Multiple Daily Injections and Continuous Glucose Monitoring in Diabetes

NCT ID: NCT02282397

Last Updated: 2017-05-15

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

316 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-09-30

Study Completion Date

2016-11-30

Brief Summary

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Evaluate if addition and use of real time continuous glucose monitoring (RT-CGM) improves glycemic outcome of patients using multiple daily injections (MDI) and self monitoring blood glucose (SMBG) testing, who are not at target glycemic control.

Detailed Description

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The study design includes two cohorts that will be treated separately. Phase 1 will include two diabetes cohorts (Type 1 diabetes mellitus and Type 2 diabetes mellitus) who will be randomized independently into two groups, Group 1-CGM and Group 2-SMBG.

The Group-1 CGM cohort who have Type 1 diabetes mellitus will be eligible for Phase 2. Phase 2 will include a separate independent randomization of either MDI therapy (Group 1a- CGM/MDI) or CSII therapy (Group 1b-CGM/CSII).

Additional assessments will be made to evaluate the incremental benefits of changing the insulin delivery method from MDI to CSII in patients already using CGM.

Cost effectiveness and quality of life will be measured between the two groups in each phase.

Conditions

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Diabetes Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Phase 1: SMBG

Type 1 or Type 2 diabetes mellitus subjects using SMBG testing and usual care for diabetes management. No intervention to be administered

Group Type NO_INTERVENTION

No interventions assigned to this group

Phase 1: CGM

Type 1 or Type 2 diabetes mellitus subjects using RT-CGM and SMBG testing for diabetes management. RT-CGM (Continuous Glucose Monitoring) is the intervention.

Group Type OTHER

Continuous Glucose Monitor

Intervention Type DEVICE

RT-CGM are adjunctive devices with glucose trend graphs and user-configurable low and high glucose alerts.

Phase 2: CGM/MDI

Type 1 Diabetes Mellitus subjects using RT-CGM and injections for diabetes management.

Group Type NO_INTERVENTION

No interventions assigned to this group

Phase 2: CGM/CSII

Type 1 Diabetes Mellitus subjects using RT-CGM and CSII for diabetes management.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Continuous Glucose Monitor

RT-CGM are adjunctive devices with glucose trend graphs and user-configurable low and high glucose alerts.

Intervention Type DEVICE

Other Intervention Names

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CGM RT-CGM

Eligibility Criteria

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Inclusion Criteria

* Age 25 years or older
* Diagnosis of Type 1 diabetes mellitus or insulin-requiring Type 2 diabetes mellitus
* Followed regularly by a physician or diabetes educator
* Using multiple daily injections
* stable control of diabetes
* willing to wear a device such as pump or continuous glucose monitor

Exclusion Criteria

* recent or planned use of non-insulin injectable hypoglycemic agents
* Pregnancy or planning to become pregnant during the study
* Medical conditions that make it inappropriate or unsafe to target an A1C of \<7%
* Renal disease with Glomerular Filtration Rate \<45
* Extensive skin changes/disease that precludes wearing the sensor on normal skin
* Known allergy to medical-grade adhesives
* Recent hospitalization or emergency room visit in the 6 months prior to screening resulting in primary diagnosis of uncontrolled diabetes
Minimum Eligible Age

25 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jaeb Center for Health Research

OTHER

Sponsor Role collaborator

DexCom, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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David Price, MD

Role: STUDY_DIRECTOR

DexCom, Inc.

Locations

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Marin Endocrine Care & Research

