Type2 Diabetes
Conditions
Keywords
continuous glucose monitoring, immediate feedback counseling, delayed feedback counseling
Brief summary
This study is designed to explore the effect of feedback counseling using professional continuous glucose monitoring on glycemic control, self-efficacy, and self-management behaviors among middle aged and older adults with poor controlled type 2 diabetes mellitus. This study also explores the difference on timing of feedback after continuous glucose monitoring exam.
Detailed description
After scheduled routine professional continuous glucose monitoring (CGM) exam, participants in both the intervention and control group receive ordinary education and regimen adjustment as indicated based on CGM results. For participants in the intervention group, they will also receive CGM counseling immediately on the day of CGM sensor removal. For participants in the control group, they will receive CGM counseling on the day of routine 3 months outpatient visit. Qualitative data are collected through in-depth interview: User expectation, acceptability and satisfaction of CGM are also explored during in-depth interview with a semi-structured questionnaire. Quantitative data were collected through validated questionnaires, including evaluation of depression by a short form of the Center for Epidemiologic Studies Depression Scale Revised (CES-D-R), emotional stress by Problem Areas in Diabetes Scale (PAID), self efficacy by Stanford Self-Efficacy for Diabetes (SES), at pretest and 3 months after CGM counseling. Anthropometric Measurements. Body height, body weight, body mass index, and blood pressure were recorded at pre-test and post-test interview. Blood Tests. Routine biochemistry, fasting plasma glucose, hemoglobin A1c (HbA1c) are collected within 2 weeks of pretest and posttest day.
Interventions
BEHAVIORALfeedback counseling
Professoinal CGM in combination with diet and exercise record is used as teaching material to help patient realize their blood glucose pattern and to modify their behavior after counseling feedback.
Sponsors
National Cheng-Kung University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
45 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 45 years old or more at recent outpatient visits; * Type 2 diabetic patients followed up at National Cheng Kung University Hospital; * Patients planned to receive CGM suggested by primary care physician due to inadequate controlled blood glucose.
Exclusion criteria
* Patients with diagnosis of generalized inflammation, advanced malignancy, end-stage renal disease on regular dialysis, status post renal transplantation, end-stage liver, heart or pulmonary disease; * Patients who are taking systemic glucocorticoids; * Any acute or chronic inflammatory disease as determined by a leukocyte count over 10,000/mm3 or clinical signs of infection; * Patients who could not complete the questionnaires or who could not follow order due to cognitive impairment or in bed-ridden status; * Patients diagnosed as thalassemia, glucose-6-phosphate dehydrogenase deficiency, and any other hemoglobinopathies that may influence the accuracy of hemoglobulin A1c measurement were also excluded. Patients who received blood transfusion in recent 3 months were also excluded.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of HbA1c | Baseline and 3 months after CGM counseling | Change of HbA1c in 3 months after CGM counseling. |
| Change of score for self efficacy | Baseline and 3 months after CGM counseling | Change of Stanford Self-Efficacy for Diabetes Scale (SES) in 3 months after CGM counseling. The score for each item ranged from 1-10. The score of the scale is the mean of the eight items. Higher number indicated higher self-efficacy. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in diet composition | Baseline and 3 months after CGM counseling | Change of carbohydrate amounts, fruits amount in 3 months after CGM counseling. |
| Change in exercise amount, time spent in light activity | Baseline and 3 months after CGM counseling | Exercise amount recorded by acelerometers, built in sports bracelet (Fitbit Charge HRTM Wireless Heart Rate + Activity Wristband). Time spent in light activity per day in 3 months after CGM counseling feedback is compared with baseline. |
| Change of score for diabetes associated stress | Baseline and 3 months after CGM counseling | Change of score for Problem Areas in Diabetes Scale (PAID) in 3 months after CGM counseling. PAID is a 20-item self-reported questionnaire with scale 0-4 for each question, generating a total score of 0-100. A score of ≥ 40 is defined as emotional burnout. |
| Change in exercise amount, time spent in intense activity | Baseline and 3 months after CGM counseling | Exercise amount recorded by acelerometers, built in sports bracelet (Fitbit Charge HRTM Wireless Heart Rate + Activity Wristband). Time spent in intense activity per day in 3 months after CGM counseling feedback is compared with baseline. |
| Change in exercise amount (time spent in sedentary behavior) | Baseline and 3 months after CGM counseling | Exercise amount recorded by acelerometers, built in sports bracelet (Fitbit Charge HRTM Wireless Heart Rate + Activity Wristband). Time spent in sedentary behavior in 3 months after CGM counseling feedback is compared with baseline. |
| Change in exercise amount, time spent in moderate activity | Baseline and 3 months after CGM counseling | Exercise amount recorded by acelerometers, built in sports bracelet (Fitbit Charge HRTM Wireless Heart Rate + Activity Wristband). Time spent in moderate activity per day in 3 months after CGM counseling feedback is compared with baseline. |
| Change of score for depression | Baseline and 3 months after CGM counseling | Change of score for Center for Epidemiologic Studies Depression Scale Revised (CESD-R) in 3 months after CGM counseling. With 10-ietm CESD-R scale scoring 10 or more defined as having depression (range 0 to 30). |
Outcome results
None listed