Use of Continuous Glucose Sensors by Adolescents With Inadequate Diabetic Control (CGM-Teens)
Tutkimuksen yleiskatsaus
Tila
Tila
Ehdot
Ehdot
Interventio / Hoito
Interventio / Hoito
Yksityiskohtainen kuvaus
Opintotyyppi
Opintotyyppi
Ilmoittautuminen (Todellinen)
Ilmoittautuminen
Vaihe
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskelupaikat
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-
Florida
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Jacksonville, Florida, Yhdysvallat, 32207
- Nemours Children's Clinic
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
- Age of adolescent > 11 years and < 17 years. This age range was chosen because families of adolescents often struggle with diabetes management. Youths > 18 years old may be likely to leave home during the study.
- Diagnosis of type 1 diabetes based on the clinician's best judgment regarding the adolescent's proper diagnostic category.
- Duration of type 1 diabetes > 2 years or > 1 year with negligible stimulated c-peptide level, to exclude those with significant residual pancreatic insulin production.
- Treatment of diabetes for the 6 months prior to enrollment must consist of an intensified regimen including either daily use of an insulin pump or 3 or more daily insulin injections with pre-meal insulin doses calculated using a correction factor that considers prevailing blood glucose levels and planned carbohydrate intake.
- Adolescent must have established diabetes care at a participating Nemours Children's Clinic site as evidenced by at least two diabetes clinic visits within the prior 12 months.
- Most recent HbA1C > 7.5% and < 10.0% or mean HbA1C over the prior 12 months within that same range.
- Intention to remain in the same region and to maintain diabetes care at the enrolling center for 12 months.
- Family has working telephone service.
Exclusion Criteria:
- Youth has not used a CGM device with real-time glucose feedback for clinical management of diabetes within the prior 6 months. Intermittent or one-time use of "blinded" CGM devices for retrospective analysis only is permissible.
- Absence of any other medical conditions that, in the opinion of the attending endocrinologist, would impede completion of the study protocol.
- Youths may not be on daily glucocorticoid medications due to hyperglycemic effects of these agents.
- Not enrolled in special education for mental retardation, autism or severe behavior disorders.
- Child not in an inpatient psychiatric unit or day treatment program during the 6 months prior to enrollment.
- Primary diabetes caregiver not diagnosed or in treatment for major depression, psychosis, bipolar disorder or substance use disorder within the 6 months prior to enrollment; Child not in an inpatient psychiatric unit or day treatment program during the 6 months prior to enrollment.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Terveyspalvelututkimus
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseiden lukumäärä
Aseet ja interventiot
Osallistujaryhmä / ArmOsallistujaryhmä / Arm |
Interventio / HoitoInterventio / Hoito |
|---|---|
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Active Comparator: Standard Care
Standard Care constitutes intensified diabetes management, an enrollment criterion for the study, consisting of either continuous subcutaneous insulin infusion (insulin pump) or multiple daily injections using a "basal-bolus" approach.
All patients must be using carbohydrate counting and have prescribed correction factors for targeted insulin bolus dose adjustments.
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Intensified diabetes management based on either insulin pump or multiple daily injection insulin regimen, employing carbohydrate counting and a bolus dose correction factor for adjusting insulin doses.
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Active Comparator: Continuous Glucose Sensor
Patients will have the same diabetes management regimen as those in the Standard Care group.
In addition they will be given a continuous glucose sensor, receive expert instruction in its use, and be guided by a physician and diabetes educator in achieving glycemic benefits through retrospective and real-time interpretation of CGS results and by learning to respond judiciously to the various CGS alarms.
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Education and medical management to promote optimal therapeutic benefit from adding use of a continuous glucose sensor to daily diabetes management.
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Kokeellinen: CGS + Behavior Therapy
Patients in the use group will receive the same medical management as the Continuous Glucose Sensor group above.
In addition, they will have 6 scheduled encounters with a behavior therapist that are designed to reduce or eliminate typical behavioral and/or psychological barriers to optimal use of CGS as part of diabetes care.
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Patients in this group will receive 6 scheduled encounters with a behavior therapist who will assist the adolescent and parent in reducing or eliminating common behavioral and psychological barriers to achieving optimal benefit from CGS use in diabetes care.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Glycated Hemoglobin (HbA1c)
Aikaikkuna: Baseline, 3, 6, 9 months
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Glycated hemoglobin (HbA1c) expressed as a percentage of hemoglobin molecules bound to glucose.
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Baseline, 3, 6, 9 months
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Toissijaiset tulostoimenpiteet
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Diabetes Technology Questionnaire-Adolescents
Aikaikkuna: Baseline, 3 6, 9 months
|
Adolescent's total score on the DTQ-Current items.
