Time in Range (TIR) and Time Below Range (TBR) in Insulin-Treated Elderly Patients With Type 2 Diabetes
NCT ID: NCT04411277
Last Updated: 2022-06-15
Study Results
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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COMPLETED
71 participants
OBSERVATIONAL
2020-08-05
2022-04-30
Brief Summary
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Using CGM technology, we will assess an efficacy outcome : time in range (TIR) between 70-180 mg/dl and a safety outcome: incidence of hypoglycemia (time below range (TBR) less than 70, 54, and 40 mg/dl in insulin treated older adults with T2DM.
Patients will return to clinic every 2 weeks for new continuous glucose monitoring (CGM) placement, assessment of glycemic control and hypoglycemia, adherence to therapy and CGM use.
CGM data will be downloaded every 2 weeks.
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Detailed Description
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On the first visit to the research centers, after signing the informed consent form (ICF), patients will be evaluated for the presence of other comorbidities associated with diabetes such as the presence of cardiovascular disease, hypertension and dyslipidemia.
The screening for the presence of sarcopenia will be performed with the application of the SARC-F questionnaire; measuring muscle strength with grip strength; the functional test of getting up from the chair without supporting the arms and walking for 3 meters, turning 180º and returning to sit. The time in which the elderly person performs this task is timed and the time up to 20 seconds is considered normal.
Patients will undergo a complete physical examination and body composition analysis using the InBody 270 multifrequency bioimpedance to calculate the appendicular skeletal musculature.
After the first evaluation at the research centers, patients will be referred to partner laboratories that use the same methodologies for measuring HbA1c, blood count, urea, creatinine, glutamic oxalacetic transaminase (TGO) and glutamic-pyruvic transaminase (TGP), which will be performed only at the initial visit.
During the second visit to the research center, the FreeStyle Libre Flash interstitial glucose sensor will be inserted for the first time in the posterior and upper arm and the patient will be instructed to read the glucose at least 10 times a day, being sure to check glucose for a period longer than 8 hours. The patient should be instructed to return to the research center every 2 weeks to change the sensor until completing the 6-week period.
The patient's travel to the research center will be reimbursed by the study team. The study will be carried out at the Hospital da Cruz Vermelha Brasileira-Filial do Paraná, located in Curitiba in partnership with the independent research center Cline Research Center (CRC). Eligible patients will be randomly selected from clinical outpatients at participating institutions, concomitantly.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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T2DM Elderly on Insulin CGM
70 patients with type 2 diabetes \> 65 years of age taking insulin as treatment. The sample size was calculated to estimate the minimal number of patients necessary to describe the mean TIR (minutes/day).
Application of the FreeStyle Libre Flash Glucose CGM.
Assessment of glycemic control and hypoglycemia, adherence to therapy and CGM use.
InBody 270 multifrequency bioimpedance
analysis of body composition to calculate appendicular skeletal muscle.
Interventions
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Application of the FreeStyle Libre Flash Glucose CGM.
Assessment of glycemic control and hypoglycemia, adherence to therapy and CGM use.
InBody 270 multifrequency bioimpedance
analysis of body composition to calculate appendicular skeletal muscle.
Eligibility Criteria
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Inclusion Criteria
* Known history of type 2 Diabetes Mellitus
* BMI between 18.5 and 35kg/m2
* HbA1c between 7% and 9.0%
* Insulin with or without oral agent treatment for diabetes mellitus
Exclusion Criteria
* Patients with eGFR\<30 (epidermal growth factor receptor) using (calculated CKD EPI)
* Anemia (Hb\<11 grams)
* Chronic liver chronic disease (ALT\>3xULN)
* Use of glucocorticoids within 3 months preceding the investigation
* Neoplasia treatment
* Inability by the patient or caretaker to commit to protocol instructions and visit schedule.
* Type 1 diabetes
65 Years
ALL
No
Sponsors
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Abbott Diabetes Care
INDUSTRY
Cline Research Center
OTHER
Responsible Party
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Silmara Leite
Director
Principal Investigators
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Silmara Leite, MD, PhD
Role: PRINCIPAL_INVESTIGATOR
Cline Research Center
Locations
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Cline Research Center
Curitiba, Paraná, Brazil
Countries
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Related Links
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The physiology of endocrine systems with ageing
Diabetes in the older patient: heterogeneity requires individualization of therapeutic strategies
Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections: A Randomized Trial.
Estimating the mean and variance from the median, range, and the size of a sample.
A power primer.
The Relationship of Hemoglobin A1C to Time-in-Range in Patients with Diabetes.
Other Identifiers
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ADC-OUS-IIS-19-47
Identifier Type: -
Identifier Source: org_study_id
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