INTERPRET - International Report on Routine Practice of Sensor-enabled Pump Therapy

International Report on Routine Practice of Sensor-enabled Pump Therapy

The aim of the project is to document the international routine practice in sensor usage in patients treated with sensor-augmented pump therapy and to assess which variables (e.g. training of patients, frequency of sensor usage etc) are associated with an improvement in clinical outcome(s) from the start of the sensor use to the end of the follow-up period.

Study Overview

• Status: Completed
• Conditions: Diabetes Mellitus, Type 1

Detailed Description

Pump therapy has been established as "gold standard" for insulin delivery offering improvements over multiple daily insulin injections, but there is a proportion of patients for whom the Continuous Subcutaneous Insulin Infusion (CSII) has not been completely successful therapy leaving some room for improvement of the glucose level of those patients. Continuous glucose monitoring (CGM) systems represent an important advance in diabetes technology that can facilitate optimal glucose control in type 1 diabetes. Numerous randomized control trials have demonstrated the safety and efficacy of real-time CGM in both sub-optimally and well-controlled type 1 diabetes. In all these trials, the benefits of CGM correlate with frequent sensor wear and more advanced age. In clinical practice, the sensor-augmented pump therapy (SAP therapy) is indicated for patients who cannot achieve good metabolic control on CSII, who have a history of severe hypoglycemia and/or hypoglycemia unawareness, or who desire increased flexibility in their daily lives while maintaining or even improving their HbA1c levels.

This was a post-market release, minimally interventional study. All the study devices and related software were CE-marked and commercially available in the countries participating to the study. The devices were prescribed and reimbursed, if applicable, according to routine practice.

The gathered information during this study may help to define which patient groups benefit the most from the treatment with SAP therapy systems. The real-life results of these descriptive analyses will aid improvement of guidelines helping the medical community to better choose the right patient population and treatment patterns. Moreover, based on these real-life data, hypotheses could be defined when addressing further research questions.

• Study Type: Observational
• Enrollment (Actual): 274

Contacts and Locations

Study Locations

• Austria
  • Salzburg, Austria, 5010
    • LKH Salzburg/Universitätsklinikum der Paracelsus Med Privatuniversität/Innere Medizin I
• Belgium
  • Antwerpen, Belgium
    • Universitair Ziekenhuis Antwerpen
  • Bonheiden, Belgium
    • AZ Imelda
• Denmark
  • Fredericia, Denmark
    • Fredericia Hospital
  • Hvidovre, Denmark, 2650
    • Hvidovre Hospital
• France
  • Dax, France
    • Hôpital de Dax
  • Haguenau, France
    • Centre Hospitalier de Haguenau
  • La Rochelle, France
    • Centre Hospitalier La Rochelle
• Hungary
  • Budapest, Hungary, 1076
    • Péterfy Hospital, Outpatient Clinic
  • Békéscsaba, Hungary, 5600
    • Réthy Pál Hospital
  • Nyiregyhaza, Hungary
    • Josa Andras Teaching Hospital
• Israel
  • Tel Hashomer, Ramat Gan, Israel, 52621
    • Chaim Sheba Medical Center
• Italy
  • Milan, Italy, 20157
    • Sacco Hospital, University of Milan
  • Roma, Italy
    • Ospedale S. Camillo Forlanini
• Lithuania
  • Kaunas, Lithuania
    • Kaunas University Hospital
• Poland
  • Bialystok, Poland
    • Klinika Chorób Dzieci Uniwersytecki Dzieciecy Szp
  • Gliwice, Poland
    • Specjalistyczna Praktyka Lekarska
  • Krakow, Poland
    • Oddzial Kliniczny Kliniki Chorób Metabolicznych Sz
• Serbia
  • Belgrade, Serbia
    • Clinical Center of Serbia
• Slovakia
  • Kosice, Slovakia
    • TopCare s.r.o.
  • Lubochna, Slovakia
    • National Institute of Endocrinology
• Slovenia
  • Ljubjana, Slovenia
    • University Childrens Hospital
• Spain
  • Badajoz, Spain
    • Hospital Universitario Infanta Cristina
  • Santiago de Compostela, Spain
    • Complejo Hosp. Santiago De Compostela
  • Sevilla, Spain
    • Hospital Virgen del Rocío
• Sweden
  • Stockholm, Sweden
    • Astrid Lindgrens Barnsjukhus

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients with type 1 diabetes on insulin infusion pump therapy

Description

Inclusion Criteria:

• Patient (and/or legal representative) has signed Patient Informed Consent (PIC)
• Patient was diagnosed with Type 1 DM and has been on insulin infusion pump therapy (without any additional insulin injection) for at least 6 months prior to signature of the PIC
• The treating physician decided independently of the study to prescribe non-blinded continuous glucose monitoring as part of the patient's pump therapy for at least 10% of the study time (estimated as days per month)

Exclusion Criteria:

• Participation in any other clinical trial - currently and/or in the last 3 months prior to signature of informed consent
• Patient has preliminary experience with non-blinded continuous glucose monitoring prior to signature of informed consent (not naïve to non-blinded continuous glucose monitoring)
• For children: no reliable contact person

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Frequency as Percentage of Sensor Usage	To calculate the percentage of time that sensors were used during 3 months: the total number of recorded sensor readings during 3 months was divided by the theoretical number of sensor readings that would be observed if sensor was worn every day of using pump to deliver insulin during the same period (ie, observed readings / (theoretical 288 readings per day x nber of days with insulin use)) and multiplied by 100	every 3 months
HbA1c		every 3 months
Percentage of Patients Achieving HbA1c < 7%		every 3 months
Percentage of Patients Achieving HbA1c < 7.5%		every 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Fear of Hypoglycemia Survey (HFS-II) - Total Score and Behavior Score	sub-group of patients (adults only in Hungary and Denmark) were asked to answer the fear of hypoglycemia validated questionnaires. The total HFS-II questionnaire is represented by 33 items. The respondents rank the responses on a 5- point Likert scale where zero is never and four is always.The total HFS-II score ranges from 0 to 132. Lower score at 6 months or 12 months compared to baseline represents a better outcome. The HFS-II questionnaire is divided into 2 subscales: the behavior and the worry subscales. The behavior score is represented by 15 items and ranges from 0 to 60. Lower score at 6 months or 12 months compared to baseline represents a better outcome.	at baseline, after 6 and after 12 months
Fear of Hypoglycemia Survey (HFS-II) - Worry Score	sub-group of patients (adults only) were asked to answer the fear of hypoglycemia validated questionnaires. The respondents rank the responses on a 5- point Likert scale where zero is never and four is always. The worry subscale is the mean of 18 items which evaluate the worry score (range from 0 to 72). Lower score at 6 months or 12 months compared to baseline represents a better outcome.	at baseline, after 6 and after 12 months
Diabetes Treatment Satisfaction Questionnaire Status Version (DTSQs)	A sub-group of patients (adults) were asked to complete the Diabetes Treatment Satisfaction Questionnaire (DTSQs) The treatment satisfaction is measured by means of the Diabetes Treatment Satisfaction Questionnaire, status version (DTSQs, Bradley, 1990). It consists of a six-item scale assessing treatment satisfaction (TS) and two items assessing perceived frequency of hyperglycaemia and hypoglycaemia. The DTSQs items are scored on a scale from 6 to 0. The scale total is computed by adding the six items 1, 4, 5, 6, 7, and 8, to produce the Treatment Satisfaction scale total, which has a min of 0 and a max of 36. Higher score at 6 month or 12 months compared to baseline represents a better outcome. Items 2 (perceived frequency of hyperglycaemia) and 3 (perceived frequency of hypoglycaemia) are treated individually in data analysis. Lower score at 6 months or 12 months compared to baseline represents a better outcome.	at baseline, after 3 and after 12 months

Collaborators and Investigators

• Sponsor: Medtronic Diabetes
• Investigators: Principal Investigator: Ohad Cohen, Prof, Chaim Sheba Medical Center, Tel Hashomer, Israel; Principal Investigator: Kirsten Noergaard, MD, Hvidovre Hospital, Hvidovre, Denmark; Principal Investigator: Andrea Scaramuzza, MD, Sacco Hospital, University of Milan, Italy

Study record dates

Study Major Dates

• Study Start: February 1, 2009
• Primary Completion (Actual): March 1, 2012
• Study Completion (Actual): May 1, 2012

Study Registration Dates

• First Submitted: November 12, 2008
• First Submitted That Met QC Criteria: November 12, 2008
• First Posted (Estimate): November 13, 2008

Study Record Updates

• Last Update Posted (Actual): February 20, 2019
• Last Update Submitted That Met QC Criteria: October 15, 2018
• Last Verified: October 1, 2018

More Information

Terms related to this study

• Keywords: continuous glucose monitoring; Diabetes Mellitus, Type 1; sensor-augmented pump therapy
• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Immune System Diseases; Autoimmune Diseases; Endocrine System Diseases; Diabetes Mellitus; Diabetes Mellitus, Type 1
• Other Study ID Numbers: EUR04

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Nørgaard K et al. Routine sensor-augmented pump therapy in type 1 diabetes: the INTERPRET study. Diabetes Technol Ther. 2013 Apr;15(4):273-80. doi: 10.1089/dia.2012.0288. Epub 2013 Feb 25.