Steno2tech - Continuous Glucose Monitoring and Type 2 Diabetes.

NCT ID: NCT04331444

Last Updated: 2023-10-12

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

96 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-01

Study Completion Date

2023-07-01

Brief Summary

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The overall objective of this research study is to examine the effectiveness of the use of CGM vs. SMBG in persons with insulin-treated type 2 diabetes on glycemic variables and patient reported outcomes on treatment satisfaction, health behavior and wellbeing. The independent effect of peer-support will also be studied.

Detailed Description

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The prevalence of type 2 diabetes is increasing. Although medical treatment options have increased, still less than a third obtain their optimal glycemic goal. The use of continuous glucose monitoring (CGM) in persons with type 1 diabetes has shown to be the most important driver for improvement in glycemic control-even more than insulin-pump therapy-but the use of technology in type 2 diabetes are not yet reimbursed and has been investigated in very few studies.

The study will be a single center, prospective, randomized, open-labelled, three-armed study with the randomization 2:1:2 in group A with CGM, group B with CGM and peer-support, group C as a control group with SMBG. The study will run for 12 months and will include 100 adult participants with insulin-treated type 2 diabetes, treated at the outpatient clinic at Steno Diabetes Center Copenhagen. Recruitment will begin in August 2020 and end in May 2022. Final 12-month follow-up is anticipated to be in July 2023.

The study is investor-initiated. The primary investigator (Nanna Lind, PhD. Student) will be responsible for execution of this study under guidance by the sponsor Kirsten Nørgaard. Results will be published in international peer-reviewed journals.

Our study will provide evidence of the effectiveness of the use of CGM in the treatment for type 2 diabetes, potentially shaping clinical guidelines for SMBG frequency and timing as well as use of technology in type 2 diabetes with an impact on both healthcare and healthcare costs.

Conditions

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Type 2 Diabetes Treated With Insulin

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group A, CGM

Addition of a calibration free real-time CGM in 12 months in persons with type 2 diabetes treated with insulin.

The participants will participate in a training course that will include the influence of different food items and exercise on glucose levels, how to measure SMBG correctly. Furthermore, participants in group A (intervention) will, in similarity to the HCPs, receive a CGM-education and training session led by the study investigator and will be interactive and hands-on, using case studies. The training session will include spoken and written instructions on how to insert and wear the CGM device and how to interpret the CGM information to better understand the relation between participants blood glucose and their diabetes self-management.

Group Type EXPERIMENTAL

CGM

Intervention Type DEVICE

Using the CGM during the entire study period of 12 months.

training course

Intervention Type BEHAVIORAL

The participants in the three groups will attend a three-hour training course with different content depending on the group allocation. The aim of this training course is to ensure that the participants have the knowledge, support and confidence to work collaboratively with their HCPs to increase TIR and decrease HbA1c.

Group B, CGM + peer-support

Addition of a calibration free real-time CGM in 12 months in persons with type 2 diabetes treated with insulin plus 3 sessions of peer-support in groups of 6 participants.

The participants will participate in a training course that will include the influence of different food items and exercise on glucose levels, how to measure SMBG correctly. Furthermore, participants in group B (intervention incl. peer-support) will, in similarity to group A, receive a CGM-education and training session. The training and CGM-course for participants in group B are similar to the course for group A with the addition of three peer-support sessions. The approach will be participatory and adaptable to allow flexibility in the content of the peer-support sessions and involving customized use of participatory methods i.e. dialogue tools and exercises.

Group Type EXPERIMENTAL

CGM

Intervention Type DEVICE

Using the CGM during the entire study period of 12 months.

training course

Intervention Type BEHAVIORAL

The participants in the three groups will attend a three-hour training course with different content depending on the group allocation. The aim of this training course is to ensure that the participants have the knowledge, support and confidence to work collaboratively with their HCPs to increase TIR and decrease HbA1c.

Peer-support

Intervention Type BEHAVIORAL

The peer-support will be facilitator-led by the primary investigator with peer exchange in group sessions (3 sessions over the study period, 3 hours per session) with 6-8 participants in every group.

