Glycemic Rises After Waking Up In Response To An Alarm Clock In Type 1-Diabetic Patients Analysed With Continuous Glucose Monitoring (GlucoDay®)

NCT ID: NCT00740012

Last Updated: 2008-09-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-03-31

Study Completion Date

2008-09-30

Brief Summary

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Study hypothesis: Waking up in response to an alarm clock may evoke a stress reaction that leads to rising glucose concentrations.

The purpose of this study was to prove this hypothesis with continuous glucose monitoring over three nights.

Night (a) with an alarm clock set at 2 h intervals for glucose self monitoring,

Night (b) with a nurse performing blood glucose determinations, and

Night (c) with the patients left undisturbed.

Detailed Description

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To provide nocturnal glucose control in patients with type 1 diabetes is a therapeutic challenge. Nocturnal glucose profiles are an important tool to secure adequate glycemic control during the night. Often, patients are asked to perform self-monitoring with the help of an alarm clock. Such a recommendation depends on the accuracy of glucose concentrations determined this way. We hypothesized that alarm clocks may trigger a stressful arousal that might be accompanied by rises in glucose concentrations, consecutively leading to nocturnal glucose profiles that are not representative for undisturbed conditions.

We want to prove this hypothesis with 30 patients over three nights.

Night (a) with an alarm clock set at 2 h intervals (midnight, 2 a.m., 4a.m. and 6:45 a.m) for glucose self monitoring,

Night (b) with a nurse performing blood glucose determinations at the 2 h intervals (midnight, 2 a.m., 4a.m. and 6:45 a.m), and

Night (c) with the patients left undisturbed.

All the patients are going to use a continuous glucose monitor and half of the patients (uneven numbers) are going to have an indwelling venous cannula during night (a) and (b.

During night (a) and (b) 5-7 minutes after the scheduled times for glucose measurements the doctoral candidate is going to take the pulse, another capillary blood sample for a laboratory glucose determination (EBIOS, Eppendorf, Hamburg, Germany). Also the doctoral candidate is going to take a venous blood sample in half of the patients (uneven numbers), blood from the indwelling venous cannula for the determination of epinephrine, norepinephrine, cortisol, glucagon, growth hormone, and prolactin (determined by specific immunoassays at Biocientia laboratories, Jena, Germany).

Conditions

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Stress Type 1 Diabetes

Keywords

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Nocturnal glucose profiles continuous glucose profiles

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Blinding Strategy

NONE

Study Groups

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Even, low numbers

They start with a alarm- clock night. No venous blood drawing.

Group Type ACTIVE_COMPARATOR

Continuous glucose monitoring

Intervention Type OTHER

Glucoday S (microdialysis system). Continuous glucose monitoring all three nights

alarm- clock intervention, patient perform blood glucose self monitoring

Intervention Type OTHER

Alarm clock intervention at midnight, 2 a.m., 4 a.m. and 6:45 a.m.

nurse intervention

Intervention Type OTHER

Nurse intervention: gently drawing capillary sample (blood glucose)at midnight, 2 a.m., 4 a.m. and 6:45 a.m. .

Taking the patients pulse

Intervention Type OTHER

In nights (a) and (b) the doctoral candidate takes the patients pulse 5-7 minutes after the alarm clock or the nurse.

Other capillary sample

Intervention Type OTHER

5-7 minutes after the alarm clock or the nurse the doctoral candidate takes another capillary sample for a laboratory glucose determination (EBIOS, Eppendorf, Hamburg, Germany) analyzer.

Even, high numbers

They start with a nurse performing blood glucose determination. No venous blood drawing.

Group Type ACTIVE_COMPARATOR

Continuous glucose monitoring

Intervention Type OTHER

Glucoday S (microdialysis system). Continuous glucose monitoring all three nights

alarm- clock intervention, patient perform blood glucose self monitoring

Intervention Type OTHER

Alarm clock intervention at midnight, 2 a.m., 4 a.m. and 6:45 a.m.

nurse intervention

Intervention Type OTHER

Nurse intervention: gently drawing capillary sample (blood glucose)at midnight, 2 a.m., 4 a.m. and 6:45 a.m. .

