MedPath

Glycemic Optimization On Discharge From the Emergency Room

Not Applicable
Completed
Conditions
Diabetes Mellitus
Interventions
Device: Continuous Glucose Monitoring
Other: Care Coordination
Registration Number
NCT05197829
Lead Sponsor
Mark O'Connor
Brief Summary

Continuous glucose monitors can help people with diabetes avoid blood sugar levels that are either dangerously high or low. This study evaluates whether continuous glucose monitoring after discharge from the emergency room can help people with type 1 or type 2 diabetes avoid repeat emergency room visits, achieve improved blood sugar control, and feel less distressed about managing their diabetes.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Seen in the Emergency Department for hypo- or hyperglycemia
  • Either an existing diabetes center patient or a new referral
  • Type 1 or type 2 diabetes
  • Able to provide informed consent
  • Fluent in English or Spanish
Exclusion Criteria
  • Current CGM use
  • Need for hospital admission
  • Upcoming CT or MRI within 2 weeks
  • Pregnancy
  • Altered mental status
  • Not appropriate for diabetes center follow up
  • Prisoners

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Continuous Glucose MonitoringContinuous Glucose Monitoring-
Continuous Glucose MonitoringCare Coordination-
Care CoordinationCare Coordination-
Primary Outcome Measures
NameTimeMethod
Change in Diabetes DistressChange from emergency room visit to first outpatient follow-up visit (2 or 3 weeks)

Diabetes-related distress will be measured via the 17-question Diabetes Distress Scale (DDS). A higher score indicates more diabetes-related distress. The scale ranges from 1 (low distress) to 6 (high distress).

Outpatient Clinic Attendance RateFollow-up visits will generally occur within 2 or 3 weeks

This outcome will measure whether or not each participant attends a subspecialty follow-up appointment as recommended by the emergency room care team.

Change in the Problem Areas in Diabetes ScoreChange from emergency room visit to first outpatient follow-up visit (2 or 3 weeks)

Each participant will fill out the five-question Problem Areas In Diabetes (PAID5) scale. A higher score indicates worse quality of life. Scores range from 0 (good quality of life) to 20 (poor quality of life).

Secondary Outcome Measures
NameTimeMethod
Time In RangeUp to 14 days after the initial emergency visit

For participants in the continuous glucose monitoring arm, we will measure the percentage of time spent with a blood sugar level between 70 and 180 mg/dl.

Percentage Time CGM ActiveUp to 14 days after the initial emergency visit

For participants in the continuous glucose monitoring arm, we will measure the amount of time the sensor was worn.

Number of Sensor Checks Per DayUp to 14 days after the initial emergency visit

For participants in the continuous glucose monitoring arm, we will measure the number of times per day the sensor was used to check a blood sugar level.

Number of Patients With Repeat Emergency Utilization6 months

This metric will include repeat emergency room visits and emergency medical services calls.

Change in Hemoglobin A1c6 Months

Hemoglobin A1c values drawn as part of routine care will be recorded. A positive value indicates that the hemoglobin A1c was lower at follow up than it was at baseline.

Outpatient Visits for Which the CGM Data Changed Management2-3 Weeks

For each patient in the CGM arm, the provider will complete a survey at the time of the initial outpatient follow-up appointment.

Trial Locations

Locations (1)

UMass Memorial Medical Center

🇺🇸

Worcester, Massachusetts, United States

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