Group C, SMBG

Standard self-monitoring of blood glucose according to standard guidelines, in 12 months.

The participants will participate in a training course that will include the influence of different food items and exercise on glucose levels, how to measure SMBG correctly.

Group Type ACTIVE_COMPARATOR

training course

Intervention Type BEHAVIORAL

The participants in the three groups will attend a three-hour training course with different content depending on the group allocation. The aim of this training course is to ensure that the participants have the knowledge, support and confidence to work collaboratively with their HCPs to increase TIR and decrease HbA1c.

Interventions

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CGM

Using the CGM during the entire study period of 12 months.

Intervention Type DEVICE

training course

The participants in the three groups will attend a three-hour training course with different content depending on the group allocation. The aim of this training course is to ensure that the participants have the knowledge, support and confidence to work collaboratively with their HCPs to increase TIR and decrease HbA1c.

Intervention Type BEHAVIORAL

Peer-support

The peer-support will be facilitator-led by the primary investigator with peer exchange in group sessions (3 sessions over the study period, 3 hours per session) with 6-8 participants in every group.

Intervention Type BEHAVIORAL

Other Intervention Names

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Continuous glucose monitoring Group sessions

Eligibility Criteria

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Inclusion Criteria

* Type 2 diabetes according to clinical definitions
* Treated with insulin injections at least once daily on top of diet and exercise recommendations. Insulin therapy has been used for at least 12 months. Can be additionally treated with one or more different oral antidiabetic drugs (except sulfonylurea), and/or glucagon-like-peptide 1 (GLP-1) analogues
* Attending the outpatient clinic at Steno Diabetes Center Copenhagen for at least 12 months
* Age ≥ 18 years
* HbA1c \> 58 mmol/mol (7.5%) at two consecutively measurements over at least 3 months
* Willing to use possible interventions; to perform self-monitoring of blood glucose (SMBG) as requested by the investigators AND to use CGM continuously without calibration for a 12-month period.
* Willing to intensify non-medical and medical treatment to achieve better glucose control.

Exclusion Criteria

* Inability to understand the patient information and give informed consent
* Not speaking and understanding Danish
* Treatment with sulfonylurea (SU) during the last 3 months before study start
* New antidiabetic treatment the last three months
* Use of systematic corticosteroids
* Visual impairment
* Severe skin allergy for adhesive tape to the patch of CGM or other skin condition that inhibits the use of a CGM device
* Comorbidity which does not allow lowering of HbA1c to 53 mmol/mol (7.0%)
* Hypoglycemic unawareness
* Impaired renal disease with eGFR \< 45 ml/min/1.73m2
* Conditions that impact the stability of a HbA1c measurement (chronic liver disease, haemoglobinopathy, anemia etc.)
* Known or suspected alcohol or drug abuse
* Already using Flash glucose monitoring (Libre) or CGM
* Enrolled in another clinical study
* Pregnancy, intend to become pregnant, breastfeeding or not using adequate contraceptive methods
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Steno Diabetes Center Copenhagen

OTHER

Sponsor Role lead

Responsible Party

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Nanna Lind

RN, MSc. in nursing

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nanna Lind, RN MSc

Role: PRINCIPAL_INVESTIGATOR

Steno Diabetes Center Copenhagen

Locations

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Steno Diabetes Center Copenhagen

Gentofte Municipality, Capital Region, Denmark

Site Status

Countries

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Denmark

References

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Lind N, Lindqvist Hansen D, Saetre Rasmussen S, Norgaard K. Real-time continuous glucose monitoring versus self-monitoring of blood glucose in adults with insulin-treated type 2 diabetes: a protocol for a randomised controlled single-centre trial. BMJ Open. 2021 Jan 15;11(1):e040648. doi: 10.1136/bmjopen-2020-040648.

Reference Type DERIVED
PMID: 33452188 (View on PubMed)

Other Identifiers

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Steno2tech CGM

Identifier Type: -

Identifier Source: org_study_id

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