National Institute of Diabetes and Digestive Kidney Diseases* Share Plus: Continuous Glucose Monitoring with Data Sharing in Older Adults with Type 1 Diabetes* and Their Care Partners to Improve Time in Range and Reduce Diabetes Distress.

NCT ID: NCT05937321

Last Updated: 2025-01-31

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

RECRUITING

Clinical Phase

NA

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-02

Study Completion Date

2026-02-28

Brief Summary

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The purpose of this study is to test the Share plus intervention aimed at improving the use of data sharing between people with diabetes and their care partners in order to maximize the benefits of continuous glucose monitoring.

Hypothesis: Compared to the control group, persons with diabetes enrolled in the Share plus intervention group will experience clinically significant improvements in time-in-range (TIR) (\>5%) at 12- and 24-weeks into the study, and improvement on diabetes distress. Care partners enrolled in the Share plus intervention group will experience lower diabetes distress at 12- and 24-weeks into the study.

Detailed Description

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Older adults with type 1 diabetes (T1D) have an increased risk of hypoglycemia and hyperglycemia that can result in grave health consequences, such as seizures, falls, and myocardial infarctions. Care partners (e.g., spouses, friends) regularly become part of the diabetes care team to assist in self-management as a person with diabetes ages. A technological advancement that is available to people with diabetes and their care partners to address harmful hypoglycemia and hyperglycemia is to use continuous glucose monitoring (CGM), with a data-sharing app that allows the older adult with T1D and their care partner (dyad) to see glucose data on their smart-phones and to receive an alert before hypoglycemia or hyperglycemia occurs. Our long-term goal is to leverage the full potential of technology and care partner interventions to optimize the support that care partners can provide for effective glucose management in older adults with T1D. Our overall objective is to test an intervention, called Share plus, aimed at improving the use of data sharing between persons with diabetes and their care partners in order to maximize the benefits of CGM. The Share plus intervention provides instruction to current CGM users about how to set up the data sharing app, dyadic communication and problem solving, and how to establish a data-sharing action plan for older adults with T1D and their care partners.

Our central hypothesis is that Share plus will result in increased time-in-range and decreased diabetes distress for both persons with diabetes (PWD) and their care partners (CPs) compared to the control group. The rationale for this pilot study is that demonstrating the efficacy of Share plus will provide new opportunities for a clinically useful approach to increase time in glucose range and decrease diabetes distress among older adults with T1D and their care partners. The central hypothesis will be tested by pursuing three specific aims: 1) evaluate feasibility, usability, and acceptability of the Share plus intervention compared to the control group receiving data sharing with diabetes self-management education, 2) evaluate the effect of Share plus intervention on time-in-range and Diabetes Distress, and 3) explore the differences between groups in PWD and CP dyadic appraisal and coping, quality of life, diabetes self-care and care partner burden. To test our central hypothesis, we will conduct a pilot randomized 1:1 control trial in older adults with T1D already using CGM (N=80 dyads) in a telehealth format where the intervention group will receive data sharing and Share plus and the control group will receive diabetes self-management education and assistance setting up the data sharing app. The trial will include a 12-week active intervention to determine a change in primary outcomes and a 12-week observation-only phase to determine maintenance of changes. The research proposed in this application is innovative because it provides a needed and substantive departure from the status quo by bringing a dyadic perspective of T1D management using data-sharing technology.

Conditions

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Diabetes Mellitus, Type 1

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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Intervention Group- Virtual with Dyad Follow + Share plus

The Share plus intervention is a behavioral intervention administered by a certified diabetes education and care specialist (CDCES) using telehealth. Share plus consists of three educational sessions to facilitate dyads' success in data sharing glucose levels. The Share plus intervention has five major components that are delivered using techniques of motivational interviewing: 1) shared appraisal, 2) communication strategies, 3) problem-solving strategies, 4) action planning and, 5) re-evaluating, practicing, and advancing.

Group Type EXPERIMENTAL

Share plus intervention

Intervention Type BEHAVIORAL

Participants will receive the Share plus intervention:

* Set up Follow app
* Start Share plus intervention
* Communication and problem-solving strategies
* Detailed action plan including glucose targets
* Review communication and problems
* New communication content
* Revise action plan as needed for communication and problem-solving hypo- and hyperglycemia,
* Dyadic glucose pattern management training using Clarity, set automatic Clarity downloads
* Dyad set goals for regular times to discuss glucose trends and problem-solving
* Dyadic review of glucose targets after an in-depth analysis of CGM data and dyadic treatment strategies to improve glucose TIR

Control Group- Virtual with Dyad Follow + Diabetes Self-Management Education

Participants will receive diabetes self-management education using the Association of Diabetes Care and Education Specialists 7 education curriculum (ADCES7).

Group Type ACTIVE_COMPARATOR

Control group

Intervention Type BEHAVIORAL

Diabetes self-management education materials

Interventions

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Share plus intervention

Participants will receive the Share plus intervention:

* Set up Follow app
* Start Share plus intervention
* Communication and problem-solving strategies
* Detailed action plan including glucose targets
* Review communication and problems
* New communication content
* Revise action plan as needed for communication and problem-solving hypo- and hyperglycemia,
* Dyadic glucose pattern management training using Clarity, set automatic Clarity downloads
* Dyad set goals for regular times to discuss glucose trends and problem-solving
* Dyadic review of glucose targets after an in-depth analysis of CGM data and dyadic treatment strategies to improve glucose TIR

Intervention Type BEHAVIORAL

Control group

Diabetes self-management education materials

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* 60 + years of age
* Type 1 Diabetes Diagnosis
* HbA1c no greater than 11.0%
* Currently using continuous glucose monitoring
* Able to manage diabetes with respect to insulin administration and glucose monitoring (which may include assistance from a care partner


* ≥18 years of age
* Participant understands the study protocol and agrees to comply with it

Exclusion Criteria

* Life expectancy estimated at \< 1 year
* Extreme visual or hearing impairment that would hinder the ability to use CGM
* Stage 4 or 5 renal disease or most recent Glomerular filtration rate (GFR) \<30 ml/min/m2 from a local lab within the past six months
* The presence of a significant medical or psychiatric condition or use of a medication that in the investigator's judgment may affect the completion of any aspect of the protocol.
* Clinical diagnosis of moderate or severe dementia
* Inpatient psychiatric treatment in the past six months
* Participation in an intervention study in the past six weeks
* Montreal Cognitive Assessment Score \< 19


* Cognitive impairment or dementia
* Medical condition that will make it inappropriate or unsafe to fulfill the role of a CP
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Utah

OTHER

Sponsor Role lead

Responsible Party

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Nancy Ann Allen

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nancy A Allen, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Utah College of Nursing

Locations

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University of Utah College of Nursing

Salt Lake City, Utah, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Bruno Gonzales, BA

Role: CONTACT

8015855958

Nancy A Allen, PhD

Role: CONTACT

8015823892

Facility Contacts

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Nancy A Allen, PhD

Role: primary

801-585-3892

References

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Allen NA, Berg CA, Iacob E, Gonzales BR, Butner JE, Litchman ML. Examining Share plus-A Continuous Glucose Monitoring Plus Data-Sharing Intervention in Older Adults and Their Care Partners: Protocol for a Randomized Control Study. JMIR Res Protoc. 2024 Dec 16;13:e60004. doi: 10.2196/60004.

Reference Type DERIVED
PMID: 39680874 (View on PubMed)

Other Identifiers

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00160673

Identifier Type: -

Identifier Source: org_study_id

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