Type 2 Diabetes Mellitus Clinical Trial
Official title:
Protocol: Comparing the Effect of Using an Internet-Based Glucose Monitoring System Versus the Continuous Glucose Monitoring System on HbA1c Levels in Type 2 DM
Management of type 2 diabetes is an ongoing challenge for patients and their doctors. In order to prevent short and long term complications, patients need to monitor and control their blood sugar levels. In addition, they may need to have an ongoing communication with their doctor in order to modify treatment. In this study the investigators wish to compare two systems of monitoring and communication of blood sugar levels. The first is the use of continuous glucose monitoring system and the second is the use of an Internet-based glucose monitoring system. The investigators want to compare their effect and/or benefits.
Purpose: To compare the benefits of the Internet-based glucose monitoring system with the
Continuous Glucose monitoring system in patients with type 2 diabetes mellitus.
Hypothesis:The investigators propose that the benefits from the Internet-based glucose
monitoring system (IBGMS) will be comparable to the benefits of the Continuous Glucose
monitoring system (CGMS) for patients with type 2 DM.
Justification: Half of the subject will be on the standard treatment, which will involve
glucose monitoring by testing blood glucose 3 times daily, performing a laboratory test of
blood hemoglobin every three months, and visiting the doctor every three months for standard
care. They will also use the internet system to report their glucose readings,which will
allow the health care professions to view the results and provide feedback. The other half
will use the continuous glucose monitoring system, which will involve a minimum of testing
blood glucose at least 2 times a day to calibrate the sensor, performing laboratory test of
blood hemoglobin every three months, and visiting the doctor every three months for standard
care. All of the subjects will be under standard care;
Research Method: Type 2 diabetes patients who satisfy the inclusion criteria will be
recruited from St. Paul's Diabetes Teaching and Training Centre. They will be randomized
into 2 groups (IBGMS and CGMS). There is an equal chance, a 50/50 chance, of being placed in
either group.
The IBGMS group will receive standard care and will be asked to perform self-blood glucose
monitoring 3 times daily for 6 months. The IBGMS group will also be asked to report their
blood glucose reading every 2 weeks through an Internet based glucose monitoring system. The
IBGMS group will make visits to the endocrinologist every 3 months with A1c and serum
creatinine measurements at 3-month intervals for 6 months.
The CGMS group will also receive standard care and will be asked to perform self-blood
glucose monitoring at least 2 times a day for 6 months to calibrate the sensor.The CGMS
group will also be using the internet system to generate a report of their blood glucose
readings and can be used at the patient's own preference. Their readings will also be sent
to the endocrinologist for feedback every 2 weeks. The CGMS group will make visits to the
endocrinologist every 3 months with A1c and serum creatinine measurements at 3-month
intervals for 6 months. The laboratory measurements of both groups will be recorded and used
for data analysis.
Statistical Analysis: The primary endpoint is the A1c level or the change in A1c level. The
secondary endpoints include severe hypoglycemia defined as requiring external aid, hospital
admissions for any CVD related intervention, and adverse events such as unplanned
hospitalizations for any cause that last more than 24 hours. Patients who do not have the
required number of SMBG (Self monitored blood glucose) tests performed or patients requiring
new laser therapy will be asked to discontinue the study.
For each group, A1C levels before the start of study will be compared to A1C levels 3 and 6
months after the start of the study. Paired t-tests and random effects models (longitudinal
analyses) will examine differences in A1C values before and after the study duration.
Unpaired, independent t-tests will be done to examine the difference in A1C values between
the two groups before and after the interventions. The planned sample size is 50.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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