Poor Glycemic Control, Quality of Life
Conditions
Keywords
Metabolic control, Quality of life
Brief summary
It it hypothesized that children and adolescents with type 1 diabetes, who are counting carbohydrates can achieve better metabolic control by concurrent use of the Accu-Chek Aviva Expert. Additionally, it is proposed that carbohydrate counting in combination with the the Accu-Chek Aviva Expert will lead to better quality of life as a result of fewer restrictions when eating and less variation in blood glucose.
Detailed description
Carbohydrate (Carb) counting is a meal planning approach for patients with diabetes mellitus that focuses on carbohydrate as the primary nutrient affecting postprandial glycaemic response. In the early 1990's the Diabetes Control and Complications Trial (DCCT) used Carb counting as one of its education tools. More recently, short acting insulin analogues and insulin pumps have made the role of Carb counting important and popular. Carb counting can be used to estimate carbohydrate intake and adjust insulin around mixed meals and snacks using insulin to carbohydrate ratio. This effectively addresses the variable eating habits of most children and adolescents. Carb counting can make food planning more flexible and thus more acceptable for young patients with diabetes. Roche has recently launched the Accu-Chek Aviva Expert recently preliminary tested in adults4, being a blood glucose meter with integrated bolus calculator and memory function. This bolus calculator estimates the dose of insulin to be administrated on the basis of the following parameters: Current blood glucose, grams of carbohydrate, carbohydrate to insulin ratio, insulin sensitivity, target blood glucose and insulin action time. Hypothesis: It is hypothesized that paediatric patients in MDI therapy with suboptimal regulated diabetes will achieve better glycemic control by using Accu-Chek Aviva Expert rather than carbohydrate counting alone without the use of an external calculator.
Interventions
DEVICEaccu chek Aviva Expert
This bolus calculator estimates the dose of insulin to be administrated on the basis of the following parameters: current blood glucose, grams of carbohydrate, carbohydrate to insulin ratio, insulin sensitivity, target blood glucose and quantity of insulin previously administered.
DEVICEAccu Chek Aviva Nano
This meter is a normal glucometer without bolus calculator.
Sponsors
Universitaire Ziekenhuizen KU Leuven
University of Copenhagen
Hospital Sant Joan de Deu
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
1 Years to 18 Years
Healthy volunteers
No
Inclusion criteria
* \- Patients with type 1 diabetes (n=120) Age \> 1 year and \< 18 years * Diabetes duration \>12 months * MDI therapy (fast acting analog for meals; long acting analog as basal) * HbA1c \> 7.0% and \<11%
Exclusion criteria
* Insulin pump therapy * Missing consent declaration
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| better metabolic control as assessed by HbA1C | 12 months | We hypothesize that children and adolescents with type 1 diabetes, who are counting carbohydrates can achieve better metabolic control as assessed by HbA1C. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| better quality of life as assessed by Hvidore questionnaire | 12 months | quality of life as assessed by Hvidore questionnaire |
| better metabolic control as assessed by glucose variability | 12 months | We hypothesize that children and adolescents with type 1 diabetes, who are counting carbohydrates can achieve better metabolic control as assessed by glucose variability by concurrent use of the Accu-Chek Aviva Expert. Additionally, we propose that carbohydrate counting in combination with the the Accu-Chek Aviva Expert will lead to better quality of life as a result of fewer restrictions when eating and less variation in blood glucose. |
Countries
Belgium
Outcome results
None listed