Insulin Degludec Titration Using Mobile Insulin Dosing System
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Type 2 Diabetes Mellitus
- Sponsor
- Glooko
- Enrollment
- 240
- Locations
- 1
- Primary Endpoint
- Change in HbA1c
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
This is an open label randomized, controlled, parallel intervention study. Group 1 will receive usual care for insulin degludec titration using the STEP WISE degludec titration algorithm Group 2 will receive Glooko mobile insulin dosing system, using the STEP WISE degludec titration algorithm.An estimated n= 240 subjects with type 2 diabetes will be enrolled in order to obtain approximately 200 evaluable subjects who will complete the 16 week study.
Detailed Description
This is a prospective randomized controlled two-group parallel design intervention trial. The primary endpoint, change from baseline to week 16 in HbA1c is planned to be tested for superiority of the Glooko Mobile Insulin Dosing System versus standard of care for insulin degludec titration - both with treatment of Tresiba® U-200 FlexTouch®. An estimated n= 240 subjects with type 2 diabetes will be enrolled in order to obtain approximately 200 evaluable subjects who will complete the 16 week study. The subjects, will be already on long-acting insulin or insulin naïve subjects and will be started on long-acting insulin degludec (Tresiba® U-200 FlexTouch®). The subjects will be randomized into one of the two groups: Group 1 will receive standard of care using the STEP WISE degludec titration algorithm for long acting insulin titration. Group 2 will receive standard of care along with treatment facilitated by Glooko mobile insulin dosing system, using the STEP WISE degludec titration algorithm. Major study assessment will be conducted at Baseline (Screening \& Visit 1), at a second Visit (Visit 2) after 12 weeks or 3 months and, after 16 weeks or 4 months, a final set of labs, meter download, and subject surveys will be administered (Exit Labs and Meter Download), in addition, any interactions and subsequent care plan changes completed by the HCP during Unscheduled HCP Interactions will be documented. Baseline, Visit 2 and the final screen/Exit Labs visit will include: blood draw, body weight, and questionnaires.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Subject has the ability to sign an informed consent form. Prior to randomization patients has signed the informed consent, approved by an Institutional Review Board/Independent Ethics Committee, and provided Health Insurance Portability and Accountability Act authorization (HIPAA) or other privacy authorization prior to any participation in study.
- •Subject 18 and older who has documented type 2 diabetes diagnosis at least 3 months before the screening
- •Subject has HbA1c \>/= 7.5% and \</=12.5 % measured using a NGSP certified method
- •Subject is initiating basal insulin therapy with insulin degludec or switching to insulin degludec from any basal insulin. The subject may also be on concomitant anti-hyperglycemic agents, including oral hypoglycemic (OAs), non-insulin injectables (e.g. GLP-1) which has been at a stable dose for approx. 3 months, or as determined by the Investigator
- •Subject is a male or non-pregnant, non-lactating female, at least 6 weeks postpartum prior to screening visit. A urine pregnancy test is required for all female subjects unless she is not of childbearing potential, defined as postmenopausal for at least one year prior to screening visit or surgically sterile (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy)
- •If female is of childbearing potential, is practicing one of the following methods of birth control (and will continue through the duration of the study):
- •Condoms, sponge, diaphragm, or intrauterine device;
- •Oral or parenteral contraceptives for 3 months prior to screening visit;
- •Vasectomized partner;
- •Total abstinence from sexual intercourse
Exclusion Criteria
- •Subject has had a severe hypoglycemia episode in the last 90 days
- •Subject has type 1 diabetes
- •Subject does not have access to a Glooko compatible smart device (smartphone or tablet)
- •Subject must not be using Glooko or any other electronic application for insulin titration
- •Subject is unable to read and understand English
- •Subject is using short acting or pre-mixed insulin for more than 10 days in the last 3 months
- •Subject is going to initiate short acting insulin prior to the study start
- •Pregnant or breastfeeding women, or the intention of becoming pregnant or not using adequate contraceptive measures
- •Visual impairment resulting in inability to see application.
- •Use of systemic steroids for one week or more in the last 90 days from screening
Outcomes
Primary Outcomes
Change in HbA1c
Time Frame: Week 16
Change in HbA1c at 16 weeks from baseline for all subjects that adhere to treatment.
Secondary Outcomes
- Change from baseline in HbA1c(Week 12)
- Proportion of synced BG readings < 54 mg/dL(Week 16)
- Proportion of synced BG readings < 70 mg/dL(Week 16)
- Proportion of synced BG readings >250 mg/dL(Week 16)
- Proportion of synced BG readings in target range (80-180mg/dL)(Week 16)
- Change in avg BG between first month and last month of study period(Baseline and Week 16)
- Number of visits to Health Care Professional (HCP) outside of the study visits during study period(Week 16)
- Number of telephone calls to HCP for insulin titration during study period(Week 16)
- Total insulin degludec dose(Week 12 and Week 16)
- Change from baseline in Hypoglycemia fear survey- II response(Week 16)
- Change from baseline in Diabetes Distress Scale (DDS) response(week 16)
- Change from baseline in Diabetes treatment satisfaction questionnaire (DTSQ) response(week 16)
- Number of days with at least one BG test(week 16)
- Change from baseline in Body weight(week 16)
- Number of Adverse events during study period(week 16)
- Number of Serious adverse events during study period(week 16)
- Correlation of number of dose adjustment completions to change in HbA1c(week 16)
- Number of subjects that have attained an avg fasting blood glucose target range for at least three of last five titration cycles of study period during trial(week 16)
- Number of dose adjustments to first reach avg FBG target range during study period(week 16)
- Total insulin degludec dose for subjects who reached avg FBG target at last dose checkup.(week 16)
- Frequency of FBG tests during study period(week 16)
- Proportion of accepted MIDS recommended insulin degludec doses(week 16)