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Continuous glucose monitoring (CGM) and insulin pump, a new medical device, have been proved and highly recommended in the treatment of type 1 diabetes patients worldwide, and related technology development and market are growing rapidly.
In order to maximize the medical and socioeconomic effects of the latest blood glucose devices including CGM and insulin pump, structured education is necessary. In this study, we will develop patient-oriented structured education for patients with type 1 diabetes mellitus when applying CGM, and we will assess the efficacy of this education protocol for patients with type 1 diabetes using CGM.
In 50 patients with type 1 diabetes with over 7% of glycated hemoglobin, whose blood glucose level is not well controlled, and who are undergoing multiple daily insulin injection therapy or insulin pump therapy, continuous glucose monitoring (CGM) is applied to obtain basal continuous glucose levels for 1 week (window period of 2 week).
These 50 patients are 1:1 randomly assigned to 2 groups including control group and intervention group. Control group (n=25) applied CGM without structured education and after 3 months of applying CGM, continuous glucose data for 2 consecutive weeks and HbA1c level, and other glycometabolic parameters are collected. As a sequential extension clinical trial, those 25 patients in control group are provided structured education, followed by applying CGM for 3 months. Continuous glucose levels for 2 consecutive weeks and HbA1c level, and other glycometabolic parameters are collected.
In Intervention group (n=25), structured education program is provided for each patient from the time of enrollment, followed by applying CGM for 3 months. Continuous glucose levels for 2 consecutive weeks and HbA1c level and other blood tests are performed after the 3 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | Placebo Comparator | Without structured education when applying CGM for 3months, and as a sequential extension clinical trial, after 3 months, structured education is provided, followed by CGM apply |
|
| Intervention | Active Comparator | provide structured education when applying CGM for 3 months |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Structured Education for new glucose management devices | Behavioral | Individualized professional education based on new glucose management devices in patients with type 1 diabetes mellitus |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of time in target range 70-180 mg/dL | Percentage of time in target range 70-180 mg/dL by continuous glucose monitoring system | 3months (control and intervention groups) and 6months (for extension study in control group) |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of time in level 2 hypoglycemia (<54mg/dL) | Percentage of time in level 2 hypoglycemia (<54mg/dL) by continuous glucose monitoring system | 3months (control and intervention groups) and 6months (for extension study in control group) |
| Percentage of time in level 1 hypoglycemia (<70-54mg/dL) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jae Hyeon Kim, MD PhD | Contact | 82-2-3410-3439 | jaehyeonmd.kim@samsung.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Samsung Medical Center | Recruiting | Seoul | 135-710 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35065101 | Derived | Yoo JH, Kim G, Lee HJ, Sim KH, Jin SM, Kim JH. Effect of structured individualized education on continuous glucose monitoring use in poorly controlled patients with type 1 diabetes: A randomized controlled trial. Diabetes Res Clin Pract. 2022 Feb;184:109209. doi: 10.1016/j.diabres.2022.109209. Epub 2022 Jan 19. |
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| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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CGM apply followed by structured education of CGM
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Percentage of time in level 1 hypoglycemia (<70-54mg/dL) by continuous glucose monitoring system |
| 3months (control and intervention groups) and 6months (for extension study in control group) |
| Percentage of time in level 1 hyperglycemia (>180mg/dL) | Percentage of time in level 1 hyperglycemia (>180mg/dL) by continuous glucose monitoring system | 3months (control and intervention groups) and 6months (for extension study in control group) |
| Percentage of time in level 2 hyperglycemia (>250mg/dL) | Percentage of time in level 2 hyperglycemia (>250mg/dL) by continuous glucose monitoring system | 3months (control and intervention groups) and 6months (for extension study in control group) |
| Glycemic variability, reported as coefficient of variance (CV) | Glycemic variability, reported as coefficient of variance (CV) by continuous glucose monitoring system | 3months (control and intervention groups) and 6months (for extension study in control group) |
| Glycemic variability, reported as standard deviation (SD) | Glycemic variability, reported as standard deviation (SD) by continuous glucose monitoring system | 3months (control and intervention groups) and 6months (for extension study in control group) |
| Mean glucose by continuous glucose monitoring system | Mean glucose by continuous glucose monitoring system | 3months (control and intervention groups) and 6months (for extension study in control group) |
| HbA1C | HbA1C | 3months (control and intervention groups) and 6months (for extension study in control group) |
| glycated albumin | glycated albumin | 3months (control and intervention groups) and 6months (for extension study in control group) |
| Personalized education time for each patient | Personalized education time for each patient | baseline (intervention group) and 3months (for extension study in control group) |
| Frequency of hypoglycemia | Frequency of hypoglycemia | 3months (control and intervention groups) and 6months (for extension study in control group) |
| Adverse event | Adverse event occurred | 3months (control and intervention groups) and 6months (for extension study in control group) |
| Percentage of time in target range 70-180 mg/dL | Percentage of time in target range 70-180 mg/dL by continuous glucose monitoring system | 6months (for extension study in control group) |
| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |