]
432367
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Intermittently Scanned-Continuous Glucose Monitor (Abbott Libre 2) and/or the participant's own continuous glucose monitor
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Timepoint [1]
432367
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Final two weeks of each stage (week 10 to 12 and week 24 to 26) and for three months of each stage (week 0 to 12 and week 14 to 26) post-commencement of intervention
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Secondary outcome [2]
432368
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Glucose management indicator on continuous glucose monitor across entire day, daytime, nighttime and post-prandial
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Assessment method [2]
432368
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Intermittently Scanned-Continuous Glucose Monitor (Abbott Libre 2) and/or the participant's own continuous glucose monitor
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Timepoint [2]
432368
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Final two weeks of each stage (week 10 to 12 and week 24 to 26) and for three months of each stage (week 0 to 12 and week 14 to 26) post-commencement of intervention
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Secondary outcome [3]
432369
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Glycaemic variability on continuous glucose monitor across entire day, daytime, nighttime and post-prandial
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Assessment method [3]
432369
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Intermittently Scanned-Continuous Glucose Monitor (Abbott Libre 2) and/or the participant's own continuous glucose monitor
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Timepoint [3]
432369
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Final two weeks of each stage (week 10 to 12 and week 24 to 26) and for three months of each stage (week 0 to 12 and week 14 to 26) post-commencement of intervention
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Secondary outcome [4]
432370
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Percentage time above range (>13.9 mmol/L) on continuous glucose monitor across entire day, daytime, nighttime and post-prandial
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Assessment method [4]
432370
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Intermittently Scanned-Continuous Glucose Monitor (Abbott Libre 2) and/or the participant's own continuous glucose monitor
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Timepoint [4]
432370
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Final two weeks of each stage (week 10 to 12 and week 24 to 26) and for three months of each stage (week 0 to 12 and week 14 to 26) post-commencement of intervention
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Secondary outcome [5]
432371
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Percentage time above range (10.1-13.9 mmol/L) on continuous glucose monitor across entire day, daytime, nighttime and post-prandial
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Assessment method [5]
432371
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Intermittently Scanned-Continuous Glucose Monitor (Abbott Libre 2) and/or the participant's own continuous glucose monitor
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Timepoint [5]
432371
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Final two weeks of each stage (week 10 to 12 and week 24 to 26) and for three months of each stage (week 0 to 12 and week 14 to 26) post-commencement of intervention
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Secondary outcome [6]
432372
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Percentage time in range (3.9-10.0 mmol/L) on continuous glucose monitor across entire day, daytime, nighttime and post-prandial
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Assessment method [6]
432372
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Intermittently Scanned-Continuous Glucose Monitor (Abbott Libre 2) and/or the participant's own continuous glucose monitor
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Timepoint [6]
432372
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Final two weeks of each stage (week 10 to 12 and week 24 to 26) and for three months of each stage (week 0 to 12 and week 14 to 26) post-commencement of intervention
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Secondary outcome [7]
432373
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Percentage time below range (3.0-3.8 mmol/L) on continuous glucose monitor across entire day, daytime, nighttime and post-prandial
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Assessment method [7]
432373
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Intermittently Scanned-Continuous Glucose Monitor (Abbott Libre 2) and/or the participant's own continuous glucose monitor
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Timepoint [7]
432373
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Final two weeks of each stage (week 10 to 12 and week 24 to 26) and for three months of each stage (week 0 to 12 and week 14 to 26) post-commencement of intervention
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Secondary outcome [8]
432376
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Percentage time below range (<3.0 mmol/L) on continuous glucose monitor across entire day, daytime, nighttime and post-prandial
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Assessment method [8]
432376
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Intermittently Scanned-Continuous Glucose Monitor (Abbott Libre 2) and/or the participant's own continuous glucose monitor
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Timepoint [8]
432376
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Final two weeks of each stage (week 10 to 12 and week 24 to 26) and for three months of each stage (week 0 to 12 and week 14 to 26) post-commencement of intervention
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Secondary outcome [9]
432377
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Glycaemic risk index
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Assessment method [9]
432377
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Intermittently Scanned-Continuous Glucose Monitor (Abbott Libre 2) and/or the participant's own continuous glucose monitor
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Timepoint [9]
432377
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Final two weeks of each stage (week 10 to 12 and week 24 to 26) and for three months of each stage (week 0 to 12 and week 14 to 26) post-commencement of intervention
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Secondary outcome [10]
432378
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HbA1c
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Assessment method [10]
432378
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Blood test
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Timepoint [10]
432378
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Baseline (week 0/pre-intervention), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [11]
432380
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Percentage time ketone levels above 0.6 mmol/L
