Type 1 Diabetes Mellitus
Conditions
Keywords
Type 1 Diabetes Mellitus, Adolescents, Carbohydrate Counting, Glycemic Control, Self-Management, T1DM
Brief summary
Helping individuals with diabetes to control their blood sugars through self-management is an important goal, and counting carbohydrates (CHO) remains a key part of diabetes education and management. There is very little research examining CHO counting education with adolescents who have type 1 diabetes (T1DM). The purpose of this pilot study is to evaluate a newly developed internet-based teaching module of CHO counting for adolescents, ages 12-17 years, with T1DM and who do not regularly CHO count and require instruction. A secondary aim is to assess feasibility for a future, larger-scale clinical trail. An effective web-based CHO counting tutorial could be used to strengthen current diabetes education programs and may serve as a basis for developing other teaching modules. Advantages of web-based teaching include convenience, increased accessibility, and the ability to review and reinforce teaching concepts through repetition. It may also encourage adolescents to take the initiative for their own diabetes care, beginning with a self-directed, active learning experience.
Interventions
BEHAVIORALIn-person Carbohydrate Counting Class
An in-person carbohydrate counting class led by a registered dietician. The in class session covers topics including the role of CHO in nutrition and diabetes, sources of CHO, different CHO and non-CHO foods, resources for CHO counting, label reading, and meal planning. This is the standard procedure for CHO counting education at SickKids.
BEHAVIORALOnline Carbohydrate Counting Tutorial
A web-based CHO counting tutorial that covers the same concepts reviewed during the standard in-person instructional session held at SickKids. A teen delivers the educational messages in short segments using techniques designed to maintain the viewer's attention (e.g., visuals of food portions and short segment highlights to emphasize important points). The online module includes brief interactive question/answer components for reinforcement. The secure online tutorial will be accessible for one week through a link provided by REDCap. Users will be able to repeat sessions, log on and off during sessions, and choose specific modules for repetition/review. The investigators will be able to capture the number of times patients log on and detail frequency and specifics of usage.
Sponsors
The Lawson Foundation
The Hospital for Sick Children
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
12 Years to 17 Years
Healthy volunteers
No
Inclusion criteria
* Adolescents aged 12-17 years with a diagnosis of T1DM for more than 1 year * Followed at the SickKids Diabetes Clinic * Have access to a computer with Internet connection * Able to communicate in English
Exclusion criteria
* Patients with type 2 diabetes, medication-induced diabetes or other forms of non T1DM * Patients with Celiac disease, due to differences in prescribed dietary regimen * Patients who are unable to communicate in English * No computer or internet access * Patient with cognitive delay impeding their ability to learn CHO counting * Patients who have attended a CHO counting class within the past 6 months * Patients who do not eat the foods presented on the planned meal & snack trays
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Carbohydrate Counting Accuracy Measured Using a Standardized Meal & Snack Tray Test at Baseline and 3-months Post-Education | Baseline; 3-months post-education | Test trays will comprise foods commonly consumed by adolescents (e.g., hamburger, grilled cheese sandwich). CHO counting accuracy using food trays will be checked against a computerized food analysis. Several tray combinations will be used with randomization to tray order within each group for both pre- and post- assessments. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Carbohydrate Counting Knowledge Tested Using the PedCarbQuiz (PCQ) at Baseline and 3-months Post-Education | Baseline; 3-months post-education | A 52 item assessment of carbohydrate and insulin dose calculating knowledge in youth with T1DM |
Countries
Canada
Outcome results
None listed