Taking the patients pulse

Intervention Type OTHER

In nights (a) and (b) the doctoral candidate takes the patients pulse 5-7 minutes after the alarm clock or the nurse.

Other capillary sample

Intervention Type OTHER

5-7 minutes after the alarm clock or the nurse the doctoral candidate takes another capillary sample for a laboratory glucose determination (EBIOS, Eppendorf, Hamburg, Germany) analyzer.

Uneven, low numbers

They start with an alarm- clock night and have venous blood drawing.

Group Type ACTIVE_COMPARATOR

Continuous glucose monitoring

Intervention Type OTHER

Glucoday S (microdialysis system). Continuous glucose monitoring all three nights

alarm- clock intervention, patient perform blood glucose self monitoring

Intervention Type OTHER

Alarm clock intervention at midnight, 2 a.m., 4 a.m. and 6:45 a.m.

nurse intervention

Intervention Type OTHER

Nurse intervention: gently drawing capillary sample (blood glucose)at midnight, 2 a.m., 4 a.m. and 6:45 a.m. .

Taking the patients pulse

Intervention Type OTHER

In nights (a) and (b) the doctoral candidate takes the patients pulse 5-7 minutes after the alarm clock or the nurse.

Venous blood drawing

Intervention Type OTHER

Venous blood drawing for the determination of epinephrine, norepinephrine, cortisol, glucagon, growth hormone, and prolactin (determined by specific immunoassays at Biocientia laboratories, Jena, Germany) (6-10 minutes after midnight, 2 a.m., 4 a.m. and 6:45 a.m.)in night (a) and (b)

Other capillary sample

Intervention Type OTHER

5-7 minutes after the alarm clock or the nurse the doctoral candidate takes another capillary sample for a laboratory glucose determination (EBIOS, Eppendorf, Hamburg, Germany) analyzer.

Uneven, high numbers

They start with a nurse performing blood glucose determination and have venous blood drawing.

Group Type ACTIVE_COMPARATOR

Continuous glucose monitoring

Intervention Type OTHER

Glucoday S (microdialysis system). Continuous glucose monitoring all three nights

alarm- clock intervention, patient perform blood glucose self monitoring

Intervention Type OTHER

Alarm clock intervention at midnight, 2 a.m., 4 a.m. and 6:45 a.m.

nurse intervention

Intervention Type OTHER

Nurse intervention: gently drawing capillary sample (blood glucose)at midnight, 2 a.m., 4 a.m. and 6:45 a.m. .

Taking the patients pulse

Intervention Type OTHER

In nights (a) and (b) the doctoral candidate takes the patients pulse 5-7 minutes after the alarm clock or the nurse.

Venous blood drawing

Intervention Type OTHER

Venous blood drawing for the determination of epinephrine, norepinephrine, cortisol, glucagon, growth hormone, and prolactin (determined by specific immunoassays at Biocientia laboratories, Jena, Germany) (6-10 minutes after midnight, 2 a.m., 4 a.m. and 6:45 a.m.)in night (a) and (b)

Other capillary sample

Intervention Type OTHER

5-7 minutes after the alarm clock or the nurse the doctoral candidate takes another capillary sample for a laboratory glucose determination (EBIOS, Eppendorf, Hamburg, Germany) analyzer.

Interventions

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Continuous glucose monitoring

Glucoday S (microdialysis system). Continuous glucose monitoring all three nights

Intervention Type OTHER

alarm- clock intervention, patient perform blood glucose self monitoring

Alarm clock intervention at midnight, 2 a.m., 4 a.m. and 6:45 a.m.

Intervention Type OTHER

nurse intervention

Nurse intervention: gently drawing capillary sample (blood glucose)at midnight, 2 a.m., 4 a.m. and 6:45 a.m. .

Intervention Type OTHER

Taking the patients pulse

In nights (a) and (b) the doctoral candidate takes the patients pulse 5-7 minutes after the alarm clock or the nurse.

