Comparing Internet Blood Glucose Monitoring System and Continuous Glucose Monitoring System
Protocol: Comparing the Effect of Using an Internet-Based Glucose Monitoring System Versus the Continuous Glucose Monitoring System on HbA1c Levels in Type 2 DM
調査の概要
詳細な説明
Purpose: To compare the benefits of the Internet-based glucose monitoring system with the Continuous Glucose monitoring system in patients with type 2 diabetes mellitus.
Hypothesis:The investigators propose that the benefits from the Internet-based glucose monitoring system (IBGMS) will be comparable to the benefits of the Continuous Glucose monitoring system (CGMS) for patients with type 2 DM.
Justification: Half of the subject will be on the standard treatment, which will involve glucose monitoring by testing blood glucose 3 times daily, performing a laboratory test of blood hemoglobin every three months, and visiting the doctor every three months for standard care. They will also use the internet system to report their glucose readings,which will allow the health care professions to view the results and provide feedback. The other half will use the continuous glucose monitoring system, which will involve a minimum of testing blood glucose at least 2 times a day to calibrate the sensor, performing laboratory test of blood hemoglobin every three months, and visiting the doctor every three months for standard care. All of the subjects will be under standard care;
Research Method: Type 2 diabetes patients who satisfy the inclusion criteria will be recruited from St. Paul's Diabetes Teaching and Training Centre. They will be randomized into 2 groups (IBGMS and CGMS). There is an equal chance, a 50/50 chance, of being placed in either group.
The IBGMS group will receive standard care and will be asked to perform self-blood glucose monitoring 3 times daily for 6 months. The IBGMS group will also be asked to report their blood glucose reading every 2 weeks through an Internet based glucose monitoring system. The IBGMS group will make visits to the endocrinologist every 3 months with A1c and serum creatinine measurements at 3-month intervals for 6 months.
The CGMS group will also receive standard care and will be asked to perform self-blood glucose monitoring at least 2 times a day for 6 months to calibrate the sensor.The CGMS group will also be using the internet system to generate a report of their blood glucose readings and can be used at the patient's own preference. Their readings will also be sent to the endocrinologist for feedback every 2 weeks. The CGMS group will make visits to the endocrinologist every 3 months with A1c and serum creatinine measurements at 3-month intervals for 6 months. The laboratory measurements of both groups will be recorded and used for data analysis.
Statistical Analysis: The primary endpoint is the A1c level or the change in A1c level. The secondary endpoints include severe hypoglycemia defined as requiring external aid, hospital admissions for any CVD related intervention, and adverse events such as unplanned hospitalizations for any cause that last more than 24 hours. Patients who do not have the required number of SMBG (Self monitored blood glucose) tests performed or patients requiring new laser therapy will be asked to discontinue the study.
For each group, A1C levels before the start of study will be compared to A1C levels 3 and 6 months after the start of the study. Paired t-tests and random effects models (longitudinal analyses) will examine differences in A1C values before and after the study duration. Unpaired, independent t-tests will be done to examine the difference in A1C values between the two groups before and after the interventions. The planned sample size is 50.
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
研究場所
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British Columbia
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Vancouver、British Columbia、カナダ
- St. Paul's Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Type 2 diabetes patients being treated with insulin for at least 3 months
- HbA1c > 7%
- > 25 years of age
- Willingness to test blood glucose levels a minimum of 3 times daily
- Willingness to be trained on using the Continuous Glucose Monitoring System
- Willingness to be randomized
- Trained in self-blood glucose monitoring
- Internet Access on a Windows Personal Computer
- No prior use or training on CGMS in the past 6 months
- No prior use or training on IBGMS in the past 6 months
Exclusion Criteria:
Patients who do not meet the above criteria or are not willing to participate will not be included in the study. Additional exclusion criteria include:
- Patient with medical conditions that may affect their study participation or results will be excluded.
