The Influence of Personality Characteristics and Emotions on Blood Glucose Levels Among Type 1 Diabetes Mellitus Patients

The research goal is to find a correlation between patient personality characteristics, patients' mood and glycemic control. Eventually, using this information may allow treating physicians the ability to better balance glucose blood levels in patients with T1DM, by recognizing influencing psychological parameters. The conclusion from this research will add to other physiological parameters that are being studied today, and in the future will be integrated into an artificial pancreas.

The investigators believe that there is a correlation that hasn't been studied in the past between personality characteristics, daily emotions and the ability to balance glucose blood levels in patients with T1DM.

Study Overview

• Status: Completed
• Conditions: Diabetes Mellitus, Type 1; Sleep; Emotions; Personality

Detailed Description

Background:

Type 1 diabetes mellitus (T1DM), is an autoimmune disease in which cells from the immune system attack the beta cells, that produce insulin, in the pancreas. As a result of the subsequent complete insulinopenia, glycemic levels rise, and the patient completely relies on exogenous administration of sub-cutaneous insulin injections. The patients must adjust the amount of insulin along the day in accordance with measured glucose blood levels and their activities (eating, physical activity, etc.) Recently patients diagnosed with T1DM, are eligible for a continuous glucose monitor with FLASH technology (Freestyle Libre glucose monitor), within the Israeli health medical basket services. As a result, nowadays treating physicians can better monitor glucose blood levels during the day. The Freestyle Libre constantly measures subcutaneous glucose levels, translating them using a specifically designed algorithm to projected blood glucose levels. This allows for improved glycemic control and more accurate insulin dosing decisions for the patient with a tool to assess disease severity and control for the treating physician.

Using advanced algorithms, there is an enormous research effort in order to create an artificial pancreas- a glucose blood level monitor that informs an insulin pump regarding the amount of insulin that should be injected throughout the day. This will replace the patients ongoing burden of managing their glycemic levels and reduce patient dosing errors. In order to improve the already existing algorithms, inserting additional parameters into the equation may improve the predictive value of the algorithms, and thus improve the ability to balance glycemic levels in different situations. So far, most of the research in this area was performed using physiological parameters (heart rate, physical activity, nutrition, etc.).

In the suggested study the researchers wish to examine the influence of character and emotions on glycemic levels during the day. Finding a correlation between the mental and mood status and glycemia may allow for the creation of a more accurate algorithm, to better predict and balance glycemic levels in patients with T1DM.

Research hypothesis:

The investigators' hypothesis is that there is a significant correlation between baseline personality characteristics, changing emotions throughout the day, and glycemic levels in patients with T1DM.

Research goal:

The research goal is to find a correlation between patient personality characteristics, patients' mood, and glycemic control. Eventually, using this information may allow treating physicians the ability to better balance glucose blood levels in patients with T1DM, by recognizing influencing psychological parameters. The conclusion from this research will add to other physiological parameters that are being studied today, and in the future will be integrated into an artificial pancreas.

The investigators believe that there is a correlation that hasn't been studied in the past between personality characteristics, daily emotions, and the ability to balance glucose blood levels in patients with T1DM.

Methods:

During the first visit, participants will receive an explanation of nature, duration, and side effects required during the research period.

After signing the informed consent, the following information will be collected:

• Demographic and socioeconomic background
• Personality characteristics questionnaire
• Medical history including the most recent blood tests During that visit, the participant will download a designated application for his mobile device and will receive instructions on using it.

The duration of the follow-up period will be a week. During that period the patient will not change their current treatment or lifestyle. The patient will report their emotions, treatment, physical activity, behavior, and nutrition using a specifically designed smartphone application.

At the end of the data collection week, and following their next visit to the clinic, glycemic information will be downloaded from the patients' CGM/FGM device.

The mobile application: the designated application, will be built specifically for the study. The application is a questionnaire that is always available to the patient, in an accessible manner.

Through the application, the patient will be able to fill out the questionnaire at any time, asking participants for details about their mood and emotions at the time. In addition, the app will collect data, if the participant will confirm it, which is collected by the smart device (steps, pulse, etc.) The data will be stored on a computer that is locked with a password, there will be complete separation between the patient's identifying data and the research related data. Data analysis will include correlation studies between the different parameters collected- specifically looking for emotional patterns/ events that affect glycemia.

• Study Type: Observational
• Enrollment (Actual): 75

Contacts and Locations

Study Locations

• Israel
  • Tel Aviv, Israel, 64239
    • The Institute of Endocrinology Metabolism and Hypertension

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 120 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients with a type 1 Diabetes Mellitus diagnosis

Description

Inclusion Criteria:

1. Males or females above 18 years old
2. Patients with a prior medical history diagnosis of T1DM
3. Patients who are using a continuous glucose monitor (CGM or FGM)

Exclusion Criteria:

1. Patients without a diagnosis of type 1 DM
2. patients who are not using a continuous glucose monitor (CGM or FGM)
3. patients who did not sign an informed consent
4. lack of judgment and underage populations
5. Patients without a mobile smart device (smart phone)

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Type 1 diabetes mellitus (T1DM); Males or females above 18 years old; Patients with a prior medical history diagnosis of T1DM; Patients who are using a continuous glucose monitor (CGM or FGM)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
correlation between baseline personality characteristics, changing emotions throughout the day, and glycemic levels in patients with T1DM	correlation between patient personality characteristics, patients' mood and glycemic control. Eventually, using this information may allow us the ability to better balance glucose blood levels in patients with T1DM, by recognizing influencing psychological parameters	through study completion, an average of 1 year

Collaborators and Investigators

• Sponsor: Tel-Aviv Sourasky Medical Center
• Collaborators: Rambam Health Care Campus; Tel Aviv University
• Investigators: Study Director: Gon Shoham, MD, Tel Aviv University

Study record dates

Study Major Dates

• Study Start (Actual): February 17, 2020
• Primary Completion (Actual): November 30, 2020
• Study Completion (Actual): March 1, 2021

Study Registration Dates

• First Submitted: March 2, 2021
• First Submitted That Met QC Criteria: July 25, 2021
• First Posted (Actual): July 27, 2021

Study Record Updates

• Last Update Posted (Actual): August 9, 2021
• Last Update Submitted That Met QC Criteria: August 1, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Glucose Metabolism Disorders; Metabolic Diseases; Immune System Diseases; Autoimmune Diseases; Endocrine System Diseases; Personality Disorders; Diabetes Mellitus; Diabetes Mellitus, Type 1
• Other Study ID Numbers: 0436-19-TLV

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No