- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04452396
CGM (Continuous Glucose Monitoring) Use in Diagnosis of Spontaneous and Reactive Hypoglycaemia
Continuous Glucose Monitoring: An Evaluation of Impact on Improving the Efficiency of Diagnostic Processes and Enhancing Patient Safety in the Management of Reactive and Spontaneous Hypoglycaemia
Use of CGM to determine diagnosis in possible spontaneous or reactive hypoglycaemia.
Use of CGM to aid treatment optimisation in spontaneous or reactive hypoglycaemia
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The human body's blood sugar levels are tightly controlled by the hormone insulin, produced by the pancreas. If the pancreas produces too much insulin, then the blood sugar will fall to low levels (hypoglycaemia). Insulin overproduction can happen as a result of the body misreading a change in blood sugar levels after eating (such as after obesity surgery) or through tumours of the pancreas which overproduce insulin (insulinomas).
Hypoglycaemia can cause subtle symptoms such as tiredness, poor concentration, or dizziness and if untreated more severe symptoms including fits, coma and death. Low blood sugars can go unnoticed at night and if levels fall frequently, people can lose their ability to notice subtle symptoms.
People suspected of having hypoglycaemia require a series of investigations to try and reproduce a low blood sugar under controlled conditions. This often requires an admission to hospital for a few days and multiple finger pricks to test the blood sugar - which patients often find painful. If low blood sugars caused by too much insulin are confirmed then medical treatment is started in the first instance, with surgery possibly following later. The only way to check whether these medications are working is by home fingerprick glucose measurements. If people have low sugars at night or have lost their ability to notice symptoms of low blood sugar, it is very difficult to be sure that the medical treatment is working.
The investigators plan to use continuous glucose monitoring probes to measure patient's blood sugar prior to and during admission for formal investigation for hypoglycaemia (alongside conventional fingerprick and blood testing). This might allow us to exclude hypoglycaemia as a cause of their symptoms, avoiding lengthy admissions.
The investigators will also use this technology (alongside fingerprick testing) to test how well medical treatment is working in patients with proven hypoglycaemia.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Scott Akker, MBBS
- Phone Number: 0207 377 7000
- Email: bhnt.endocrine@nhs.net
Study Contact Backup
- Name: Craig Stiles, MBBS
- Phone Number: 57133 0207 377 7000
- Email: bhnt.endocrine@nhs.net
Study Locations
-
-
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London, United Kingdom, EC1A 7BE
- St Bartholomew's Hospital, dept of endocrinology
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- phase 1 - under investigation for possible/probable hypoglycaemia
- phase 2 - on medical therapy for established hypoglycaemia
- Must be Able and willing to give informed consent. No vulnerable adults will be included.
- Must be Aged >18 years
Can be;
- Any ethnicity
- Any socio economic group
- Either conventional gender, or non-binary.
Exclusion Criteria:
- Must not be unwilling or unable to give consent
- Must not be unable to speak sufficient English to give consent and understand study requirements
- Must not be Aged<18 or >90 years
- Must not be lack capacity to consent
- Must not have an underlying hepatic condition
- Must not have a current excessive alcohol consumption (men regularly consuming >50 units/week, women >35 units/week)
- Must not have Diabetes Mellitus
- Must not be currently using Diabetic medication or insulin
- Must not be currently pregnant
- Must not be on haemo or peritoneal dialysis
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: patients
patients undergoing CGM monitoring
|
Patients will wear a CGM device whilst undergoing diagnostic testing for reactive/spontaneous hypoglycaemia and then optimisation of anti-hypoglycaemic medication.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
study arm 1 - diagnosing hypoglycaemic episodes using Continuous Glucose Monitoring of interstitial fluid as a proxy marker of blood glucose
Time Frame: up to 5 days prior to admission for hypoglycaemia investigations
|
outpatient - CGM findings reflect patient's fingerprick glucose readings
|
up to 5 days prior to admission for hypoglycaemia investigations
|
study arm 1 - diagnosing hypoglycaemic episodes (glucose measurement <4mmol/L) using Continuous Glucose Monitoring of interstitial fluid as a proxy marker of blood glucose
Time Frame: up to 5 days in hospital during investigations for hypoglycaemia
|
inpatient - CGM findings reflect patient's fingerprick glucose readings
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up to 5 days in hospital during investigations for hypoglycaemia
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study arm 2 - using Continuous Glucose Monitoring of interstitial fluid as a proxy marker of blood glucose to optimise hypoglycaemia treatment in patients with an established diagnosis of spontaneous or reactive hypoglycaemia
Time Frame: up to 30 days
|
blinded phase - CGM findings reflect patient's fingerprick glucose readings- any episodes of true hypoglycaemia (as decided by fingerprick glucose testing) are captured by CGM device unblinded phase - CGM recordings help with titration of anti hypoglycaemic medications and this reduces overall incidence of hypoglycaemic episodes or duration of time spent in hypoglycaemic range (<4, <3.0, <2.2 mmol/L)
|
up to 30 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
assessing concordance between CGMS and lab/finger prick glucose testing
Time Frame: up to 10 days (study arm 1) or up to 30 days (study arm 2)
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To determine whether CGM systems accurately record hypoglycaemia and can be used in this context
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up to 10 days (study arm 1) or up to 30 days (study arm 2)
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- Glucose Metabolism Disorders
- Metabolic Diseases
- Neoplasms by Histologic Type
- Neoplasms
- Neoplasms by Site
- Neoplasms, Glandular and Epithelial
- Endocrine System Diseases
- Digestive System Neoplasms
- Neuroectodermal Tumors
- Neoplasms, Germ Cell and Embryonal
- Neoplasms, Nerve Tissue
- Hyperinsulinism
- Pancreatic Diseases
- Adenoma
- Pancreatic Neoplasms
- Adenoma, Islet Cell
- Hypoglycemia
- Insulin Resistance
- Neuroendocrine Tumors
- Endocrine Gland Neoplasms
- Insulinoma
Other Study ID Numbers
- 265405
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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