- Patients with the potential to become pregnant
- Patients using medications known to influence control of diabetes (eg steroids systemic or inhaled)
- Liver disease (AST or ALT levels > 2.5 times the reference level)
- Renal insufficient with a serum creatinine level > 200 μmol/L
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:支持療法
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
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アクティブコンパレータ:インターネット介入
インターネット治療介入群に登録された被験者は、血糖値を少なくとも 1 日 3 回検査し、3 か月ごとに内分泌専門医を受診することで標準的なケアを受けます。ただし、医療従事者が表示してコメントできるように、血糖測定値を2週間ごとにオンラインでアップロードすることも求められます.
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インターネット治療介入群に登録された被験者は、血糖値を少なくとも 1 日 3 回検査し、3 か月ごとに内分泌専門医を受診することで標準的なケアを受けます。ただし、医療従事者が表示してコメントできるように、血糖測定値を2週間ごとにオンラインでアップロードすることも求められます.
他の名前:
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アクティブコンパレータ:Continuous Glucose Monitoring
The use of CGMS (Sensor, receiver, transmitter) plus the uploading of results to the Internet-based software utility of CareLink Personal and generating reports that can be viewed and used at the patient's own preference.
This group will send the uploaded data and receive feedback from their endocrinologist every 2 weeks.
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CGMS (センサー、レシーバー、トランスミッター) (Medtronic Diabetes) の使用に加えて、CareLink Personal のインターネットベースのソフトウェア ユーティリティへの結果のアップロード、および患者自身の好みで表示および使用できるレポートの生成。
このグループは、アップロードされたグルコース データに基づくフィードバックや提案を受け取りません。
他の名前:
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
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主要評価項目は、A1c レベルまたは A1c レベルの変化です
時間枠:6ヵ月
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6ヵ月
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二次結果の測定
結果測定 |
時間枠 |
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The secondary endpoint include severe hypoglycemia defined as requiring external aid (hospital or other).
時間枠:6 Months
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6 Months
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A secondary endpoint includes adverse events such as unplanned hospitalizations for any cause that last more than 24 hours
時間枠:6 monthns
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6 monthns
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協力者と研究者
捜査官
- 主任研究者:Hugh D Tildesley, MD、Providence Health Care, University of British Columbia
出版物と役立つリンク
一般刊行物
- Austin MM, Haas L, Johnson T, Parkin CG, Parkin CL, Spollett G, Volpone MT. Self-monitoring of blood glucose: benefits and utilization. Diabetes Educ. 2006 Nov-Dec;32(6):835-6, 844-7. doi: 10.1177/0145721706295873. No abstract available.
- Hirsch IB, Bode BW, Childs BP, Close KL, Fisher WA, Gavin JR, Ginsberg BH, Raine CH, Verderese CA. Self-Monitoring of Blood Glucose (SMBG) in insulin- and non-insulin-using adults with diabetes: consensus recommendations for improving SMBG accuracy, utilization, and research. Diabetes Technol Ther. 2008 Dec;10(6):419-39. doi: 10.1089/dia.2008.0104.
- Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998 Sep 12;352(9131):837-53. Erratum In: Lancet 1999 Aug 14;354(9178):602.
- Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM, Orchard TJ, Raskin P, Zinman B; Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005 Dec 22;353(25):2643-53. doi: 10.1056/NEJMoa052187.
- Klonoff DC, Bergenstal R, Blonde L, Boren SA, Church TS, Gaffaney J, Jovanovic L, Kendall DM, Kollman C, Kovatchev BP, Leippert C, Owens DR, Polonsky WH, Reach G, Renard E, Riddell MC, Rubin RR, Schnell O, Siminiero LM, Vigersky RA, Wilson DM, Wollitzer AO. Consensus report of the coalition for clinical research-self-monitoring of blood glucose. J Diabetes Sci Technol. 2008 Nov;2(6):1030-53. doi: 10.1177/193229680800200612.
- Yoo HJ, An HG, Park SY, Ryu OH, Kim HY, Seo JA, Hong EG, Shin DH, Kim YH, Kim SG, Choi KM, Park IB, Yu JM, Baik SH. Use of a real time continuous glucose monitoring system as a motivational device for poorly controlled type 2 diabetes. Diabetes Res Clin Pract. 2008 Oct;82(1):73-9. doi: 10.1016/j.diabres.2008.06.015. Epub 2008 Aug 12.
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- IBGMS vs CGMS
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