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CompletedNCT03378271Updated Feb 29, 2024

Accuracy and Treatment Experience of Two Glucose Monitoring Systems Tested in Patients With Type 1 Diabetes and Renal Impairment

An interventional study of Simultanious CGM/FGM in Diabetes Mellitus Complication and Renal Impairment, sponsored by Vastra Gotaland Region. Completed at 1 site in Sweden. Open to participants aged 18 Years to 79 Years. Per ClinicalTrials.gov, last updated 2024-02-29.

Sponsored by Vastra Gotaland Region · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Not applicable
Ages
18 Years to 79 Years
Sex
All
01

Study summary

The study aims to evaluate the accuracy of two commercial glucose monitoring systems in patients with type 1 or type 2 diabetes and renal impairment, including patients with or without dialysis. Patients treatment experience will even be evaluated.

Read the detailed description

Continuous glucose monitoring (CGM) and Flash glucose monitoring (FGM) are tools today mainly used in the treatment of patients with type 1 diabetes. Both glucose monitors are subcutaneous tissue sensors, which provide a tissue fluid glucose measurement every 1 to 5 minutes. The real-time glucose sensor trend data can help patients with diabetes better manage their insulin needs with meals and exercise. The following glucose monitoring systems are two of the most current sensor technologies available for clinical use the Dexcom G5 (Dexcom Corporation), and the FGM (Abbot Freestyle Libre).

High glucose levels in patients with type 1 or 2-diabetes lead to increased risks of micro- and macrovascular complications, while low glucose levels may lead to unconsciousness. Therefore, it is important for patients to manage glucose levels as close to normal (4-7 mmol/l) as possible. This is generally performed by appropriate dosage of different insulins, calculated from the preprandial glucose level, carbohydrate intake, and physical activity. In spite of careful dosage, glucose levels often become too low or too high.

CGM is a novel tool to detect low and high glucose levels, and it is capable of sounding an alarm for low and high glucose levels. CGM has been available in clinical practice in Sweden for approximately 5 years. FGM is as CGM also a novel tool to detect low and high glucose levels, but is not capable of sounding an alarm for low and high glucose levels. FGM has been available in clinical practice in Sweden since late 2014.

Since both CGM and FGM measure the glucose level by a sensor in subcutaneous tissue, there is uncertainty in the estimation of blood glucose levels. The accuracy of a certain CGM or FGM system can be assessed by comparing the glucose levels estimated by the glucose monitors with measured glucose levels in capillary blood samples. To our knowledge there are no studies comparing the accuracy of the Dexcom G5 sensor with the Freestyle Libre sensor. In the current study, we will compare the accuracy and treatment experience of these two glucose monitoring sensors available on the market for clinical use in patients with type 1 or 2 diabetes and renal impairment with an eGFR\<30 ml/min both in and not in dialysis.

02

Conditions studied

  • Diabetes Mellitus Complication
  • Renal Impairment

Keywords

  • Continuous Glucose Monitoring
  • Flash glucose Monitoring
  • Renal Impairment
  • Type 1 Diabetes
  • Type 2 Diabetes
03

Who can participate

Ages eligible
18 Years to 79 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Type 1 or type 2 diabetes with renal impairment and eGFR \<30 ml/min measured within the last three months.
  2. Adult patients, age 18 or older and \<80 years.
  3. Written Informed Consent

Exclusion criteria

Exclusion criteria:

  1. Pregnancy
  2. Patients with severe cognitive dysfunction or other disease which makes glucose monitoring use difficult.
  3. Patients requiring continuous use of paracetamol. Paracetamol must not have been used the week before the study and shall not be used during the duration because it disturbs the interpretation of blood glucose levels estimated by the Dexcom G5. However, other pain killers can be used throughout the study period.
  4. Current CGM or FGM use.
  5. History of allergic reaction to any of the CGM or FGM materials or adhesives in contact with the skin.
  6. History of allergic reaction to chlorhexidine or alcohol anti-septic solution.
  7. Abnormal skin at the anticipated glucose sensor attachment sites (excessive hair, burn, inflammation, infection, rash, and/or tattoo).
  8. Patients with renal impairment and eGFR greater or equal to 30 ml/min estimated by the MDRD formula.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
40 participants (actual)

Study arms

  • Experimental
    FGM/CGM

    each patient will have a CGM and a FGM, subcutaneous glucose sensors, the data will be compared to the time-matched reference blood glucose measurements. Each ambulatory patient will sample capillary blood with the HemoCue meter and measure the concentration of glucose minimum 3 times per day for 14 days. The concentration of finger-stick capillary blood glucose will be measured using the self-monitoring blood glucose (SMBG) hemocue meter in their daily living. The subjects will record SMBG, in a written diary. Subjects will dose insulin according to their routine methods throughout the 14 day study

    Device: Simultanious CGM/FGM

Interventions

  • DeviceSimultanious CGM/FGM

    Patients will use both CGM and FGM and document their values as well as documenting a capillary blood glucose value.

05

What researchers measure

Primary outcomes

  1. Accuracy of CGM and FGM

    Evaluation of accuracy in estimating capillary glucose levels of two commercial glucose monitoring systems (CGM and FGM), Dexcom G5 system (Dexcom sensor) and the Abbot Freestyle Libre sensor, in ambulatory patients with type 1 or type 2 diabetes and renal impairment with an eGFR\<30 ml/min both in and not in dialysis.

    Time frame: The whole study period Day 1-14

Secondary outcomes

  1. The evaluation of the accuracy of the 2 glucose monitoring systems during each studied time interval (day 1-3 and day 4-6)

    The evaluation of the accuracy of the 2 glucose monitoring systems for various glucose intervals (hypo, normo- and hyperglycaemia)

    Time frame: Day 1-6 of study period

  2. The evaluation of the accuracy of the 2 glucose monitoring systems for various glucose intervals (hypo, normo- and hyperglycaemia)

    Time frame: The whole study period Day 1-14

  3. The evaluation of the accuracy of the 2 glucose monitoring systems during dialysis and not in dialysis

    Time frame: The whole study period Day 1-14

  4. The evaluation of patients preferences and experience of the two glucose monitoring systems.

    Patients will answer questionnaires on both systems to see which system they prefer to use and find more user friendly. the questionnaire will be in the form of a Lickert scale from 0-10.

    Time frame: The whole study period Day 1-14

06

Study locations

1 site
  • NU-Hospital Group
    Uddevalla, 45180, Sweden
07

Registry details

Key details

Study ID
NCT03378271
Lead sponsor
Vastra Gotaland Region
Responsible party
Sponsor
First posted
Dec 19, 2017
Start date
May 5, 2016
Primary completion
Dec 30, 2019
Completion
Dec 31, 2022
Last update
Feb 29, 2024

Study contacts

Marcus Lind, PhD
principal investigator · Gothenburgh University

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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