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Use of the MyDose Coach Digital Tool for Self-titration of Insulin in Patients With Type 2 Diabetes

Primary Purpose

Diabetes Mellitus, Type 2

Status
Unknown status
Phase
Not Applicable
Locations
Mexico
Study Type
Interventional
Intervention
MyDoseCoach app
Sponsored by
Hospital Universitario Dr. Jose E. Gonzalez
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Diabetes Mellitus, Type 2

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Have type 2 diabetes
  • Greater than 18 years and up to 75 years of age
  • Use of basal insulin once a day or candidate for basal insulin once a day based on% HbA1c according to international guidelines and doctor's criteria
  • HbA1c > 7% in patients aged 18 to 65 years
  • HbA1c > 7.5% in patients older than 65 years
  • Patients who use basal insulin twice a day or premix with diagnosed hypoglycemia and who are candidates for switching from therapy to a basal insulin of one application per day
  • Have a Smartphone
  • Informed consent signature

Exclusion Criteria:

  • Refuse to participate in the study.
  • Age younger than 18 years old and over 75 years old.
  • Diabetes type 1 or gestational (other than type 2 diabetes mellitus).
  • Patients with the following chronic complications of diabetes: retinopathy and chronic kidney disease with a glomerular filtration rate <30 ml / min.
  • The MyDose Coach tool is not appropriate for the patient or the use of the application is contraindicated (in the opinion of the Researcher, for example, patients with terminal illness, patients with cognitive or neurological disorders that are detailed below, patients who live alone and they do not have support from the family, patients with carpal tunnel who are not recommended to use a mobile phone, patients with musculoskeletal injuries in their hands, etc.)
  • Patients who use insulin during the meal (short-acting analogue, regular human insulin or insulin premix) for more than 10 days in the last 3 months before the screening visit.
  • Patients with severe hypoglycemia in the last 90 days.
  • Hospitalization in the last 30 days (whatever the reason for hospitalization) In the last 3 months prior to the screening period: history of myocardial infarction, unstable angina, acute coronary syndrome, revascularization procedure, cerebrovascular accident requiring hospitalization.
  • Severe or uncontrolled congestive heart failure (functional classification III and IV of the New York Heart Association [NYHA]).
  • Use of systemic glucocorticoids (excluding topical application or inhaled forms) for a week or more within 90 days prior to the time of the test.
  • Unable to meet specific protocol requirements (for example, inability to perform blood glucose measurements, administer your own insulin dose, or consider it unlikely that you will administer the titration safely according to your physician's guidance).
  • Patients with cognitive disorders, dementia or any neurological disorder that affects the patient's ability to participate in the study, including the inability to understand the requirements of the study or to provide complete information about the adverse symptoms.
  • Pregnant or breast-feeding women or women who intend to become pregnant during the study period.

Sites / Locations

  • Clínica NovaRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

MyDose Coach app intervention

Arm Description

The intervention involves the use of the MyDose Coach application, which has been previously programmed with the following titration scheme according to fasting glucose.

Outcomes

Primary Outcome Measures

Percentage of patients reaching fasting SMPG target without a severe hypoglycemic episode during the 16-week on-treatment period
Percentage of patients reaching fasting SMPG (Self-Measured Plasma Glucose) target range 90-130 mg/dL (5.0-7.2 mmol/L) at Week 16 (mean of the last 4 readings recorded over the last 2 weeks) without a severe hypoglycemic episode (defined as having low blood glucose levels that requires assistance from another person to treat) during the 16-week on-treatment period

Secondary Outcome Measures

Mean HbA1c change from baseline
Mean Glycated hemoglobin A1c (in percentage) from baseline
Percentage of patients reaching HbA1c of <7.5% and <7%
Percentage of patients reaching Glycated hemoglobin A1c of <7.5% and <7%
Mean fasting SMPG glucose change from baseline
Mean fasting Self-Measured Plasma Glucose (mean of the last 4 readings recorded over the last 2 weeks, in mg/dl)
Time to reach the first fasting SMPG target
Time in weeks to reach the first fasting SMPG target range of 90-130 mg/dL (5.0-7.2 mmol/L)
Mean FPG glucose change from baseline
Mean fasting plasma glucose glucose change from baseline, in mg/dl
Percentage of patients with hypoglycemic events
Percentage of patients with hypoglycemic events (blood glucose less than 70 mg/dL)
Number of hypoglycemic events
Number of hypoglycemic events (blood glucose less than 70 mg/dL)
Percentage of patients with adverse events
Percentage of patients with adverse events (other than hypoglycemia)
Assessment of emotional well-being using WHO-5 well-being index
Assessment of emotional well-being using WHO-5 well-being index. The World Health Organisation- Five Well-Being Index (WHO-5) is a short self-reported measure of current mental wellbeing.

