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Trial registered on ANZCTR
Registration number
ACTRN12612000449831
Ethics application status
Approved
Date submitted
19/04/2012
Date registered
20/04/2012
Date last updated
7/06/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Study of changes to insulin pump basal rates in type 1 diabetes
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Scientific title
Time to reach steady state insulin levels following a clinically-relevant increment and reduction in subcutaneous basal insulin infusion rates administered via an insulin pump in adults with type 1 diabetes
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Secondary ID [1]
279957
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Nil
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Universal Trial Number (UTN)
U1111-1128-2409
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 1 diabetes
285873
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Condition category
Condition code
Metabolic and Endocrine
286059
286059
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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
Insulin pump therapy with aspart insulin. Insulin pumps are small computerised devices delivering subcutaneous rapid-acting insulin continuously, accurately and flexibly.
Intervention - following a stable baseline subcutaneous insulin infusion rate for 6 hours, a clinically-relevant change is to be made to the basal insulin infusion rate. For the next 5 hours, circulating insulin levels are to be tested 15-minutely to assess the time to reach steady state circulating insulin levels. At the first study visit, the basal insulin rate change is to be an increment, and at the second study visit (1-6 weeks after the first visit) the rate change is to be a reduction. The total dose of subcutaneous insulin infused during the 5-hour intervention period will be between 2 units and 10 units (depending on the insulin requirements of the individual). Standardised insulin pumps and aspart insulin will be used for each study visit, and participants will resume their usual insulin and insulin pump at the conclusion of each visit.
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Intervention code [1]
284289
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Treatment: Devices
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Intervention code [2]
284686
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Treatment: Drugs
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Comparator / control treatment
None
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Time to reach steady state circulating insulin levels following a change in basal insulin infusion rate. Insulin levels will be measured using plasma from venous blood for free insulin radioimmunoassay (plasma with insulin antibodies will be pre-treated with polyethylene glycol to precipitate bound insulin).
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Assessment method [1]
286540
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Timepoint [1]
286540
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Insulin levels assessed for 5 hours after basal insulin infusion rate change (insulin levels tested 15-minutely over this period)
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Secondary outcome [1]
296120
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Time to reach 90% steady state circulating insulin levels following a change in basal insulin infusion rate. Insulin levels will be measured using plasma from venous blood for free insulin radioimmunoassay (plasma with insulin antibodies will be pre-treated with polyethylene glycol to precipitate bound insulin).
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Assessment method [1]
296120
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Timepoint [1]
296120
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Insulin levels assessed for 5 hours after basal insulin infusion rate change (insulin levels tested 15-minutely over this period)
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Secondary outcome [2]
296121
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The impact of the baseline insulin infusion rate on time to reach steady state circulating insulin levels following a change in basal insulin infusion rate. Insulin levels will be measured using plasma from venous blood for free insulin radioimmunoassay (plasma with insulin antibodies will be pre-treated with polyethylene glycol to precipitate bound insulin).
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Assessment method [2]
296121
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Timepoint [2]
296121
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Insulin levels assessed for 5 hours after basal insulin infusion rate change (insulin levels tested 15-minutely over this period)
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Secondary outcome [3]
296122
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The impact of percentage increment in insulin infusion rate on time to reach steady state circulating insulin levels following a change in basal insulin infusion rate. Insulin levels will be measured using plasma from venous blood for free insulin radioimmunoassay (plasma with insulin antibodies will be pre-treated with polyethylene glycol to precipitate bound insulin).
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Assessment method [3]
296122
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Timepoint [3]
296122
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Insulin levels assessed for 5 hours after basal insulin infusion rate change (insulin levels tested 15-minutely over this period)
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Secondary outcome [4]
297174
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Time to reach steady state blood glucose levels following a change in basal insulin infusion rate. Glucose concentrations will be measured via the glucose oxidase method using plasma from venous blood.
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Assessment method [4]
297174
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Timepoint [4]
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Venous glucose levels assessed for 5 hours after basal insulin infusion rate change (venous glucose levels tested 15-minutely over this period)
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Secondary outcome [5]
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Time to reach steady state interstitial glucose levels following a change in basal insulin infusion rate. Interstitial glucose will be measured using a continuous glucose monitoring device with a small sensor inserted under the skin for the duration of the intervention.
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Assessment method [5]
297175
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Timepoint [5]
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Interstitial glucose levels assessed continuously for 5 hours after basal insulin infusion rate change
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Eligibility
Key inclusion criteria
Clinical diagnosis of type 1 diabetes, managed with insulin pump therapy for minimum of 3 months, established insulin:carbohydrate ratio, established insulin sensitivity, established basal insulin delivery profile including a rate of 0.60-1.40 units per hour overnight (without significant variation during this period).
