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Continuous Glucose Monitoring in Dialysis Patients to Overcome Dysglycemia Trial

Not Applicable
Recruiting
Conditions
Diabete Mellitus
Continuous Glucose Monitoring
Hemodialysis
Interventions
Device: Continuous glucose monitoring (CGM)
Device: Usual care (Self-monitored blood glucose)
Registration Number
NCT05509881
Lead Sponsor
University of California, Irvine
Brief Summary

This randomized controlled trial will investigate whether use of continuous glucose monitoring (CGM) vs. usual care with self-monitored blood glucose 1) enhances glycemic control, 2) reduces hypoglycemia risk, and 3) improves quality of life, diabetes distress, and fear of hypoglycemia in hemodialysis patients with diabetes mellitus.

Detailed Description

This is a parallel, two-arm randomized controlled trial comparing real-time CGM using Dexcom devices vs. usual care (self-monitored blood glucose 4-times/day) among 122 in-center hemodialysis patients with diabetes mellitus over a 12-week period. Our primary objective will be to determine the effects of CGM vs. usual care on glycemic control, defined by percent (%) of time in target glucose range (70-180 mg/dl). Our main and exploratory secondary objectives will be to determine the effects of CGM on CGM-indices of hypoglycemia, blood-based glycemic markers (HbA1c, glycated albumin, fructosamine), and patient-reported outcomes (health-related quality of life, diabetes distress, hypoglycemia fear). We will also evaluate feasibility endpoints by measuring CGM compliance during the intervention period and success/ease of implementing CGM training sessions among patients.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
122
Inclusion Criteria
  • Ability to provide written informed consent
  • Age ≥18 years old
  • End-stage kidney disease status receiving in-center hemodialysis ≥4 weeks
  • Type 1 or type 2 diabetes
  • Actively performing self-monitored blood glucose (SMBG) testing for ≥4 weeks
  • ≥70% compliance wearing continuous glucose monitoring (CGM) device during the pre-trial period
Exclusion Criteria
  • Inability to provide informed consent or comply with the study protocol
  • Limited visual acuity
  • Inability to wear CGM device
  • Prior use of CGM
  • Active pregnancy or planning a pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Continuous glucose monitoring (CGM) armContinuous glucose monitoring (CGM)During the intervention period, patients in the CGM arm will undergo continuous real-time "unblinded" CGM using Dexcom CGM devices.
Usual care armUsual care (Self-monitored blood glucose)During the intervention period, patients in the usual care arm will conduct self-monitored blood glucose (SMBG) at least 4 times/day. At Weeks 6 and 12 of the intervention period, usual care arm patients will also undergo 10-days of blinded CGM data collection.
Primary Outcome Measures
NameTimeMethod
Percent (%) of time in target glucose range (70-180 mg/dl)12 weeks

Ascertained by continous glucose monitoring

Secondary Outcome Measures
NameTimeMethod
Short Form 36 Survey Physical Component Summary Score12 weeks

Ascertained by Short Form 36 Survey; Minimum-Maximum range is 0-100; Higher scores indicate better health-related quality of life

Hypoglycemia Fear12 weeks

Ascertained by Hypoglycemia Fear Survey II

Percent (%) of time spent in hypoglycemia (<70 mg/dl)12 weeks

Ascertained by continous glucose monitoring

Glycemic variability12 weeks

Ascertained by continous glucose monitoring

Percent (%) of time spent in relative hypoglycemia (<100 mg/dl)12 weeks

Ascertained by continous glucose monitoring

Hemoglobin A1c level12 weeks

Ascertained by blood test

Glycated albumin level12 weeks

Ascertained by blood test

Fructosamine level12 weeks

Ascertained by blood test

Diabetes Distress Scale Survey Score12 weeks

Ascertained by Diabetes Distress Scale Survey; Minimum-Maximum range is 1-6; Higher scores indicate higher states of distress

Trial Locations

Locations (1)

University of California, Irvine

🇺🇸

Orange, California, United States

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