Timing of Initiation of Continuous Glucose Monitoring in Established Pediatric Diabetes (The CGM TIME Trial)

NCT ID: NCT01295788

Last Updated: 2021-06-02

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

144 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-05-31

Study Completion Date

2017-12-31

Brief Summary

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The investigators hypothesize that REAL-Time Continuous Glucose Monitoring (RT-CGM) will be more effective if introduced in children and adolescents with established diabetes at the same time as they are starting pump therapy. This randomized controlled trial will compare the effectiveness of simultaneous vs delayed introduction of RT-CGM in children and adolescents with type 1 diabetes who are starting insulin pump therapy.

Detailed Description

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REAL-Time Continuous Glucose Monitoring (RT-CGM) improves diabetes control in adults with type 1 diabetes. However, studies of RT-CGM in children and adolescents have been mostly negative. The lack of effectiveness in the pediatric population appears directly related to adherence to RT-CGM, i.e., the willingness of children and teens to wear and use this technology. Most previous RT-CGM studies have focused on experienced pump users or children with new-onset diabetes. At the time of pump initiation, children and adolescents who have been living with diabetes (and their parents) are highly motivated to make changes in their diabetes management and to take on additional responsibilities to improve their diabetes control and lifestyle, the two primary reasons for initiating pump therapy in the pediatric population. The investigators hypothesize that readiness for making changes in diabetes management will be greater at the time of pump initiation than at six months after the pump start. Further, the investigators hypothesize that readiness for change at the time of RT-CGM initiation will predict future adherence to RT-CGM and its effectiveness.

Conditions

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Type 1 Diabetes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Simultaneous or Delayed initiation of continuous glucose monitoring
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Simultaneous RT-CGM and Pump Initiation

The experimental group will initiate RT-CGM at the same time as they begin insulin pump therapy.

Group Type EXPERIMENTAL

Simultaneous RT-CGM and Pump Initiation

Intervention Type DEVICE

Subjects in this group will start using RT-CGM at the same time as they initiate insulin pump therapy.

Delayed RT-CGM Initiation

The control group will use standard pump therapy until the 6 month study visit at which time RT-CGM will be initiated.

Group Type ACTIVE_COMPARATOR

Delayed Initiation of RT-CGM

Intervention Type DEVICE

Subjects in this group will start using RT-CGM 6 months after initiation of insulin pump therapy.

Interventions

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Simultaneous RT-CGM and Pump Initiation

Subjects in this group will start using RT-CGM at the same time as they initiate insulin pump therapy.

Intervention Type DEVICE

Delayed Initiation of RT-CGM

Subjects in this group will start using RT-CGM 6 months after initiation of insulin pump therapy.

Intervention Type DEVICE

Other Intervention Names

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Sensor-Augmented Pump Therapy at Pump Initiation

Eligibility Criteria

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Inclusion Criteria

* Males and females age 5-18 years old.
* Established T1D diagnosis for a minimum of one year.
* Naïve to CSII therapy and ready to start CSII with the Veo pump (Medtronic) .
* Willing to use RT-CGM and to be randomly assigned to either simultaneous or delayed RT-CGM initiation.
* Regular diabetes follow up at one of the 5 participating sites.
* Internet access at home (to upload RT-CGM data).
* Parent(s) or legally acceptable representative able to speak and read English or French.
* Ability of the subject and parent(s) or legally acceptable representative to participate in all aspects of this clinical trial.
* Written informed consent must be obtained and documented, with assent of the child if \<14 years of age.

Exclusion Criteria

* Conditions which in the opinion of the investigator may interfere with the subject's ability to participate in the study.
* Has received oral and/or intravenous steroid therapy (for any indication, at any dose and/or for any duration) on more than 2 separate occasions in the past 12 months. Use of inhaled and/or topical steroid therapy in the last 12 months does not exclude the subject.
* Prior use of RT-CGM for more than 50% of the time over the past 6 months.
* Prior enrollment in the current study.
* Current enrollment in another intervention trial.
Minimum Eligible Age

5 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Juvenile Diabetes Research Foundation

OTHER

Sponsor Role collaborator

Canadian Clinical Trial Network

UNKNOWN

Sponsor Role collaborator

Children's Hospital of Eastern Ontario

OTHER

Sponsor Role lead

Responsible Party

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Margaret Lawson

Professor of Pediatrics

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Margaret L Lawson, MD

Role: STUDY_DIRECTOR

Children's Hospital of Eastern Ontario

Locations

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McMaster Children's Hospital

Hamilton, Ontario, Canada

Site Status

Children's Hospital of Western Ontario

London, Ontario, Canada

Site Status

Markham-Stouffville Hospital

Markham, Ontario, Canada

Site Status

Children's Hospital of Eastern Ontario

Ottawa, Ontario, Canada

Site Status

Hospital for Sick Children

Toronto, Ontario, Canada

Site Status

Countries

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Canada

References

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Lawson ML, Verbeeten KC, Courtney JM, Bradley BJ, McAssey K, Clarson C, Kirsch S, Curtis JR, Mahmud FH, Richardson C, Cooper T, Chan J, Tang K. Timing of CGM initiation in pediatric diabetes: The CGM TIME Trial. Pediatr Diabetes. 2021 Mar;22(2):279-287. doi: 10.1111/pedi.13144. Epub 2020 Nov 4.

Reference Type RESULT
PMID: 33098212 (View on PubMed)

Verbeeten KC, Perez Trejo ME, Tang K, Chan J, Courtney JM, Bradley BJ, McAssey K, Clarson C, Kirsch S, Curtis JR, Mahmud FH, Richardson C, Cooper T, Lawson ML; CGM TIME Trial Study Group and the JDRF Canadian Clinical Trials Group. Fear of hypoglycemia in children with type 1 diabetes and their parents: Effect of pump therapy and continuous glucose monitoring with option of low glucose suspend in the CGM TIME trial. Pediatr Diabetes. 2021 Mar;22(2):288-293. doi: 10.1111/pedi.13150. Epub 2020 Nov 27.

Reference Type RESULT
PMID: 33179818 (View on PubMed)

Lawson ML, Bradley B, McAssey K, Clarson C, Kirsch SE, Mahmud FH, Curtis JR, Richardson C, Courtney J, Cooper T, Downie CJ, Rajamannar G, Barrowman N; CGM TIME Trial Study Group; JDRF Canadian Clinical Trial Network CCTN1101. The JDRF CCTN CGM TIME Trial: Timing of Initiation of continuous glucose Monitoring in Established pediatric type 1 diabetes: study protocol, recruitment and baseline characteristics. BMC Pediatr. 2014 Jul 18;14:183. doi: 10.1186/1471-2431-14-183.

Reference Type DERIVED
PMID: 25034216 (View on PubMed)

Olivier P, Lawson ML, Huot C, Richardson C, Nakhla M, Romain J. Lessons learned from a pilot RCT of simultaneous versus delayed initiation of continuous glucose monitoring in children and adolescents with type 1 diabetes starting insulin pump therapy. J Diabetes Sci Technol. 2014 May;8(3):523-8. doi: 10.1177/1932296814524855. Epub 2014 Feb 27.

Reference Type DERIVED
PMID: 24876616 (View on PubMed)

Other Identifiers

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CHEO 09/05E

Identifier Type: -

Identifier Source: org_study_id

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