Greenbrae, California, United States

Site Status

Coastal Metabolic Research Centre

Ventura, California, United States

Site Status

East Coast Institute for Research, LLC

Jacksonville, Florida, United States

Site Status

East Coast Institute for Research, LLC

Jacksonville, Florida, United States

Site Status

Laureate Medical Group at Northside, LLC

Atlanta, Georgia, United States

Site Status

Atlanta Diabetes Associates

Atlanta, Georgia, United States

Site Status

Columbus Regional Research Institute

Columbus, Georgia, United States

Site Status

Physicians Research Associates, LLC

Lawrenceville, Georgia, United States

Site Status

Endocrine Research Solutions

Roswell, Georgia, United States

Site Status

Rocky Mountain Diabetes & Osteoporosis Center

Idaho Falls, Idaho, United States

Site Status

Iowa Diabetes & Endocrinology Research Center

Des Moines, Iowa, United States

Site Status

Joslin Diabetes Center

Boston, Massachusetts, United States

Site Status

Henry Ford Health System

Detroit, Michigan, United States

Site Status

International Diabetes Center

Minneapolis, Minnesota, United States

Site Status

Washington University in St. Louis

St Louis, Missouri, United States

Site Status

Diabetes & Endocrine Associates, PC

Omaha, Nebraska, United States

Site Status

Accent Clinical Research

Las Vegas, Nevada, United States

Site Status

Albany Medical College

Albany, New York, United States

Site Status

Mountain Diabetes and Endocrine Center

Asheville, North Carolina, United States

Site Status

Legacy Research Institute

Portland, Oregon, United States

Site Status

Oregon Health & Science University

Portland, Oregon, United States

Site Status

Amarillo Medical Specialists, LLP

Amarillo, Texas, United States

Site Status

Research Institute of Dallas

Dallas, Texas, United States

Site Status

Diabetes and Glandular Disease

San Antonio, Texas, United States

Site Status

Consano Clinical Research

San Antonio, Texas, United States

Site Status

Advanced Research Associates

Ogden, Utah, United States

Site Status

Granger Medical Clinic

Riverton, Utah, United States

Site Status

LMC Clinical Research

Barrie, Ontario, Canada

Site Status

LMC Clinical Research

Thornhill, Ontario, Canada

Site Status

LMC Clinical Research

Toronto, Ontario, Canada

Site Status

Countries

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United States Canada

References

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Hermanns N, Ehrmann D, Heinemann L, Freckmann G, Waldenmaier D, Calhoun P. Real-Time Continuous Glucose Monitoring Can Predict Severe Hypoglycemia in People with Type 1 Diabetes: Combined Analysis of the HypoDE and DIAMOND Trials. Diabetes Technol Ther. 2022 Sep;24(9):603-610. doi: 10.1089/dia.2022.0130. Epub 2022 Jun 10.

Reference Type DERIVED
PMID: 35604794 (View on PubMed)

Puhr S, Welsh JB, Bauza CE, Walker TC. Patients with Type 2 Diabetes and Residual Insulin Secretory Capacity Realize Glycemic Benefits from Real-Time Continuous Glucose Monitoring. J Diabetes Sci Technol. 2021 Jul;15(4):965-967. doi: 10.1177/19322968211007880. Epub 2021 Apr 15. No abstract available.

Reference Type DERIVED
PMID: 33855888 (View on PubMed)

Calhoun P, Price D, Beck RW. Glycemic Improvement Using Continuous Glucose Monitoring by Baseline Time in Range: Subgroup Analyses from the DIAMOND Type 1 Diabetes Study. Diabetes Technol Ther. 2021 Mar;23(3):230-233. doi: 10.1089/dia.2020.0471. Epub 2020 Oct 20.

Reference Type DERIVED
PMID: 33006904 (View on PubMed)

Puhr S, Calhoun P, Welsh JB, Walker TC. The Effect of Reduced Self-Monitored Blood Glucose Testing After Adoption of Continuous Glucose Monitoring on Hemoglobin A1c and Time in Range. Diabetes Technol Ther. 2018 Aug;20(8):557-560. doi: 10.1089/dia.2018.0134. Epub 2018 Jul 23.

Reference Type DERIVED
PMID: 30036082 (View on PubMed)

Beck RW, Riddlesworth TD, Ruedy K, Ahmann A, Haller S, Kruger D, McGill JB, Polonsky W, Price D, Aronoff S, Aronson R, Toschi E, Kollman C, Bergenstal R; DIAMOND Study Group. Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections: A Randomized Trial. Ann Intern Med. 2017 Sep 19;167(6):365-374. doi: 10.7326/M16-2855. Epub 2017 Aug 22.

Reference Type DERIVED
PMID: 28828487 (View on PubMed)

Beck RW, Riddlesworth TD, Ruedy KJ, Kollman C, Ahmann AJ, Bergenstal RM, Bhargava A, Bode BW, Haller S, Kruger DF, McGill JB, Polonsky W, Price D, Toschi E; DIAMOND Study Group. Effect of initiating use of an insulin pump in adults with type 1 diabetes using multiple daily insulin injections and continuous glucose monitoring (DIAMOND): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol. 2017 Sep;5(9):700-708. doi: 10.1016/S2213-8587(17)30217-6. Epub 2017 Jul 12.

Reference Type DERIVED
PMID: 28711468 (View on PubMed)

Riddlesworth T, Price D, Cohen N, Beck RW. Hypoglycemic Event Frequency and the Effect of Continuous Glucose Monitoring in Adults with Type 1 Diabetes Using Multiple Daily Insulin Injections. Diabetes Ther. 2017 Aug;8(4):947-951. doi: 10.1007/s13300-017-0281-4. Epub 2017 Jun 14.

Reference Type DERIVED
PMID: 28616804 (View on PubMed)

Polonsky WH, Hessler D, Ruedy KJ, Beck RW; DIAMOND Study Group. The Impact of Continuous Glucose Monitoring on Markers of Quality of Life in Adults With Type 1 Diabetes: Further Findings From the DIAMOND Randomized Clinical Trial. Diabetes Care. 2017 Jun;40(6):736-741. doi: 10.2337/dc17-0133. Epub 2017 Apr 7.

Reference Type DERIVED
PMID: 28389582 (View on PubMed)

Beck RW, Riddlesworth T, Ruedy K, Ahmann A, Bergenstal R, Haller S, Kollman C, Kruger D, McGill JB, Polonsky W, Toschi E, Wolpert H, Price D; DIAMOND Study Group. Effect of Continuous Glucose Monitoring on Glycemic Control in Adults With Type 1 Diabetes Using Insulin Injections: The DIAMOND Randomized Clinical Trial. JAMA. 2017 Jan 24;317(4):371-378. doi: 10.1001/jama.2016.19975.

Reference Type DERIVED
PMID: 28118453 (View on PubMed)

Other Identifiers

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PTL-901148

Identifier Type: -

Identifier Source: org_study_id

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