Range 30-150.
Higher scores indicate more favorable satisfaction with and impact of the package of diabetes technology (e.g.
pump, meter, CGM, etc.) in use by the patient during the prior 3 months.
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Baseline, 3 6, 9 months
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Diabetes Technology Questionnaire-Parents' Total Scores on DTQ Current Items
Aikaikkuna: Baseline, 3, 6, 9 months
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Parents' ratings of impact and satisfaction with the diabetes devices currently in use (e.g.
pump, meter, CGM etc.) Score range from 30-150.
Higher score signify greater satisfaction and impact.
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Baseline, 3, 6, 9 months
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Blood Glucose Monitoring Communication Questionnaire-Adolescent
Aikaikkuna: Baseline, 3, 6, 9 months
|
Adolescent report of communication with parents about blood glucose monitoring and results.
Range 8-24.
Higher scores indicate more negative communication about BG results.
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Baseline, 3, 6, 9 months
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Blood Glucose Monitoring Communication Questionnaire-Parents
Aikaikkuna: Baseline, 3, 6, 9 months
|
Parents perspectives of communication with adolescent around blood glucose monitoring and results.
Score range 8-24.
Higher scores signify more negative communication about BG results.
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Baseline, 3, 6, 9 months
|
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Diabetes Family Conflict Scale-Adolescent
Aikaikkuna: Baseline, 3, 6, 9 months
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Adolescent ratings of degree of diabetes-related family conflict.
Score range 19-57.
Higher scores indicate more frequent family conflict around diabetes.
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Baseline, 3, 6, 9 months
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Diabetes Family Conflict Scale-Parent
Aikaikkuna: Baseline, 3, 6, 9 months
|
Parents' ratings of degree of diabetes-related family conflict.
Score range 19-57.
Higher scores indicate more family conflict around diabetes.
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Baseline, 3, 6, 9 months
|
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Diabetes Family Responsibility Questionnaire-Adolescent
Aikaikkuna: Baserline, 3, 6, 9 months
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Adolescent's self-ratings of their degree of responsibility for 38 diabetes tasks.
Score range 0-76.
Lower scores indicate greater adolescent responsibility for diabetes care.
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Baserline, 3, 6, 9 months
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Diabetes Family Responsibility Questionnaire-Parent
Aikaikkuna: Baseline, 3, 6, 9 months
|
Parent ratings of adolescent's degree of responsibility for 38 diabetes tasks.
Score range 0-76.
Lower scores indicate great adolescent responsibility for diabetes care tasks.
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Baseline, 3, 6, 9 months
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Diabetes Self Management Profile-Adolescent
Aikaikkuna: Baseline, 3, 6, 9 months
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Adolescent self-report of diabetes management behaviors.
Score range 0-86.
Higher scores indicate more meticulous diabetes treatment adherence.
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Baseline, 3, 6, 9 months
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Diabetes Self Management Profile-Parent
Aikaikkuna: Baseline, 3, 6, 9 months
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Parent report of adolescent's diabetes self-management behaviors.
Score range 0-86.
Higher scores indicate more meticulous diabetes treatment adherence.
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Baseline, 3, 6, 9 months
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Hypoglycemia Fear Survey-Adolescent
Aikaikkuna: Baseline, 3, 6, 9 months
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Adolescent worry and behavior related to apprehension of low BG episodes.
Score range 24-72.
Higher scores indicate greater fear and avoidance of hypoglycemia
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Baseline, 3, 6, 9 months
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Hypoglycemia Fear Survey-Parent
Aikaikkuna: Baseline, 3, 6, 9 months
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Parental worry and behavior related to apprehension of low BG events.
Score range 24-72.
Higher scores indicate greater parental fear and avoidance of hypoglycemia.
|
Baseline, 3, 6, 9 months
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Yhteistyökumppanit ja tutkijat
Sponsori
Sponsori
Yhteistyökumppanit
Yhteistyökumppanit
Tutkijat
Tutkijat
- Päätutkija: Tim Wysocki, Ph.D., Nemours Children's Clinic Jacksonville
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus
Opiskelun aloitus
Ensisijainen valmistuminen (Todellinen)
Ensisijainen valmistuminen
Opintojen valmistuminen (Todellinen)
Opintojen valmistuminen
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Arvio)
Ensimmäinen Lähetetty
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin päivitys julkaistu
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
Muut tutkimustunnusnumerot
- 1R01DK080831 (Yhdysvaltain NIH-apuraha/sopimus)
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