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Trial registered on ANZCTR
Registration number
ACTRN12611001043921
Ethics application status
Not yet submitted
Date submitted
27/09/2011
Date registered
5/10/2011
Date last updated
5/10/2011
Type of registration
Prospectively registered
Titles & IDs
Public title
Evaluation of a tool to predict technology usage in youth with type 1 diabetes.
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Scientific title
Evaluation of a tool to predict diabetes' technology usage in children and adolescents using, or about to commence, continuous subcutaneous insulin infusion (CSII) for type 1 diabetes mellitus.
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Secondary ID [1]
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 1 diabetes mellitus
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Condition category
Condition code
Metabolic and Endocrine
279048
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0
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Diabetes
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Assessment of the ability of our questionnaire to predict users who will demonstrate recommended usage of their diabetes technology. This questionnaire is a composite of the most-weighted items from previously validated questionnaires widely used in the diabetes literature. Each of these questionnaires was designed to assess various individual characteristics e.g. family conflict/self-efficacy/personality factors that we have identified as having a robust reproducible impact on HbA1c or self-care. The questionnaire is designed to be completed by participants within 20-30 minutes. To show that this questionnaire is applicable to different kinds of diabetes technology, we will assess its ability to predict recommended usage of CGM after 3 months usage, and usage of CSII at 6 months after commencing. Usage of these technologies at these timepoints has been shown to be predictive of medium to long term usage.
50 Participants already using a CGM-compatible pump will be recruited to the CGM arm, where they will be provided with and shown how to use CGM for 3 months, after completing the questionnaire. Usage of >70% will be designated appropriate usage of CGM as this is the usage demonstrated to result in a clinically significant benefit of reduction in HbA1c of 0.5%. This can be downloaded from the device directly. After three months, the device will be returned and the participant's involvement in the study complete.
50 patients about to begin using insulin pump therapy (CSII) will also be recruited and asked to complete the questionnaire 6 weeks prior to starting the CSII 'pumpstart' program at our institution. Usage will be assessed from a pump download after 6 months and recommended usage will be designated as having >5 self-monitored blood glucose readings per day entered into the pump. This download will be assessed at a participant's routine outpatient appointment, which are scheduled every 3 months. After completing the questionnaire, participants in the CSII arm need not have any further contact with the study team.
These arms are independent of each other, but both are necessary to show that the questionnaire can apply to various types of advanced diabetes technology. The sensitivity and specificity of our questionnaire to predict usage will be our primary outcome.
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Intervention code [1]
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Not applicable
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Comparator / control treatment
Nil
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Sensitivity and specificity of the questionnaire (Qp) to predict low usage of technology (2 types being assessed in two arms - insulin pump and continuous glucose monitoring)
Low usage in the CGM arm will be usage of <70% as downloaded from the device. Low usage in the CSII arm will be designated as <5 blood glucose levels entered into the pump per day.
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Assessment method [1]
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Timepoint [1]
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3 months for continuous glucose monitoring (CGM) arm.
6 months for continuous subcutaneous insulin infusion (CSII) arm.
