- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03383627
Assessment of Glycemic Control in Patients With Type 2 Diabetes Mellitus and Late Stage Chronic Kidney Disease
March 10, 2021 updated by: Lubaina Presswala, Northwell Health
Diabetes control is often assessed by tests of glucose levels over time, such as the glycosylated hemoglobin A1c (HbA1c) and fructosamine.
In the later stages of chronic kidney disease (CKD) there is limited data available on the utility of these tests.
There are reasons to believe that the tests may be less accurate in this population.
Continuous glucose monitoring (CGM) offers an effective method for understanding the totality of glucose exposure and incidence of both hyperglycemic and hypoglycemic excursions.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
In the proposed study Investigator plan to utilize CGM in patients with late stage CKD stages 3b-5 to 1) determine accuracy of HbA1c and serum fructosamine testing as measures of glucose control in patients with Type 2 Diabetes Mellitus (T2DM), 2) Better understand test characteristics in the late stage CKD population (correlation, linear equation, slope, Y intercept, average glucose at different HbA1c levels), 3) Develop a preliminary understanding of how test characteristics differ in late stage CKD compared to other patients with diabetes, 4) quantify time burden and number of episodes of hypoglycemia, 4) study hyperglycemic burden and 5) analyze glucose variability.
The research staff will explain the study to patients that meet all inclusion criteria.
Patients will get time to understand the study, review the consent document, ask questions to the PI, and then provide their consent to participate in the study.
On Day 1 of the study, a CGM (Freestyle Libre) device will be placed on patients with CKD 3b-5 which will be worn for 14 consecutive days.
Patients will return on Day 14 to remove the CGM device.
HbA1c and fructosamine values will be drawn on Day 14 and these results will be compared with average glucose monitoring values as recorded on the CGM device.
Incidence, duration, and severity of both hypoglycemic and hyperglycemic events will be analyzed.
Investigators hypothesis that there will be significant variability in the serum HbA1c values when compared with calculated HbA1c from CGM readings.
Investigators also hypothesize that the results will reflect a greater incidence of hypoglycemia in this population by CGM analysis.
Study Type
Interventional
Enrollment (Actual)
80
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
New York
-
Great Neck, New York, United States, 11021
- Northwell Health (Division Endocrinology and Nephrology)
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- 18 years and older with ability to speak and understand English
- Established diagnosis of type 2 Diabetes Mellitus
- Chronic Kidney Disease (stages 3b, 4 or 5, eGFR (Glomerular Filtration Rate) < 45 ml/min, and not on dialysis) documented within 3 months of enrollment
Exclusion Criteria:
- Type 2 Diabetes Mellitus.
- Patient with End stage kidney disease on Dialysis.
- Presence of Hemoglobinopathies.
- Red blood cell transfusion in the last 12 weeks.
- Hb < 9 g/dL documented within 3 months of enrollment - Dosing with an erythropoiesis stimulating agent is acceptable but dose must be stable for two months.
- Use of acetaminophen on a daily basis.
- Systemic steroid treatment in the past 12 weeks.
- Greater than 50% dose change in diabetes medications or new diabetes medications started in the previous 8 weeks.
- Currently pregnant.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Continuous glucose monitoring
|
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mean Glucose Concentration Measured by CGM
Time Frame: 14 Days
|
Mean glucose concentration (mg/dL) will be measured using measurements taken by CGM device.
|
14 Days
|
Number of Participants With Hypoglycemic Events
Time Frame: 14 Days
|
Hypoglycemic event will be considered when blood sugar level is <=70 mg/dl.
Detail information like time of event, number of subjects with an event, duration of event will be analyzed.
|
14 Days
|
Mean Number of Hypoglycemic Events Per Participant.
Time Frame: 14 Days
|
Total number of hypoglycemic events per subject will be calculated during the study period.
Mean number of events per subject will be analyzed.
|
14 Days
|
Duration Hypoglycemic Events
Time Frame: 14 Days
|
As monitoring device measures blood glucose level numerous time, duration of hypoglycemic event will be calculated in percent time per subject based on total duration of time subject wore CGM device.
|
14 Days
|
Mean HbA1c
Time Frame: 14 Days
|
HbA1c collected at end of the participation.
|
14 Days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mean Serum Fructosamine Concentration
Time Frame: 14 Days
|
Serum fructosamine (µmol/L) collected at the end of participation.
|
14 Days
|
Determination of Serum Fructosamine
Time Frame: 14 days
|
Using blood glucose information measured with continuous blood glucose monitoring device, probable level of serum fructosamine (µmol/L) will be measured for each participant and mean will be analyzed.
|
14 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Lubaina Presswala, DO, Northwell Health
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Miedema K. Standardization of HbA1c and Optimal Range of Monitoring. Scand J Clin Lab Invest Suppl. 2005;240:61-72. doi: 10.1080/00365510500236143.
- Rabkin R, Ryan MP, Duckworth WC. The renal metabolism of insulin. Diabetologia. 1984 Sep;27(3):351-7. doi: 10.1007/BF00304849.
- Castellino P, DeFronzo RA. Glucose metabolism and the kidney. Semin Nephrol. 1990 Sep;10(5):458-63.
- Dolscheid-Pommerich RC, Kirchner S, Weigel C, Eichhorn L, Conrad R, Stoffel-Wagner B, Zur B. Impact of carbamylation on three different methods, HPLC, capillary electrophoresis and TINIA of measuring HbA1c levels in patients with kidney disease. Diabetes Res Clin Pract. 2015 Apr;108(1):15-22. doi: 10.1016/j.diabres.2015.01.034. Epub 2015 Jan 29.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
November 30, 2017
Primary Completion (Actual)
August 21, 2018
Study Completion (Actual)
August 21, 2018
Study Registration Dates
First Submitted
October 30, 2017
First Submitted That Met QC Criteria
December 19, 2017
First Posted (Actual)
December 26, 2017
Study Record Updates
Last Update Posted (Actual)
April 6, 2021
Last Update Submitted That Met QC Criteria
March 10, 2021
Last Verified
March 1, 2021
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 17-0531
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
IPD Plan Description
Access to study data will be limited to Institutional Review Board (IRB) approved personnel only.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
Yes
product manufactured in and exported from the U.S.
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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