FAM (Follower, Action Plan, and Remote Monitoring) Intervention to Reduce Severe Hyperglycemia in Adults With Type 1 Diabetes Mellitus at Risk for Diabetic Ketoacidosis
Study Details
Study Description
Brief Summary
Diabetic ketoacidosis (DKA) results in significant morbidity and healthcare utilization and is the main contributor to loss of life expectancy in people with diabetes mellitus type 1 (T1DM) <50 years old. This suggests the need to develop interventions to reduce DKA events. Innovative features of newer continuous glucose monitoring devices offer opportunities for novel strategies to reduce DKA. Designating a family member, friend, or caregiver as a Follower was associated with reduction in HbA1C, increased time in range, and improvement in quality of life metrics in people with T1DM. However, the previously published studies are limited as they were either retrospective, survey-based, or do not overlap with our proposed cohort involving adults ages 18-65 with T1DM (prior prospective studies involved either pregnant women with T1DM or adults ≥60 years of age with T1DM). This study is a randomized controlled trial pilot study to evaluate the effectiveness of an intervention (FAM) using a Follower, Action Plan, and Remote Monitoring of glucose data to reduce severe hyperglycemia, a modifiable risk factor for DKA, in adults with T1DM at high risk for DKA. The intervention uses real-time glucose data sharing with a Follower (family member, friend, or caregiver) and personalized diabetes education provided to the dyad (person with T1DM and their chosen Follower). The study hypothesizes that the FAM intervention will reduce the percentage of time spent with glucose ≥250 mg/dL compared to standard care alone.
Condition or Disease | Intervention/Treatment | Phase |
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|
Early Phase 1 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Active Comparator: control group anticipate 20 CGM and 5 non-CGM user dyads in the control group |
Device: FAM intervention consisting of a Follower of glucose data, Action Plan, and Remote Monitoring of glucose data
using remote monitoring and real-time glucose data sharing with a Follower.
|
Experimental: intervention group anticipate 20 CGM and 5 non-CGM user dyads in the intervention group |
Other: standard of care
self reported HbA1C or GMI
|
Outcome Measures
Primary Outcome Measures
- percentage of time with severe hyperglycemia [90 days]
number of continuous glucose monitoring or blood glucose monitoring readings with glucose ≥250 mg/dL divided by the total number of readings
Eligibility Criteria
Criteria
Inclusion Criteria:
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People with T1DM for ≥1 year ages 18 - 65
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HbA1C ≥8.0% - 14.0%
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If the person with T1DM uses a CGM, the CGM must have the capability of real-time data sharing including glycemic alerts with a Follower (including but not limited to Dexcom G6 or G7 or FreeStyle Libre 2 or 3, or Medtronic Guardian Sensor 3)
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Follower (family member or friend ages 18 years and older) willing to participate in the study and "follow" glucose data and who was no self-reported cognitive impairment
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Ability of the dyad (participant and Follower) to communicate and provide consent in English
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CGM users: ≥50% personal CGM use and ≥50% Dexcom G6 Pro CGM use during the pre-intervention period (days -14 to -1)
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Non CGM users: ≥50% Dexcom G6 Pro CGM use and average ≥2 BGM readings/day during the pre-intervention period (days -14 to -1)
Exclusion Criteria:
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Prisoner
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Active treatment with a sodium-glucose cotransporter-2 inhibitor or planning to start a sodium-glucose cotransporter-2 inhibitor in the next 6 months
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Active malignancy with the exception of non-melanoma skin cancer
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Hospice
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Skin conditions that inhibit wearing a CGM sensor and known severe allergy to adhesives
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- University of Minnesota
Investigators
- Principal Investigator: Jacob Kohlenberg, MD, University of Minnesota
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- MED-2023-32321