Euglyca Application in Children and Adolescents With Type 1 Diabetes Mellitus
The Effect of Mobile Application Euglyca in Glycemic Control of Children and Adolescents With Diabetes Mellitus Type-1
調査の概要
詳細な説明
Children and adolescents with Diabetes Mellitus Type 1 (T1DM) who visited consecutively this clinic were asked to participate in the study if they owned an Android smartphone and were familiar with its use. Patients were included after one of their parents or their legal guardian signed an informed consent. Inclusion criteria were: 1. Treatment with multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII); 2. satisfactory knowledge of the concept of carbohydrates and lipids counting acquired following previous training by the physicians and nutritionist of the department at initial diagnosis and thereafter during follow-up visits. Exclusion criteria were: 1. Use of another medical application for diabetes in the previous 3 months; 2. lack of capacity of reading greek.
80 patients met the inclusion criteria and agreed to participate in the study. Subsequently they were randomized to two equally numbered groups by drawing one of two nontransparent envelopes which contained one ticket inscribed with either a E (for Euglyca group) or a C (for Control group). To ensure equal allocation rates within the 2 groups, block randomization was employed.
At the initial visit, patients randomized to the E group were advised to download the Euglyca application on their smartphones and they were asked to use the application for the calculation of the bolus insulin dose they were injected. Patients randomized to the C group were advised to calculate bolus insulin dose they were injected, the way they used to do. Patients repeated their visit to the endocrine pediatric clinic at 3, 6 and 12 months, the latter set as the terminal time-point of this study following the initial visit. At all 4 visits, anthropometrics (weight, height, BMI), blood pressure measurement and heart rate were noted down, while a peripheral blood sample was drawn from all patients in the morning of each visit after an overnight fast for measurement of glycemia and glycosylated hemoglobin (HbA1c) levels. Glucose measurements between 70 and 180 mg/dl were categorized as normoglycemia; any glucose measurement below 70mg/dl was categorized as hypoglycemia; glucose measurements at two hours postprandial measurement found above 180mg/dl were categorized as hyperglycemia. At baseline (first visit), at 6 months (third visit) and at terminal time-point (12 months) all patients filled the World Health Organization-Standard DTSQ. Patients' logbooks and readings from their glucose meters were reviewed by the physicians and nutritionist of the department at each of the four visits and the percentage of normoglycemic, hypoglycemic and hyperglycemic episodes during the preceding trimester was calculated for each patient. The change of HbA1c values from baseline to the terminal time-point for each group was set as primary outcome, while the percentage of normoglycemic, hypoglycemic and hyperglycemic events over the total number of glucose measurements during the preceding trimester of each visit was set as secondary outcome.
Glycosylated hemoglobin was determined by Siemens DCA Vantage point-of-care immunoassay analyzer (Siemens Health care Diagnostics Ltd., Frimley, Camberley, UK) with intra- and inter- assay coefficients of variation (CV) 5% and 8%, respectively; glycemia was determined by glucose god/pap kit with intra- and inter- assay CVs 5.7% and 7.8%, respectively.
'Euglyca' is a mobile application that we developed . The application has a data base of 7000 foods and food products met in greek eating habits as well as the corresponding amount of carbohydrates and lipids for each of them. Subsequently, the amount of carbohydrates and lipids contained in a meal are calculated automatically by the application. By taking into consideration the amount of carbohydrates and lipids to be consumed, the preprandial and target post-prandial glycemia concentrations, the insulin correction factor for the patient, the carbohydrates and lipids factors and the active insulin (in case of CSII), 'Euglyca' calculates the required bolus dose of insulin.
Sample size was determined by estimating the change in HbA1c values (primary outcome) based on previous studies (7, 8), assuming 0.5% reduction in HbA1c in the intervention group with 80% power and 5% significance level. Power calculation resulted in 14 patients per group, while the target of the study had been set at recruitment of 80 patients altogether. Results are reported as mean ± standard deviation (SD) for quantitative variables. The absolute difference in a quantitative variable between two different time points was defined as Δ. All quantitative variables (HbA1c; ΔHbA1c; percentages of normoglycemic, hypoglycemic and hyperglycemic events over a total number of glucose measurements; DTSQ's scores) were normally distributed and they were compared between the two studied groups of patients at the different time-points by employing General Linear Models ANOVA and Bonferroni post-hoc test. Repeated measures ANOVA involved one factor between patients (factor "Group" with two levels) and one factor for the repeated measures within patients (factor "time" with 4 or 3 levels depending on the compared variable). Qualitative variables (gender and type of therapy) were compared by employing x2 (chi square) test after having computed absolute and relative frequencies (percentages %), Statistical significance was set at P<0,05. An intention to treat analysis was followed. IBM SPSS V23 Chicago, USA software was used for the statistical analysis.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Thessaloniki、ギリシャ、54642
- Endocrine Unit of 3rd Department of Pediatrics of Aristotle University of Thessaloniki, Hippokration General 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:
- Children and adolescents with Diabetes Mellitus type 1.
- Treatment with multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII)
- Satisfactory knowledge of the concept of carbohydrates and lipids counting
Exclusion Criteria:
- Use of another medical application for diabetes in the previous 3 months;
- Lack of capacity of reading greek.
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:独身
武器と介入
参加者グループ / アーム |
介入・治療 |
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介入なし:コントロール
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実験的:Euglyca
Patients randomized to the Euglyca group were advised to download the Euglyca application on their smartphones and they were asked to use the application for the calculation of the bolus insulin dose.
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'Euglyca' is a mobile application developed by two of the authors (CC and DF).
The application has a data base of 7000 foods and food products met in greek eating habits as well as the corresponding amount of carbohydrates and lipids for each of them.
Subsequently, the amount of carbohydrates and lipids contained in a meal are calculated automatically by the application.
By taking into consideration the amount of carbohydrates and lipids to be consumed, the preprandial and target post-prandial glycemia concentrations, the insulin correction factor for the patient, the carbohydrates and lipids factors and the active insulin (in case of CSII), 'Euglyca' calculates the required bolus dose of insulin.
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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 |
メジャーの説明 |
時間枠 |
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Level of glycosylated hemoglobin in the 2 groups
時間枠:At 3 months after the baseline visit
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Comparison of the level of glycosylated hemoglobin between the 2 groups
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At 3 months after the baseline visit
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Level of glycosylated hemoglobin in the 2 groups
時間枠:At 6 months after the baseline visit
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Comparison of the level of glycosylated hemoglobin between the 2 groups
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At 6 months after the baseline visit
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Level of glycosylated hemoglobin in the 2 groups
時間枠:At 12 months after the baseline visit
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Comparison of the level of glycosylated hemoglobin between the 2 groups
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At 12 months after the baseline visit
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Change from Baseline glycosylated hemoglobin at 3 months in the 2 groups
時間枠:At 3 months after the baseline visit
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Comparison of the differences in the level of glycosylated hemoglobin between the 2 groups
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At 3 months after the baseline visit
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Change from 3 months glycosylated hemoglobin at 6 months in the 2 groups
時間枠:At 6 months after the baseline visit
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Comparison of the differences in the level of glycosylated hemoglobin between the 2 groups
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At 6 months after the baseline visit
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Change from 6 months glycosylated hemoglobin at 12 months in the 2 groups
時間枠:At 12 months after the baseline visit
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Comparison of the differences in the level of glycosylated hemoglobin between the 2 groups
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At 12 months after the baseline visit
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Percentage of Normoglycemias in the 2 groups
時間枠:At 3 months after the baseline visit
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Comparison of the percentage of Normoglycemias between the 2 groups
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At 3 months after the baseline visit
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Percentage of Normoglycemias in the 2 groups
時間枠:At 6 months after the baseline visit
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Comparison of the percentage of Normoglycemias between the 2 groups
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At 6 months after the baseline visit
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Percentage of Normoglycemias in the 2 groups
時間枠:At 12 months after the baseline visit
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Comparison of the percentage of Normoglycemias between the 2 groups
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At 12 months after the baseline visit
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Diabetes Treatment Satisfaction Questionnaire (DTSQ) score in the 2 groups
時間枠:At 3 months after the baseline visit
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Comparison of the Diabetes Treatment Satisfaction Questionnaire (DTSQ) score between the 2 groups. DTSQ consists of 8 elements. Each element can be graded in a scale from 0 to 6. Two of the elements concern the perceived hypoglycemia or hyperglycemia. By adding the grades of each of the rest 6 elements the DTSQ score is calculated. |
At 3 months after the baseline visit
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Diabetes Treatment Satisfaction Questionnaire (DTSQ) score in the 2 groups
時間枠:At 6 months after the baseline visit
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Comparison of the Diabetes Treatment Satisfaction Questionnaire (DTSQ) score between the 2 groups. DTSQ consists of 8 elements. Each element can be graded in a scale from 0 to 6. Two of the elements concern the perceived hypoglycemia or hyperglycemia. By adding the grades of each of the rest 6 elements the DTSQ score is calculated. |
At 6 months after the baseline visit
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Diabetes Treatment Satisfaction Questionnaire (DTSQ) score in the 2 groups
時間枠:At 12 months after the baseline visit
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Comparison of the Diabetes Treatment Satisfaction Questionnaire (DTSQ) score between the 2 groups. DTSQ consists of 8 elements. Each element can be graded in a scale from 0 to 6. Two of the elements concern the perceived hypoglycemia or hyperglycemia. By adding the grades of each of the rest 6 elements the DTSQ score is calculated. |
At 12 months after the baseline visit
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協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (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 (実際)
学習記録の更新
投稿された最後の更新 (実際)
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
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Euglyca applicationの臨床試験
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Albert Einstein College of MedicineNational Institute of Mental Health (NIMH)募集
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Wuerzburg University HospitalCharite University, Berlin, Germany; Goethe University; RWTH Aachen University; Technical University... と他の協力者募集
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Johns Hopkins Bloomberg School of Public HealthNational Heart, Lung, and Blood Institute (NHLBI); Oakland University募集平時および緊急事態における食糧不安の人々における健康的な食糧アクセスの改善アメリカ