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Trial registered on ANZCTR
Registration number
ACTRN12622000500752p
Ethics application status
Submitted, not yet approved
Date submitted
27/02/2022
Date registered
29/03/2022
Date last updated
16/03/2023
Date data sharing statement initially provided
29/03/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Insulin Pumps at Diagnosis (IPAD) in children study
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Scientific title
Randomised controlled trial of insulin pumps of the effectiveness of insulin pumps in children diagnosed with Type 1 diabetes
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Secondary ID [1]
306549
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none
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Universal Trial Number (UTN)
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Trial acronym
IPAD
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 1 Diabetes
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Condition category
Condition code
Metabolic and Endocrine
322822
322822
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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 commencement at diagnosis. This will be prescribed by a paediatric endocrinologist, and education provided by a credentialed diabetes educator and paediatric dietitian. They will commence during the first admission for diabetes (within 7 days of diabetes diagnosis) and continue for 12 months. They will be reviewed by daily phone calls for the first week, weekly outpatient education for 1 months then 3 monthly outpatient clinic visits.
There are many different pumps available, and the families can choose whichever pump is most suitable for them based on information provided by their endocrinologist and diabetes educator.
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Intervention code [1]
322974
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Treatment: Other
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Intervention code [2]
323114
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Treatment: Devices
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Comparator / control treatment
The control group will commence an insulin pump as an outpatient at 3 months post diagnosis
This will be prescribed by a paediatric endocrinologist, and education provided by a credentialed diabetes educator and paediatric dietitian. They will commence as an outpatient and be followed until 12 months post diagnosis. After commencing the pump they will be reviewed by daily phone calls for the first week and as required thereafter in addition to standard 3 monthly outpatient visits
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Control group
Active
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Outcomes
Primary outcome [1]
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metabolic control as assessed by HbA1c
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Assessment method [1]
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Timepoint [1]
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12 months post diagnosis of diabetes
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Primary outcome [2]
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Time in range from continuous glucose monitor download
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Assessment method [2]
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Timepoint [2]
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12 months after diagnosis of diabetes
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Secondary outcome [1]
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incremental cost effectiveness ratio as determined by EQ-ED-Y, questionnaire of parental expenses (designed specifically for this study) and staff report of patient contact
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Assessment method [1]
406924
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Timepoint [1]
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12 months after diabetes diagnosis
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Secondary outcome [2]
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quality of life as determined by ED-5D-Y
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Assessment method [2]
406925
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Timepoint [2]
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12 months after diabetes diagnosis
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Secondary outcome [3]
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diabetes-specific quality of life as determined by Peds Qol - diabetes module
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Assessment method [3]
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Timepoint [3]
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12 months after diabetes diagnosis
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Eligibility
Key inclusion criteria
newly diagnosed T1DM
age 5-15.9 years
parent/guardian willing to provide consent
ability to access insulin pump through private health or JDRF funding
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Minimum age
5
Years
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Maximum age
16
Years
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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
If the participant or carer has a diminished understanding or comprehension
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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)
Sealed envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
randomisation using computer software
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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
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
• The study will recruit 80 participants over 24 months and continue to follow them for 1 year
• QCH current has 120 newly diagnosed children per year
– 60% of whom commence insulin pump therapy within the first year (and is increasing every year)
– Based on 50% participation rate we may expect approx. 40 participants per year
• A sample size of 80 final participants is calculated based on
– a clinically significant difference in HbA1c of 0.5% (recognised as a threshold used by IS FDA and pharmaceutical industry to determine effectiveness)
– SD of 0.8 (based on HbA1c data from 2018-2019) and
– a power of 80%
T-tests will be used to compare normally distributed measures, including the primary outcomes (CGM time in range, HbA1c and estimated C-peptide). Where outcomes are non-normally distributed, Mann-Whitney-Wilcoxon U tests will be used to compare groups. To analyse counts of events, Poisson or negative binomial regression (in the case of overdispersion) will be used. The project team is highly skilled in the management of T1D and the use and interpretation of CGM data, both in clinical and research contexts .
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
20/03/2023
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Actual
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Date of last participant enrolment
Anticipated
20/03/2025
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Actual
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Date of last data collection
Anticipated
20/03/2026
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Actual
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Sample size
Target
80
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
21847
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Queensland Children's Hospital - South Brisbane
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Recruitment postcode(s) [1]
36904
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4101 - South Brisbane
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Funding & Sponsors
Funding source category [1]
310884
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Charities/Societies/Foundations
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Name [1]
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Children's Hospital Foundation
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Address [1]
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PO Box 8009
Woolloongabba
QLD 4102
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Country [1]
310884
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Australia
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Primary sponsor type
Individual
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Name
Dr Stephanie Johnson
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Address
Department of Endocrinology
Queensland Children's Hospital
501 Stanley St
South Brisbane
QLD 4101
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
312159
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Country [1]
312159
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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Children's Health Queensland Hospital and Health Service HREC
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Ethics committee address [1]
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Centre for Children’s Health Research Queensland Children’s Hospital Precinct Level 7, 62 Graham Street South Brisbane QLD 4101
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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28/02/2022
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Approval date [1]
310444
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Ethics approval number [1]
310444
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Summary
Brief summary
Type 1 diabetes is one of the most common life-long diseases in childhood. Management is intensive with frequent blood glucose management, insulin administration and monitoring of food intake and exercise and can affect most aspects of the life of the child. Insulin can be administered by multiple injections per day or with insulin pumps. There is growing evidence for improved glycaemic control by using insulin pumps. However, the optimal time to commence pump therapy is yet to be elucidated. Results of studies of pumps at diagnosis are conflicting and complicated by the inclusion of studies with pump therapy commencing at any time in the first year since diagnosis. This randomised controlled study intends to determine the optimal time to commence insulin pump therapy for type 1 diabetes in children. Children over 5 years will be randomised to either commence their pump within days of diagnosis compared to 3 months. The outcomes of interest will be whether an early pump start will result in improved diabetes control and preserve the function of the pancreatic beta cells. Secondary outcomes will include determining the effect on quality of life for the child and their parents and determining whether this approach is cost-effective.
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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
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Dr Stephanie Johnson
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Address
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Department of Endocrinology and Diabetes
Queensland Children's Hospital
501 Stanley St
South Brisbane
QLD 4101
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Country
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Australia
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Phone
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+61 7 30685264
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Stephanie Johnson
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Address
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Department of Endocrinology and Diabetes
Queensland Children's Hospital
501 Stanley St
South Brisbane
QLD 4101
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Country
117691
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Australia
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Phone
117691
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+61 7 30685264
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Fax
117691
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Email
117691
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[email protected]
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Contact person for scientific queries
Name
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Stephanie Johnson
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Address
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Department of Endocrinology and Diabetes
Queensland Children's Hospital
501 Stanley St
South Brisbane
QLD 4101
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Country
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Australia
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Phone
117692
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+61 7 30685264
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Fax
117692
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Email
117692
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Individual deidentified participant data - all collected data
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When will data be available (start and end dates)?
02/05/2025-02/05/2027
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Available to whom?
only researchers who provide a methodologically sound proposal
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Available for what types of analyses?
only to achieve the aims in the approved proposal, including metaanalyses of pump at diagnosis studeies
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How or where can data be obtained?
by approval of the PI
[email protected]
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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.
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