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Secondary outcome [1]
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The impact of usage on HbA1c
-Measurement of HbA1c at three months for the CGM arm and at three and six months for CSII arm
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Assessment method [1]
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Timepoint [1]
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3 months for CGM arm, 6 months for CSII arm
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Secondary outcome [2]
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The validity of a 5 minute doctor questionnaire (Qd) in predicting technology usage by participants
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Assessment method [2]
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Timepoint [2]
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3 months for CGM arm, 6 months for CSII arm
-We will analyse the correlation of Qd with Qp and with HbA1c outcomes
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Secondary outcome [3]
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Usage impact on variability of blood glucose (CGM arm) and percentage of blood glucose levels (BGLs) within target
-correlation of usage with blood glucose variability, as measured by the standard deviation of BGLs downloaded from the CGM
-correlation of usage with percentage of BGLs within target, information which is downloadable from both CGM and CSII
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Assessment method [3]
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Timepoint [3]
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3 months for CGM arm, 6 months for CSII arm
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Secondary outcome [4]
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Assessment of other measures of usage
Other usage : CGM
total number of sensors used
Other usage : CSII
number of boluses per day - [recommended no. = min. 4 per day]
recommended number of line changes being performed - [recommended = every 3 days]
frequency of contact with diabetes nurse educators
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Assessment method [4]
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Timepoint [4]
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3 months for CGM arm, 6 months for CSII arm
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Secondary outcome [5]
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Impact of usage on auxology
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Assessment method [5]
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Timepoint [5]
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-We will analyse height, weight and BMI at study commencement and at 3 months (and six months in CSII group)
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Eligibility
Key inclusion criteria
Inclusion Criteria
Patients will be considered eligible if they are :
-Over the age of 8yrs
-Have a diagnosis of Type 1 Diabetes Mellitus
-Have been using a Medtronic insulin pump compatible with the MiniLink CGM device for >6mths (CGM arm of study)
-Home computer with e-mail access
-English language comprehension
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Minimum age
8
Years
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Maximum age
20
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion Criteria
-Previous self-initiated use of a continuous glucose monitoring system (this does not exclude clinician initiated previous short term use of one sensor to elucidate glycaemic patterns)
-Concurrent dermatological disorder e.g. keloid propensity or previous documented hypersensitivity to medical adhesives
-Impaired vision such that the user would be unable to read the CGM data
-Other medical condition or use of a medication that in the judgement of the investigator could affect wearing of a CGM sensor on a daily basis
-Pregnancy
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Study design
Purpose
Psychosocial
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/12/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Medtronic Australasia
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Address [1]
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Medtronic Australasia Pty Ltd
97 Waterloo Road
North Ryde NSW 2113
PO Box 945
North Ryde NSW 1670
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
The Royal Childrens Hospital
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Address
50 Flemington Road,
Parkville,
VIC 3052
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Country
Australia
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Secondary sponsor category [1]
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Charities/Societies/Foundations
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Name [1]
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Murdoch Children's Research Institute
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Address [1]
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50 Flemington Road,
Parkville,
VIC 3052
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Country [1]
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Australia
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
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HREC, The Royal Children's Hospital
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Ethics committee address [1]
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50 Flemington Road, Parkville, VIC 3052,
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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30/09/2011
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Approval date [1]
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Ethics approval number [1]
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Summary
Brief summary
There are currently very few criteria to guide as to which youth would benefit most from using more advanced diabetes technologies, for example continuous subcutaneous insulin infusion (CSII). The lack of robust selection criteria means that intermittently, patients who may not benefit are commenced on CSII and subsequently encounter disappointment and regimen disruption if they elect to switch back to injected insulin. The ability to reliably predict lower self-care, as extrapolates to technology usage, would be helpful when advising an individual regarding their regimen. The purpose of this study is to see if this questionnaire can accurately predict which individuals will be most likely to use technology so that they gain the most benefit from it for their diabetes control. We wish to explore its ability to predict use of the two most commonly used technologies presently - continuous glucose monitoring (CGM) and CSII. Studies have shown that individuals get a clinically significant improvement in their HbA1c from usage of CGM when they use it 70% of the time, which equates to 5 days in any week. From CSII, most clinical benefit is gained when users enter 5 or more blood glucose measurements in their pump per day. Our hypothesis is that our questionnaire will predict individuals who will/will not display this usage of their device. Usage of CGM will be assessed after three months, as usage at this point has previously been shown in studies to be predictive of medium to long term usage. Likewise, usage of CSII at six months after commencement has been shown to be indicative of medium term usage.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Orla Neylon
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Address
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Dept. of Endocrinology & Diabetes,
The Royal Children's Hospital,
50 Flemington Road,
Parkville,
VIC 3052
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Country
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Australia
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Phone
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+61 3 9345 5951
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Fax
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+61 3 9347 7763
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Orla Neylon
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Address
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Dept. of Endocrinology & Diabetes,
The Royal Children's Hospital,
50 Flemington Road,
Parkville,
VIC 3052
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Country
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Australia
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Phone
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+61 3 9345 5951
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Fax
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+61 3 9347 7763
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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