Intervention Type OTHER

Venous blood drawing

Venous blood drawing for the determination of epinephrine, norepinephrine, cortisol, glucagon, growth hormone, and prolactin (determined by specific immunoassays at Biocientia laboratories, Jena, Germany) (6-10 minutes after midnight, 2 a.m., 4 a.m. and 6:45 a.m.)in night (a) and (b)

Intervention Type OTHER

Other capillary sample

5-7 minutes after the alarm clock or the nurse the doctoral candidate takes another capillary sample for a laboratory glucose determination (EBIOS, Eppendorf, Hamburg, Germany) analyzer.

Intervention Type OTHER

Other Intervention Names

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Gluco Day S (Menarini Diagnostics) Ordinary alarm clock professional night nurses Pulse measurment venous blood drawing from an intravenous catheter laboratory method (EBIOS, Eppendorf, Hamburg, Germany)

Eligibility Criteria

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Inclusion Criteria

* Type 1 Diabetic patients (diagnosed longer than 2 years)
* HBA1c 5,0 - 9,5 %
* Age 18-75 years
* Hospitalized patients
* Male or female, if female exclusion of pregnancy or secure contraception
* Body-Mass-Index 19-40 kg/m²
* Patient is elucidated
* Patients agreement

Exclusion Criteria

* Type 2-Diabetic patients or other forms of diabetes beside type 1 diabetes, diagnosed after the guidelines of the Deutsche Diabetes Gesellschaft
* HbA1c \< 5,0 % or \> 9,5 %
* A severe hypoglycemia with unconsciousness within the last 2 month
* Body-Mass-Index \< 19 or \> 40 kg/m²
* No patient agreement
* Pregnancy (positive pregnancy test) or unsecured contraception.
* Agina pectoris or acute myocardial infarct, as continuous problem
* Inadequate treated arterial hypertension \> 160 mmHg systolic and/or \< 95 mmHg diastolic
* Active tumor disease
* Anemia hemoglobin \< 11,5 g/dl
* Treatment with steroids, sedative or anesthetics
* Infection/fewer \> 37.5 °C
* Renal- malfunction (serum- creatinine \> 1.5 mg/dl)
* Liver- malfunction (GPT and AP \> double of upper- limit)
* Alcohol or drug abuse
* Sleep disorder
* Participation in clinical studies within the last 3 month
* Other significant health dysfunctions, which would affect the outcome of this study
* Incapable to conform the requirements of the protocol
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Berlin-Chemie Menarini

INDUSTRY

Sponsor Role collaborator

Diabeteszentrum Bad Lauterberg im Harz

OTHER

Sponsor Role lead

Responsible Party

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Diabeteszentrum Bad Lauterberg

Principal Investigators

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Michael A. Nauck, professor

Role: PRINCIPAL_INVESTIGATOR

Diabeteszentrum Bad Lauterberg

Locations

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Diabeteszentrum Bad Lauterberg im Harz

Bad Lauterberg im Harz, Lower Saxony, Germany

Site Status

Countries

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Germany

References

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Berndt C, Köthe L, Nawrodt B, Mraz B, Patzelt-Bath A. Glycaemic rises after waking up in response to an alarm clock during the night in type 1 diabetic patients can be avoided by experienced nurses drawing blood in a hospital setting as shown by continuous glucose monitoring (GlucoDayR) (abstract 14). Diabetologia 51 (Suppl. 1): S 12

Reference Type RESULT

Berndt-Zipfel C, Kothe L, Nawrodt B, Mraz B, Patzelt-Bath A, Nauck MA. Glycaemic rises after waking up in response to an alarm clock in type 1-diabetic patients analysed with continuous glucose monitoring (GlucoDay(R) S). Exp Clin Endocrinol Diabetes. 2011 Jan;119(1):56-8. doi: 10.1055/s-0030-1265162. Epub 2011 Jan 18.

Reference Type DERIVED
PMID: 21246465 (View on PubMed)

Other Identifiers

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Glucoday BL

Identifier Type: -

Identifier Source: org_study_id