CGM (Continuous Glucose Monitoring) Use in Diagnosis of Spontaneous and Reactive Hypoglycaemia

NCT ID: NCT04452396

Last Updated: 2023-12-12

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

TERMINATED

Clinical Phase

NA

Total Enrollment

7 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-12-01

Study Completion Date

2023-01-31

Brief Summary

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Use of CGM to determine diagnosis in possible spontaneous or reactive hypoglycaemia.

Use of CGM to aid treatment optimisation in spontaneous or reactive hypoglycaemia

Detailed Description

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The human body's blood sugar levels are tightly controlled by the hormone insulin, produced by the pancreas. If the pancreas produces too much insulin, then the blood sugar will fall to low levels (hypoglycaemia). Insulin overproduction can happen as a result of the body misreading a change in blood sugar levels after eating (such as after obesity surgery) or through tumours of the pancreas which overproduce insulin (insulinomas).

Hypoglycaemia can cause subtle symptoms such as tiredness, poor concentration, or dizziness and if untreated more severe symptoms including fits, coma and death. Low blood sugars can go unnoticed at night and if levels fall frequently, people can lose their ability to notice subtle symptoms.

People suspected of having hypoglycaemia require a series of investigations to try and reproduce a low blood sugar under controlled conditions. This often requires an admission to hospital for a few days and multiple finger pricks to test the blood sugar - which patients often find painful. If low blood sugars caused by too much insulin are confirmed then medical treatment is started in the first instance, with surgery possibly following later. The only way to check whether these medications are working is by home fingerprick glucose measurements. If people have low sugars at night or have lost their ability to notice symptoms of low blood sugar, it is very difficult to be sure that the medical treatment is working.

The investigators plan to use continuous glucose monitoring probes to measure patient's blood sugar prior to and during admission for formal investigation for hypoglycaemia (alongside conventional fingerprick and blood testing). This might allow us to exclude hypoglycaemia as a cause of their symptoms, avoiding lengthy admissions.

The investigators will also use this technology (alongside fingerprick testing) to test how well medical treatment is working in patients with proven hypoglycaemia.

Conditions

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Hypoglycemia, Reactive Hypoglycaemia Night Hypoglycemia Non-Diabetic Hypoglycemia Unawareness Insulinoma Insulinoma; Malignant, Pancreas Insulin Hypoglycemia Insulin Resistance Spontaneous Hypoglycemia Neuro Endocrine Tumours

Keywords

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hypoglycaemia insulinoma

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

2 phases to study. Patients can enter at start of either phase and start phase 2 at the end of phase 1.

Phase 1 - CGM monitoring of people with suspected spontaneous/reactive hypoglycaemia phase 2 - CGM monitoring of patients with medically managed spontaneous/reactive hypoglycaemia
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Phase 1 - (diagnostic) The CGM device will be blinded to the patient and physician until investigations into hypoglycaemia are complete phase 2 - (treatment optimisation) The CGM device will be blinded to the patient and physician for the first 10 days of treatment, medication will be optimised and the patient will continue with CGM in an unblinded way for up to 20 further days to aid further treatment optimisation

Study Groups

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patients

patients undergoing CGM monitoring

Group Type EXPERIMENTAL

use of continuous glucose monitoring

Intervention Type DEVICE

Patients will wear a CGM device whilst undergoing diagnostic testing for reactive/spontaneous hypoglycaemia and then optimisation of anti-hypoglycaemic medication.

Interventions

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use of continuous glucose monitoring

Patients will wear a CGM device whilst undergoing diagnostic testing for reactive/spontaneous hypoglycaemia and then optimisation of anti-hypoglycaemic medication.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* phase 1 - under investigation for possible/probable hypoglycaemia
* phase 2 - on medical therapy for established hypoglycaemia
* Must be Able and willing to give informed consent. No vulnerable adults will be included.
* Must be Aged \>18 years

Can be;

* Any ethnicity
* Any socio economic group
* Either conventional gender, or non-binary.

Exclusion Criteria

* Must not be unwilling or unable to give consent
* Must not be unable to speak sufficient English to give consent and understand study requirements
* Must not be Aged\<18 or \>90 years
* Must not be lack capacity to consent
* Must not have an underlying hepatic condition
* Must not have a current excessive alcohol consumption (men regularly consuming \>50 units/week, women \>35 units/week)
* Must not have Diabetes Mellitus
* Must not be currently using Diabetic medication or insulin
* Must not be currently pregnant
* Must not be on haemo or peritoneal dialysis
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Barts & The London NHS Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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St Bartholomew's Hospital, dept of endocrinology

London, , United Kingdom

Site Status

Countries

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United Kingdom

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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265405

Identifier Type: -

Identifier Source: org_study_id