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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, episode of diabetic ketoacidosis or major hypoglycaemia (requiring third party assistance) within the last 3 months, significant renal impairment (estimated glomerular filtration rate <40 mL per min), unresolved adverse skin condition in the area of cannula or device placement, body mass index >30 or <18, allergy to insulin aspart.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Pharmacokinetics
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
30/04/2012
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Actual
30/04/2012
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Date of last participant enrolment
Anticipated
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Actual
26/11/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
12
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Accrual to date
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Final
12
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
311
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St Vincent's Hospital (Melbourne) Ltd - Fitzroy
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Recruitment postcode(s) [1]
5242
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3065
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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St Vincent's Hospital, Melbourne
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Address [1]
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41 Victoria Parade
Fitzroy VIC 3065
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Country [1]
285102
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Australia
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Funding source category [2]
285103
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Government body
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Name [2]
285103
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National Health and Medical Research Council
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Address [2]
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Level 1, 16 Marcus Clarke Street
Canberra ACT 2601
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Country [2]
285103
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Australia
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Funding source category [3]
285107
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Charities/Societies/Foundations
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Name [3]
285107
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Royal Australian College of Physicians Research and Education Foundation
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Address [3]
285107
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145 Macquarie Street
Sydney NSW 2000
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Country [3]
285107
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Australia
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Funding source category [4]
285108
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Commercial sector/Industry
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Name [4]
285108
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Roche Diagnostics
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Address [4]
285108
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81-89 Cotham Road
Kew VIC 3101
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Country [4]
285108
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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
41 Victoria Parade
Fitzroy VIC 3065
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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The University of Melbourne, Department of Medicine, St Vincent's
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Address [1]
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29 Regent Street
Fitzroy VIC 3065
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Country [1]
283997
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
286733
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St Vincent's Hospital, Melbourne
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Ethics committee address [1]
286733
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Research Governance Unit Level 5, Mary Aikenhead Building 27 Victoria Parade Fitzroy VIC 3065
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Ethics committee country [1]
286733
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Australia
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Date submitted for ethics approval [1]
286733
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23/01/2012
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Approval date [1]
286733
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27/03/2012
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Ethics approval number [1]
286733
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#013/12
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Summary
Brief summary
Insulin pumps are increasingly being used to deliver insulin for people with type 1 diabetes. The two main components of insulin pump delivery are firstly "bolus" insulin, used with meals or to correct high glucose levels, and secondly "basal" insulin which provides the background insulin requirements of the individual. The rate of basal insulin delivered can be adjusted with the pump, and this may vary according to the time of day, stress, illness or exercise. Information regarding changes in the basal insulin infusion rate to best match an individual's insulin requirement is essential to guide clinical decision-making. The purpose of this study is to determine the time to reach steady state circulating insulin levels after a clinically-relevant increase and also a clinically-relevant reduction in basal insulin infusion rates delivered by insulin pumps to adults with type 1 diabetes.
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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
30834
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A/Prof David O'Neal
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Address
30834
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Department of Endocrinology, St Vincent's Hospital Melbourne
35 Victoria Pde Fitzroy 3065 VIC
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Country
30834
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Australia
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Phone
30834
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+61 3 92882574
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Fax
30834
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Email
30834
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[email protected]
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Contact person for public queries
Name
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Dr Sybil McAuley
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Address
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Department of Endocrinology
St Vincent's Hospital, Melbourne
35 Victoria Parade
Fitzroy VIC 3065
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Country
14081
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Australia
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Phone
14081
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+61 3 92882211
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Fax
14081
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Email
14081
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[email protected]
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Contact person for scientific queries
Name
5009
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Dr Sybil McAuley
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Address
5009
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Department of Endocrinology
St Vincent's Hospital, Melbourne
35 Victoria Parade
Fitzroy VIC 3065
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Country
5009
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Australia
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Phone
5009
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+61 3 92882211
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Fax
5009
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Email
5009
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[email protected]
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No information has been provided regarding IPD availability
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
Source
Title
Year of Publication
DOI
Embase
Asymmetric changes in circulating insulin levels after an increase compared with a reduction in insulin pump basal rate in people with Type 1 diabetes.
2017
https://dx.doi.org/10.1111/dme.13371
N.B. These documents automatically identified may not have been verified by the study sponsor.
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