Diabetes Mellitus, Insulin-Dependent Clinical Trial
Official title:
DirecNet Randomized Clinical Trial to Assess the Effectiveness of the GlucoWatch Biographer in the Management of Type 1 Diabetes in Children
This study will evaluate the safety and effectiveness of a continuous glucose monitor in children with Type 1 diabetes mellitus (T1DM).
Intensive control of blood glucose levels has been shown to substantially prevent or delay
complications of T1DM in adolescents and adults. The major limitation to implementation of
intensive glycemic control is hypoglycemia. Younger children may be at increased risk for
hypoglycemia, and the risk/benefit ratio of intensive glycemic control may be less favorable
in this population. The Diabetes Research in Children Network (DirecNet) was established to
evaluate the feasibility and effectiveness of intensive glycemic control in children with
T1DM.
This study is designed to evaluate glycemic control, hypoglycemia, and quality of life when
using a GlucoWatch G2TM Biographer (GW2B) versus standard care. Children in the study will
use the GW2B in their home environment in order to assess if the GW2B can help to safely
lower blood sugar levels (as measured by the glycosylated hemoglobin test), to learn how
using the GW2B affects the daily lives of children with diabetes, and to find out if there
are any drawbacks to using the GlucoWatch.
As part of the study, participants in the intervention group will also use a second glucose
monitoring device called the Continuous Glucose Monitoring System (CGMS). The CGMS will be
inserted at baseline and at Months 3 and 6; it will be worn for three days after each visit.
The CGMS will be used to measure changes in biochemical hypoglycemia.
Participants at five participating centers will include a total of 200 children and
adolescents with type 1 diabetes. Of the 200 children, 100 will be randomized to wear the
GW2B and 100 will be randomized to usual care without GW2B. Each patient will be provided
with a personal computer for weekly downloading of data and completion of questionnaires
regarding hypoglycemia. Phone contacts will be made with the patients after Weeks 1, 2, and
4, then every 4 weeks to review their diabetes management. At Months 3, 6, 9 and 12, a
follow-up visit will be performed to measure HbA1c. The CGMS sensor will be inserted to
assess hypoglycemia at baseline and Months 3 and 6. At the 6-month follow-up visit,
psychosocial questionnaires will also be administered.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Treatment
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