Medical Education to Improve Diabetes Care and Outcomes in Hospitalized Patients

NCT ID: NCT07108426

Last Updated: 2025-08-07

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-08-01

Study Completion Date

2025-05-31

Brief Summary

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This clinical trial aims to evaluate whether a structured medical education strategy can improve the quality of care provided to hospitalized patients with diabetes or hyperglycemia. Internal medicine residents from four university hospitals in southern Brazil are assigned to two groups: an intervention group receiving a 30-minute online lecture and 30 days of educational follow-up via WhatsApp®, and a control group receiving no additional training.

The primary goal is to assess changes in physicians' knowledge about inpatient glycemic control. Secondary goals include evaluating the quality of insulin prescriptions, rates of hyperglycemia and hypoglycemia, and hospital length of stay.

Detailed Description

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Hospital hyperglycemia is associated with increased morbidity, length of stay, and hospital costs, especially when not properly managed. Many internal medicine teams lack adequate training on glycemic control in hospitalized patients, and guidelines are not consistently followed in clinical practice.

This multicenter, randomized, open-label trial is designed to evaluate whether a telemedicine-based educational intervention can improve medical knowledge and clinical management of inpatient hyperglycemia. Internal medicine residents from four university hospitals in southern Brazil are randomized by clinical team into two groups: one receives a 30-minute online class and continued support via WhatsApp® for 30 days; the control group receives no intervention.

Medical knowledge is assessed using a validated questionnaire before and after the intervention. Secondary outcomes include the appropriateness of glycemic monitoring and insulin prescriptions, frequency of hyper- and hypoglycemia and hospital length of stay.

Conditions

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Diabete Type 2 Hyperglycemic Therapy Medical Education Telemedecine

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a multicenter, open-label, parallel-group randomized clinical trial designed to assess the impact of a structured medical education program on physicians' knowledge and hospital outcomes in patients with diabetes. Internal medicine resident teams from four Brazilian university hospitals were randomized to either an intervention group, which received a virtual class and 30-day follow-up via WhatsApp®, or a control group with usual practice. Outcomes include improvement in medical knowledge, quality of diabetes-related prescriptions, glycemic control, hospital length of stay, and readmission rates.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Telemedicine Education Group

Internal medicine residents in this group will receive a 30-minute online theoretical class on hospital hyperglycemia, taught by hospital-based endocrinologists. After the class, for 30 days, participants will be included in a continuing medical education group via the WhatsApp® application, where they will receive short educational videos and supporting materials related to diabetes and inpatient glycemic control.

Group Type EXPERIMENTAL

Educational Intervention via Telemedicine

Intervention Type BEHAVIORAL

A structured educational program delivered remotely through WhatsApp®, including a 30-minute online lecture and daily dissemination of educational content (videos, texts, and practical guidance) on hospital hyperglycemia and glycemic management strategies.

Routine Clinical Practice Group

Internal medicine residents in this group will not receive any theoretical class or continuing education intervention. They will continue their standard clinical duties and usual care practices during the study period, without additional materials or support related to inpatient diabetes management.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Educational Intervention via Telemedicine

A structured educational program delivered remotely through WhatsApp®, including a 30-minute online lecture and daily dissemination of educational content (videos, texts, and practical guidance) on hospital hyperglycemia and glycemic management strategies.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Internal medicine residents from clinical teams at the participating university hospitals in southern Brazil.
* Residents assigned to clinical teams during the intervention month.
* Provided informed consent to participate in the study.

Exclusion Criteria

* Residents on vacation during the intervention month.
* Residents from teams supervised by endocrinologists.
* Refusal to participate in the study.
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Federal University of Health Science of Porto Alegre

OTHER

Sponsor Role collaborator

Universidade Federal do Rio Grande (FURG)

OTHER

Sponsor Role collaborator

Federal University of Pelotas

OTHER

Sponsor Role collaborator

Catholic University of Pelotas

OTHER

Sponsor Role lead

Responsible Party

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Jivago da Fonseca Lopes

Principal Investigator, Endocrinologist, Catholic University of Pelotas

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Catholic University of Pelotas

Pelotas, Rio Grande do Sul, Brazil

Site Status

Countries

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Brazil

References

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Lopes JDF, Andrade PDR, Borges MT, Krause MC, Simi MOS, Bohlke M, Weinert LS. Medical education on hospital hyperglycemia improving knowledge and outcomes. Arch Endocrinol Metab. 2024 Feb 19;68:e230003. doi: 10.20945/2359-4292-2023-0003. eCollection 2024.

Reference Type BACKGROUND
PMID: 39420910 (View on PubMed)

Faruque LI, Wiebe N, Ehteshami-Afshar A, Liu Y, Dianati-Maleki N, Hemmelgarn BR, Manns BJ, Tonelli M; Alberta Kidney Disease Network. Effect of telemedicine on glycated hemoglobin in diabetes: a systematic review and meta-analysis of randomized trials. CMAJ. 2017 Mar 6;189(9):E341-E364. doi: 10.1503/cmaj.150885. Epub 2016 Oct 31.

Reference Type BACKGROUND
PMID: 27799615 (View on PubMed)

Mendez CE, Umpierrez GE. Pharmacotherapy for Hyperglycemia in Noncritically Ill Hospitalized Patients. Diabetes Spectr. 2014 Aug;27(3):180-8. doi: 10.2337/diaspect.27.3.180.

Reference Type BACKGROUND
PMID: 26246777 (View on PubMed)

Umpierrez GE, Reyes D, Smiley D, Hermayer K, Khan A, Olson DE, Pasquel F, Jacobs S, Newton C, Peng L, Fonseca V. Hospital discharge algorithm based on admission HbA1c for the management of patients with type 2 diabetes. Diabetes Care. 2014 Nov;37(11):2934-9. doi: 10.2337/dc14-0479. Epub 2014 Aug 28.

Reference Type BACKGROUND
PMID: 25168125 (View on PubMed)

Horton WB, Law S, Darji M, Conaway MR, Akbashev MY, Kubiak NT, Kirby JL, Thigpen SC. A MULTICENTER STUDY EVALUATING PERCEPTIONS AND KNOWLEDGE OF INPATIENT GLYCEMIC CONTROL AMONG RESIDENT PHYSICIANS: ANALYZING THEMES TO INFORM AND IMPROVE CARE. Endocr Pract. 2019 Dec;25(12):1295-1303. doi: 10.4158/EP-2019-0299. Epub 2019 Aug 14.

Reference Type BACKGROUND
PMID: 31412227 (View on PubMed)

Wu EQ, Zhou S, Yu A, Lu M, Sharma H, Gill J, Graf T. Outcomes associated with insulin therapy disruption after hospital discharge among patients with type 2 diabetes mellitus who had used insulin before and during hospitalization. Endocr Pract. 2012 Sep-Oct;18(5):651-9. doi: 10.4158/EP11314.OR.

Reference Type BACKGROUND
PMID: 22440990 (View on PubMed)

Bansal V, Mottalib A, Pawar TK, Abbasakoor N, Chuang E, Chaudhry A, Sakr M, Gabbay RA, Hamdy O. Inpatient diabetes management by specialized diabetes team versus primary service team in non-critical care units: impact on 30-day readmission rate and hospital cost. BMJ Open Diabetes Res Care. 2018 Apr 5;6(1):e000460. doi: 10.1136/bmjdrc-2017-000460. eCollection 2018.

Reference Type BACKGROUND
PMID: 29657719 (View on PubMed)

Rubin DJ. Hospital readmission of patients with diabetes. Curr Diab Rep. 2015 Apr;15(4):17. doi: 10.1007/s11892-015-0584-7.

Reference Type BACKGROUND
PMID: 25712258 (View on PubMed)

Moghissi ES, Korytkowski MT, DiNardo M, Einhorn D, Hellman R, Hirsch IB, Inzucchi SE, Ismail-Beigi F, Kirkman MS, Umpierrez GE; American Association of Clinical Endocrinologists; American Diabetes Association. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009 Jun;32(6):1119-31. doi: 10.2337/dc09-9029. Epub 2009 May 8. No abstract available.

Reference Type BACKGROUND
PMID: 19429873 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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84125324.4.1001.5335

Identifier Type: -

Identifier Source: org_study_id

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