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Assessment method [11]
432380
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Abbott Sensor-Based Ketone Monitoring System
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Timepoint [11]
432380
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Daily throughout the study until week 26 (post commencement of intervention)
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Secondary outcome [12]
432381
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Percentage time ketone levels above 1.5 mmol/L
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Assessment method [12]
432381
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Abbott Sensor-Based Ketone Monitoring System
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Timepoint [12]
432381
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Daily throughout the study until week 26 (post commencement of intervention)
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Secondary outcome [13]
432382
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Percentage time ketone levels above 3.0 mmol/L
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Assessment method [13]
432382
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Abbott Sensor-Based Ketone Monitoring System
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Timepoint [13]
432382
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Daily throughout the study until week 26 (post commencement of intervention)
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Secondary outcome [14]
432383
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Number of episodes of severe hypoglycaemia
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Assessment method [14]
432383
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Any glucose level requiring the assistance of another person to actively administer carbohydrate, glucagon, or take other corrective actions. Information will be obtained from participant and/or carer history taking.
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Timepoint [14]
432383
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Daily throughout the study until week 26 (post commencement of intervention)
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Secondary outcome [15]
432384
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Mean ketone levels between midnight to 6am (likely fasting)
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Assessment method [15]
432384
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Abbott Sensor-Based Ketone Monitoring System
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Timepoint [15]
432384
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Final two weeks of each study arm (week 10 to 12 and week 24 to 26)
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Secondary outcome [16]
432386
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Mean ketone levels between 10am to 10pm (likely fed)
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Assessment method [16]
432386
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Abbott Sensor-Based Ketone Monitoring System
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Timepoint [16]
432386
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Final two weeks of each study arm (week 10 to 12 and week 24 to 26)
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Secondary outcome [17]
432387
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Change in weight
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Assessment method [17]
432387
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Weighing scales
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Timepoint [17]
432387
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Baseline (week 0/pre-intervention), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [18]
432388
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Change in body mass index
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Assessment method [18]
432388
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Weighing scales
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Timepoint [18]
432388
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Baseline (week 0/pre-intervention), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [19]
432389
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Change in estimated glomerular filtration rate
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Assessment method [19]
432389
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Blood test
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Timepoint [19]
432389
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Baseline (week 0/pre-intervention), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [20]
432390
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Change in albumin-creatinine ratio
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Assessment method [20]
432390
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Urine sample
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Timepoint [20]
432390
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Baseline (week 0/pre-intervention), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [21]
432391
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Number of presentations with cardiac failure
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Assessment method [21]
432391
0
Presentations to hospital as per hospital medical records
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Timepoint [21]
432391
0
Daily throughout the study until week 26 (post commencement of intervention)
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Secondary outcome [22]
432392
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Number of hospital presentations with cardiac ischaemia
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Assessment method [22]
432392
0
Presentations to hospital as per hospital medical records
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Timepoint [22]
432392
0
Daily throughout the study until week 26 (post commencement of intervention)
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Secondary outcome [23]
432393
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Number of hospital admissions
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Assessment method [23]
432393
0
Presentations to hospital as per hospital medical records
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Timepoint [23]
432393
0
Daily throughout the study until week 26 (post commencement of intervention)
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Secondary outcome [24]
432394
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Brain natriuretic peptide
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Assessment method [24]
432394
0
Blood test
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Timepoint [24]
432394
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Baseline (week 0/pre-intervention), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [25]
432395
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Number of urinary tract infections
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Assessment method [25]
432395
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Urinary tract infections diagnosed or treated. Information will be obtained from participant history taking.
