Diabetes Mellitus, Type 2 Clinical Trial
Official title:
Self-monitoring of Blood Glucose in Insulin-treated Patients With Type 2 Diabetes: a 9-month Randomised Controlled Trial
Primary Objective:
The objective of the study is to investigate the effect of a specific frequency of
Self-monitoring of blood glucose (SMBG) on glycemic control and quality of life in patients
with type 2 diabetes and who are in stable good glycemic control and using 1 insulin
injection daily.
The research question is:
Does a less intensive frequency of SMBG in insulin-treated patients with type 2 diabetes,
who are in stable good glycemic control, using 1 insulin injection daily, lead to a
clinically relevant increase of HbA1c (an increase of 0.5%) and what is the effect on
quality of life?
Secondary objectives:
The secondary objectives is to investigate the effect of a specific frequency of SMBG on the
number of hypo and hyper glycaemia, number of extra diabetes-related contacts with the
health care provider, and the diabetes medication.
SUMMARY
Rationale:
Self-monitoring of blood glucose (SMBG) is an important tool in diabetes care to achieve and
maintain good glycemic control. But how often 'should' the patient measure the capillary
glucose concentration? There is no general agreement between professionals, and there is no
evidence for a specific frequency and timing.
Objective:
The objective of the study is to investigate the effect of a specific frequency of SMBG on
glycemic control and quality of life in patients with type 2 diabetes and who are in stable
good glycemic control and using 1 insulin injection daily.
Study design:
An open Randomised Controlled Trial.
Study population:
Patients with insulin-treated diabetes type 2, > 18 years of age, using 1 insulin injection
daily, performing SMBG > 1 year, HbA1c ≤ 58 mmol/mol (< 7.5%) in the preceding 12 months,
sufficient knowledge of the Dutch language, no hypo-unawareness, no serious co-morbidity
Intervention:
Patients are instructed to measure their blood glucose concentrations 4 times per day
(pre-prandial and before bedtime) one day weekly in group A, one day per two weeks in group
B and one day monthly in group C. Patients are asked to keep a diary with the readings and
the probably extra measurements, including the reasons.
Main study parameters/endpoints:
The main study parameters are glycemic control and quality of life. A difference of > 0.5%
(> 5.5 mmol/mol) in HbA1c is considered to be relevant. Quality of life is measured with 3
validated questionnaires.
Nature and extent of the burden and risks associated with participation, benefit and group
relatedness:
Patients in this study are used to perform SMBG. During the study, they are asked to monitor
their glucose concentrations in a controlled, specific frequency (different kind of usual
care are compared). And they are asked to fill in 3 questionnaires in the beginning and at
the end of the study. Extra HbA1c measurements can be necessary. No side effects are
expected, but safety is incorporated through HbA1c measurements every 3 months and every 3
months the diary will be discussed in the scheduled visits. Furthermore, extra measurements
are allowed when necessary.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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