Intensive Versus Standard One Year Monitoring on Glycaemic Control After Initiating CSII in Children With DT1. DEEP Study

Diabetes Mellitus, Type 1 Clinical Trial

— DEEP  

Official title:

Impact of an Intensive Monitoring on Glycaemic Control One Year After Initiating Continuous Subcutaneous Insulin Infusion in Children With Type 1 Diabetes.

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04100070
• Other study ID #: 2018-A02932-53
• Status: Recruiting
• Phase: N/A
• Start date: September 2, 2019
• Est. completion date: December 31, 2021

Study information

• Verified date: December 2020
• Source: ISIS Diabete Service
• Contact: Arnaud Jerome, PhD
• Phone: 00 (33) 6 19 85 67 07
• Email: arnaud.jerome[@]isisdiabete.fr
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

More than half of type 1 diabetes (DT1) children are under CSII (Continuous Subcutaneous Insulin Infusion).

Several studies showed that despite a patients' follow-up mostly by hospital-based paediatricians, there are still some concerns on long-term glycaemic control with inconstant results on glycaemic control either due to CSII adherence or nutrition management issues.

Consequently, this real life study aims to compare two monitoring methods (standard versus intensive) in children initiating a CSII treatment and assess the impact on glycaemic control after one year.

Description:

As CSII becomes more and more the gold standard therapy in children with type 1 diabetes, there have been some questions regarding the long-term effect of these treatments with some concerns on the inconstant results on glycaemic control either due to CSII adherence or nutrition management issues.

The DCCT (Diabetes Control and Complications Trial) study has already shown in diabetic adults that intensification of treatment and follow-up could result in significative improvement of glycaemic control.

This study aims to test this hypothesis of significant improvement after one year following CSII initiation on glycaemic control.

Two parallel arms will be compared in real life conditions; one with standard recommendations-based follow-up by both diabetologists/pediatricians and service provider and the other with intensive follow-up with higher frequency of provider's nurses visits and personalization of patient status transferred to the physician for each diabetologists/pediatricians visit.

Thus, investigators could determine after one year if the glycaemic control is better with one or the other of these follow-up procedures.

Glycaemic control will be assessed both by the evolution of HbA1c during the study period and its last level at the end of the study. Its evaluation will be completed by counting of all symptomatic hypoglycemia occurence during the study.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 320
• Est. completion date: December 31, 2021
• Est. primary completion date: October 31, 2021
• Accepts healthy volunteers: No
• Gender: All
• Age group: 12 Months to 17 Years

Eligibility

Inclusion Criteria:

• Children (<18 yo) with not controlled type 1 diabetes seen by diabetologists/paediatricians immediately following the initiation of CSII.

• Children for whom it is the first initiation of CSII.

• Children (or their parents if necessary) having read the information note and having dated and signed the informed consent form.

Exclusion Criteria:

• Children with a history of diabetes less than 12 months.

• Children with HbA1c values below 7.5 or above 10 before CSII initiation.

• Children treated by CSII for more than 3 months.

Related Conditions & MeSH terms

• Diabetes Mellitus, Type 1
• Pediatric ALL

Intervention

Behavioral:
• Monitoring of the patients
Follow-up of the patients during the 12 months study periods including : visits with the diabetologist/pediatrician contacts with the service provider (nurses' visits) (more in intensive group) personalized monitoring of glycemic data transferred to the diabetologist/pediatrician for each visit (only in intensive group)

Locations

Country	Name	City	State
France	Isis Diabete Service	Gennevilliers	Ile De France

Sponsors (1)

Lead Sponsor	Collaborator
ISIS Diabete Service

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Impact on glycaemic control one year after CSII initiation	Evolution of HbA1c measurement between last measure before CSII initiation and 12 months after.	HbA1c values at inclusion and last known measurement at the 12 months last visit
Primary	Impact on glycaemic control all along the study	Unplanned hospitalization rate during the study Severe hypoglycemia during the study period	Assessment and counting of all unplanned hospitalizations during the 12 months period
Secondary	Impact on glycaemic control upon age classes	sub-groups based one age (<7 years old [yo], 7-12 yo, 13-17 yo)	HbA1c values at inclusion and last known measurement at the 12 months last visit