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Timepoint [25]
432395
0
Daily throughout the study until week 26 (post commencement of intervention)
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Secondary outcome [26]
432396
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Number of candida infections
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Assessment method [26]
432396
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Candida infections diagnosed or treated. Information will be obtained from participant history taking.
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Timepoint [26]
432396
0
Daily throughout the study until week 26 (post commencement of intervention)
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Secondary outcome [27]
432397
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Average total daily insulin dose
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Assessment method [27]
432397
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Insulin dosing diary completed by the participant
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Timepoint [27]
432397
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Daily for two weeks at baseline (week -2 to 0), week 10 to 12 (post commencement of intervention) and week 24 to 26 (post commencement of intervention)
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Secondary outcome [28]
432398
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Average daily bolus insulin dose
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Assessment method [28]
432398
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Insulin dosing diary completed by the participant
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Timepoint [28]
432398
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Daily for two weeks at baseline (week -2 to 0), week 10 to 12 (post commencement of intervention) and week 24 to 26 (post commencement of intervention)
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Secondary outcome [29]
432399
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Average daily basal insulin dose
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Assessment method [29]
432399
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Insulin dosing diary completed by the participant
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Timepoint [29]
432399
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Daily for two weeks at baseline (week -2 to 0), week 10 to 12 (post commencement of intervention) and week 24 to 26 (post commencement of intervention)
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Secondary outcome [30]
432400
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Change in blood pressure
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Assessment method [30]
432400
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Blood pressure monitor
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Timepoint [30]
432400
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Baseline (week 0/pre-intervention), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [31]
432401
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Change in lipids
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Assessment method [31]
432401
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Blood test measuring total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides
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Timepoint [31]
432401
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Baseline (week 0/pre-intervention), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [32]
432402
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Treatment satisfaction
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Assessment method [32]
432402
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Diabetes Medication System Rating Questionnaire (short form)
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Timepoint [32]
432402
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Mid-study (week 12 post commencement of intervention) and end of study (week 26 post commencement of intervention)
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Secondary outcome [33]
432403
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Treatment satisfaction
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Assessment method [33]
432403
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Study specific questions regarding treatment satisfaction
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Timepoint [33]
432403
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Mid-study (week 12 post commencement of intervention) and end of study (week 26 post commencement of intervention)
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Secondary outcome [34]
432404
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Ketone sensor usability
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Assessment method [34]
432404
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System Usability Scale
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Timepoint [34]
432404
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Mid-study (week 12 post commencement of intervention) and end of study (week 26 post
commencement of intervention)
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Secondary outcome [35]
432405
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Psychosocial surveys
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Assessment method [35]
432405
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Problem Areas in Diabetes, EQ-5D-5L, WHO-5 Well-being Index
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Timepoint [35]
432405
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Baseline (week -2), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [36]
432406
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Sleep
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Assessment method [36]
432406
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Pittsburgh Sleep Quality Index
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Timepoint [36]
432406
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Baseline (week -2), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [37]
432407
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Blood glucose psychological outcome
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Assessment method [37]
432407
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Gold Score, Hypoglycemia Fear Survey (short form)
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Timepoint [37]
432407
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Baseline (week -2), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [38]
432408
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Physical discomfort
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Assessment method [38]
432408
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PROMIS pain scale, ASCQ-Me Stiffness Impact (short form)
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Timepoint [38]
432408
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Baseline (week -2), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Secondary outcome [39]
433190
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Ketone sensor experience
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Assessment method [39]
433190
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User Experience Questionnaire
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Timepoint [39]
433190
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Mid-study (week 12 post commencement of intervention) and end of study (week 26 post commencement of intervention)
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Secondary outcome [40]
433191
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Fatigue
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Assessment method [40]
433191
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PROMIS Fatigue (short form)
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Timepoint [40]
433191
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Baseline (week -2), mid-study (week 12 post commencement of intervention), end of study (week 26 post commencement of intervention)
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Eligibility
Key inclusion criteria
Age equal to or greater than 18 years; type 1 diabetes of more than 1 year duration; stable on insulin therapy; HbA1c <10.0%; access to a mobile phone compatible with the ketone monitoring system; willing to adhere to all requirements of the protocol including wearing and responding to information provided by the continuous ketone sensor for the duration of the study
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Pregnancy or planned pregnancy; eGFR<30 ml/minute/1.73m2; a history of diabetic ketoacidosis in the last 3 months; diabetic gastroparesis; tape allergy; unable to exercise; use of low carbohydrate diet; heavy alcohol use; major medical or psychiatric illness that in the opinion of the investigator would interfere with protocol adherence or impact participant safety
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation will be concealed by bottles that are independently labelled at a central administration site
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software (i.e. computerised sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
3/06/2024
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Actual
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Date of last participant enrolment
Anticipated
3/12/2024
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Actual
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Date of last data collection
Anticipated
30/06/2025
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,SA,VIC
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Funding & Sponsors
Funding source category [1]
315988
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Other Collaborative groups
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Name [1]
315988
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The Australian Centre for Accelerating Diabetes Innovations
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Address [1]
315988
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Country [1]
315988
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Australia
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Primary sponsor type
Hospital
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Name
St Vincent's Hospital Melbourne
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Address
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Country
Australia
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Secondary sponsor category [1]
318182
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None
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Name [1]
318182
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Address [1]
318182
0
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Country [1]
318182
0
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314813
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St Vincent's Hospital Melbourne Human Research Ethics Committee
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Ethics committee address [1]
314813
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https://svhm.org.au/home/research/researchers/human-research-ethics-committee
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Ethics committee country [1]
314813
0
Australia
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Date submitted for ethics approval [1]
314813
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20/12/2023
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Approval date [1]
314813
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05/03/2024
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Ethics approval number [1]
314813
0
302/23
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Summary
Brief summary
This study aims to evaluate glucose control and safety with a sodium-glucose linked transporter in people living with type 1 diabetes. It will involve the use of continuous glucose monitoring and ketone sensing devices combined with education aimed at minimising the risk of diabetic ketoacidosis. The study will take place over seven months, comprising of two weeks of run-in, three months of intervention with sotagliflozin or placebo, followed by cross-over separated by a two week wash-out. Outcomes regarding glycaemia, ketones, anthropometric, cardio-renal, metabolic and psychological parameters will be assessed. We hypothesize that glucose control will improve without a significant increase in diabetes ketoacidosis occurrences in people with type 1 diabetes on Sotagliflozin compared to placebo, with the use of continuous interstitial ketone monitoring in conjunction with education regarding management.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
132806
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Prof David O'Neal
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Address
132806
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University of Melbourne Dept of Medicine, St Vincent's Hospital Melbourne, 41 Victoria Pde Fitzroy VIC 3065
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Country
132806
0
Australia
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Phone
132806
0
+61425731665
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Fax
132806
0
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Email
132806
0
[email protected]
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Contact person for public queries
Name
132807
0
Audrey Kong
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Address
132807
0
University of Melbourne Dept of Medicine, St Vincent's Hospital Melbourne, 41 Victoria Pde Fitzroy VIC 3065
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Country
132807
0
Australia
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Phone
132807
0
+61433593020
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Fax
132807
0
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Email
132807
0
[email protected]
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Contact person for scientific queries
Name
132808
0
David O'Neal
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Address
132808
0
University of Melbourne Dept of Medicine, St Vincent's Hospital Melbourne, 41 Victoria Pde Fitzroy VIC 3065
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Country
132808
0
Australia
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Phone
132808
0
+61425731665
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Fax
132808
0
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Email
132808
0
[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF