- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico NCT02980627
iOmit: Reducing Intentional Insulin Misuse in Type 1 Diabetes (iOmit)
Individuals with type 1 diabetes who intentionally omit insulin to lose weight are at high risk for diabetes-related medical complications and premature death. Conventional eating disorder (ED) treatments are not as effective for these patients, suggesting that they need a more tailored treatment approach and one that includes intervention at the time and place when they are making decisions about their diabetes self-management. The goal of treatment development project is to modify an existing mobile application (app) for EDs (Recovery Record; RR) to address the unique needs of adults with type 1 diabetes (T1D) who intentionally omit their insulin for weight control, and test whether app-supported individual treatment decreases eating disorder (ED) symptoms and improves metabolic control. The investigator will also gather preliminary data on the impact of the intervention on health care utilization and costs and calculate attrition to assess feasibility.
The investigators hypothesize that (1) participants will evidence significant decreases in mean blood glucose, (2) participation in routine medical care will increase and emergency visits will decrease, (3) the percentage of time participants are hyperglycemic will decrease, (4) participant scores on the DEPS-R will decrease and (5) participant scores on the EDE will decrease.
Visão geral do estudo
Status
Intervenção / Tratamento
Descrição detalhada
Tipo de estudo
Inscrição (Real)
Estágio
- Não aplicável
Contactos e Locais
Locais de estudo
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North Carolina
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Durham, North Carolina, Estados Unidos, 27710
- Duke University Health System
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Durham, North Carolina, Estados Unidos, 27713
- Duke University Medical Center
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
- Adult aged 18 or older
- Diagnosed with T1D
- Positive for insulin misuse for weight control
- HbA1c ≥ 7.5
- Approved for participation by their physician
- Agrees to continue care with their current physician with consent to contact
- Access to a Smartphone
Exclusion Criteria:
- Non-English speaking
- Cognitive impairments that preclude independent management of T1D
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: N / D
- Modelo Intervencional: Atribuição de grupo único
- Mascaramento: Nenhum (rótulo aberto)
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
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Experimental: Therapy with Mobile App Enhancement
Participants will complete initial assessments and then take part in a 3-month intervention consisting of 12 weekly individual therapy sessions with daily RR app use between sessions.
At the end of the 3-month intervention period, an exit interview will be conducted and participants will complete a second assessment consisting of questionnaires and an ED diagnostic interview, a blood specimen for HbA1c, and 3-days of blinded CGM monitoring.
Participants will then enter a 6-month follow-up period during which time they may continue to use the app, but will no longer attend individual sessions.
Participants will be return to the clinic at 6 and 9 months for follow-up.
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Treatment includes 12 weekly therapy sessions with daily RR app use between sessions.
Intervention is CBT-based and specifically draws from ACT. ACT is a contextual behavior therapy that emphasizes the function of behavior (e.g., affect regulation) and helps individuals accept (or "tolerate") emotional discomfort for a broader purpose (i.e., personal values).
Broadly, treatment will focus on improving diabetes management by increasing patients' capacity to effectively cope with psychological barriers to self-care using acceptance and mindfulness strategies.
Outros nomes:
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Prazo |
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Metabolic Control (Change in HbA1c)
Prazo: Baseline, 3-months, 6-months and 9-months
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Baseline, 3-months, 6-months and 9-months
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
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Mobile Technology Engagement (Frequency of Use)
Prazo: Daily monitoring for 3 months
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Improvements in metabolic control will correspond with treatment engagement as reflected in frequency of app use from 0-3 months
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Daily monitoring for 3 months
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Adequate Insulin Dosing (Frequency)
Prazo: Baseline, 3-months, 6-months and 9-months
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Participants will report less frequent under-dosing of insulin
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Baseline, 3-months, 6-months and 9-months
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Medical Utilization: Total Number of Primary Care Visits
Prazo: Baseline, 3-months, 6-months, and 9-months
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Baseline, 3-months, 6-months, and 9-months
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Medical Utilization: Total Number of Emergency Department Care Visits
Prazo: Baseline, 3-months, 6-months, and 9-months
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Baseline, 3-months, 6-months, and 9-months
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Participant Engagement in Treatment as evidenced by attendance/treatment completion
Prazo: 3 months
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Attrition will be < 20%
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3 months
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Improvement in Metabolic Control; CGM Continuous Glucose Monitoring
Prazo: Baseline, 3-months
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Baseline, 3-months
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Decrease in Diabetes-Specific Eating Disorder symptomatology
Prazo: Baseline, 3-months, 6-months, and 9-months
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Baseline, 3-months, 6-months, and 9-months
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Decrease in Overall Eating Disorder symptomatology
Prazo: Baseline, 3-months, 6-months, and 9-months
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Baseline, 3-months, 6-months, and 9-months
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Rhonda Merwin, PhD, Duke University
Publicações e links úteis
Publicações Gerais
- Merwin RM, Dmitrieva NO, Honeycutt LK, Moskovich AA, Lane JD, Zucker NL, Surwit RS, Feinglos M, Kuo J. Momentary Predictors of Insulin Restriction Among Adults With Type 1 Diabetes and Eating Disorder Symptomatology. Diabetes Care. 2015 Nov;38(11):2025-32. doi: 10.2337/dc15-0753. Epub 2015 Sep 17.
- Merwin RM, Moskovich AA, Dmitrieva NO, Pieper CF, Honeycutt LK, Zucker NL, Surwit RS, Buhi L. Disinhibited eating and weight-related insulin mismanagement among individuals with type 1 diabetes. Appetite. 2014 Oct;81:123-30. doi: 10.1016/j.appet.2014.05.028. Epub 2014 May 29.
- Merwin RM, Moskovich AA, Babyak M, Feinglos M, Honeycutt LK, Mooney J, Freeman SP, Batchelder H, Sangvai D. An open trial of app-assisted acceptance and commitment therapy (iACT) for eating disorders in type 1 diabetes. J Eat Disord. 2021 Jan 6;9(1):6. doi: 10.1186/s40337-020-00357-6.
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Real)
Conclusão do estudo (Real)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- Pro00068040
- 1R21DK106603-01A1 (Concessão/Contrato do NIH dos EUA)
Plano para dados de participantes individuais (IPD)
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