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The purpose of this study is to compare HbA1c of insulin-treated subjects with type 2 diabetes managed via usual care alone and usual care augmented with remote monitoring using Glooko
In this study, the investigator wants to evaluate if diabetes self-management supported by a mobile application, which captures a subject's blood glucose readings, lifestyle and medication information and shares it with the subject's certified diabetes educator (CDE) to enable remote monitoring, improves their glycemic control compared to standard of care.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard of Care | No Intervention | Subjects in this arm will visit their physician once every 3 months and will receive usual care. | |
| Remote Monitoring | Experimental | Subjects in this arm will visit their physician once every 3 months and will receive usual care. In addition, in between clinic visits, subjects will measure their blood glucose (BG) readings at least once a day and share their BG readings with their CDE using Glooko's mobile application. Once a week, the CDE will review the subject's BG readings on Glooko's population tracker and reach out to the subjects if he/she experienced clinical incident(s). During the conversation, the CDE will either recommend medication or lifestyle modification to address the clinical incident. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Glooko's mobile application | Device | Standard of care and Remote monitoring |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in HbA1c from baseline | Change in HbA1c from baseline | 24 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Change in HbA1c from baseline | Change in HbA1c from baseline | 12 weeks |
| Percentage of patients achieving </=7% | Percentage of patients achieving \ |
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Inclusion Criteria:
Subject has voluntarily signed and dated an informed consent form, approved by an Institutional Review Board/Independent Ethics Committee, and provided Health Insurance Portability and Accountability Act (HIPAA) or other privacy authorization prior to any participation in study.
Subject has self-reported type 2 diabetes.
Subject has HbA1c ≥ 7.5% and ≤ 12.5% measured within 30 days of screening visit.
Subject is on a stable diabetes therapeutic regimen of two or more diabetic medications (e.g., metformin plus one other antihyperglycemic agent) and/or insulin therapy for at least 2 months before screening visit. Dose changes or adjustments made within 2 months is acceptable as long as the patient has been on the medication regimen for 2 months or longer.
Subject is ≥ 18 and ≤ 75 years of age.
Subject is a male or non-pregnant, non-lactating female, at least 6 weeks postpartum prior to screening visit. A urine pregnancy test is required for all female subjects unless she is not of childbearing potential, defined as postmenopausal for at least one year prior to screening visit or surgically sterile (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy).
If female is of childbearing potential, is practicing one of the following methods of birth control (and will continue through the duration of the study):
Subject is able to speak, read and write in English
Subject has a Glooko compatible smartphone/device with an active data plan or access to Wi-Fi and downloaded at least one mobile application on their phone on their own.
Subject has performed self-monitoring of blood glucose at least five (5) times within two (2) weeks prior to screening visit.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michael Greenfield, MD | Glooko | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| John Muir Physician Network Clinical Research Center | Concord | California | 94520 | United States | ||
| Sutter Health |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19940225 | Background | Huang ES, Basu A, O'Grady M, Capretta JC. Projecting the future diabetes population size and related costs for the U.S. Diabetes Care. 2009 Dec;32(12):2225-9. doi: 10.2337/dc09-0459. | |
| 19017771 | Background | Cowie CC, Rust KF, Ford ES, Eberhardt MS, Byrd-Holt DD, Li C, Williams DE, Gregg EW, Bainbridge KE, Saydah SH, Geiss LS. Full accounting of diabetes and pre-diabetes in the U.S. population in 1988-1994 and 2005-2006. Diabetes Care. 2009 Feb;32(2):287-94. doi: 10.2337/dc08-1296. Epub 2008 Nov 18. |
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| 12 and 24 weeks |
| Basal insulin dose(Change from baseline) | Basal insulin dose(Change from baseline) | 12 and 24 weeks |
| Bolus insulin dose(Change from baseline) | Bolus insulin dose(Change from baseline) | 12 and 24 weeks |
| Change in Total insulin dose(Change from baseline) | Change in Total insulin dose(Change from baseline) | 12 and 24 weeks |
| Weight(Change from baseline) | Weight(Change from baseline) | 12 and 24 weeks |
| Problem Areas in Diabetes score(Change from baseline) | Problem Areas in Diabetes score(Change from baseline) | 12 and 24 weeks |
| Rate of hypoglycemic events (blood glucose level <70mg/dL) | Rate of hypoglycemic events (blood glucose level <70mg/dL) | 12 and 24 weeks |
| Self-monitoring blood glucose frequency | Self-monitoring blood glucose frequency | 12 and 24 weeks |
| Mean blood glucose concentration(Change from baseline) | Mean blood glucose concentration(Change from baseline) | 12 and 24 weeks |
| Number of ER visits(Change from baseline) | Number of ER visits(Change from baseline) | 12 and 24 weeks |
| Number of hospitalizations(Change from baseline) | Number of hospitalizations(Change from baseline) | 12 and 24 weeks |
| Elk Grove |
| California |
| 95758 |
| United States |
| Scripps Whittier Diabetes Institute | San Diego | California | 92121 | United States |
| Billings Clinic | Billings | Montana | 59101 | United States |
| 21788632 | Background | Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-Baldini AL. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care. 2011 Sep;34(9):1934-42. doi: 10.2337/dc11-0366. Epub 2011 Jul 25. |
| 25537706 | Background | Standards of medical care in diabetes--2015: summary of revisions. Diabetes Care. 2015 Jan;38 Suppl:S4. doi: 10.2337/dc15-S003. No abstract available. |
| 18474888 | Background | Fisher L, Glasgow RE, Mullan JT, Skaff MM, Polonsky WH. Development of a brief diabetes distress screening instrument. Ann Fam Med. 2008 May-Jun;6(3):246-52. doi: 10.1370/afm.842. |
| 9135939 | Background | Welch GW, Jacobson AM, Polonsky WH. The Problem Areas in Diabetes Scale. An evaluation of its clinical utility. Diabetes Care. 1997 May;20(5):760-6. doi: 10.2337/diacare.20.5.760. |
| 9732337 | Background | UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ. 1998 Sep 12;317(7160):703-13. |
| 23468086 | Background | American Diabetes Association. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013 Apr;36(4):1033-46. doi: 10.2337/dc12-2625. Epub 2013 Mar 6. |
| D004700 | Endocrine System Diseases |