Full Information

First Posted
September 25, 2018
Last Updated
December 13, 2018
Sponsor
Hospital Universitario Dr. Jose E. Gonzalez
Collaborators
Hospital Clinica Nova
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1. Study Identification

Unique Protocol Identification Number
NCT03775057
Brief Title
Use of the MyDose Coach Digital Tool for Self-titration of Insulin in Patients With Type 2 Diabetes
Official Title
Use of the MyDose Coach Digital Tool for Self-titration of Insulin in Patients With Type 2 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
December 2018
Overall Recruitment Status
Unknown status
Study Start Date
August 22, 2018 (Actual)
Primary Completion Date
June 22, 2019 (Anticipated)
Study Completion Date
August 22, 2019 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Hospital Universitario Dr. Jose E. Gonzalez
Collaborators
Hospital Clinica Nova

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Scientific studies show that the introduction of digital tools led to: Significant improvement in glycemic control, greater patient satisfaction, reduction of emotional burden, reduction of fear of hypoglycaemia, reduction of anxiety of the regimen, significantly fewer of additional visits to the doctor in addition to those scheduled and a reduction of resources. Primary Objective: To evaluate the efficacy and safety of the MyDose Coach digital tool in patients with T2D with basal insulin or candidates for the use of basal insulin. Secondary Objectives: Evaluate demographic variables and control variables (HbA1c, SMPG, FPG). Measure the units of insulin used before and after the intervention
Detailed Description
The maximum study duration will be 29 weeks per patient that will consist of a 12-week screening period, a 16-week treatment period, and 1-week follow-up period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus, Type 2

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
300 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
MyDose Coach app intervention
Arm Type
Experimental
Arm Description
The intervention involves the use of the MyDose Coach application, which has been previously programmed with the following titration scheme according to fasting glucose.
Intervention Type
Other
Intervention Name(s)
MyDoseCoach app
Intervention Description
The intervention involves the use of the MyDose Coach application, which has been previously programmed with the following titration scheme according to fasting glucose.
Primary Outcome Measure Information:
Title
Percentage of patients reaching fasting SMPG target without a severe hypoglycemic episode during the 16-week on-treatment period
Description
Percentage of patients reaching fasting SMPG (Self-Measured Plasma Glucose) target range 90-130 mg/dL (5.0-7.2 mmol/L) at Week 16 (mean of the last 4 readings recorded over the last 2 weeks) without a severe hypoglycemic episode (defined as having low blood glucose levels that requires assistance from another person to treat) during the 16-week on-treatment period
Time Frame
16 weeks
Secondary Outcome Measure Information:
Title
Mean HbA1c change from baseline
Description
Mean Glycated hemoglobin A1c (in percentage) from baseline
Time Frame
16 weeks
Title
Percentage of patients reaching HbA1c of <7.5% and <7%
Description
Percentage of patients reaching Glycated hemoglobin A1c of <7.5% and <7%
Time Frame
16 weeks
Title
Mean fasting SMPG glucose change from baseline
Description
Mean fasting Self-Measured Plasma Glucose (mean of the last 4 readings recorded over the last 2 weeks, in mg/dl)
Time Frame
16 weeks
Title
Time to reach the first fasting SMPG target
Description
Time in weeks to reach the first fasting SMPG target range of 90-130 mg/dL (5.0-7.2 mmol/L)
Time Frame
16 weeks
Title
Mean FPG glucose change from baseline
Description
Mean fasting plasma glucose glucose change from baseline, in mg/dl
Time Frame
16 weeks
Title
Percentage of patients with hypoglycemic events
Description
Percentage of patients with hypoglycemic events (blood glucose less than 70 mg/dL)
Time Frame
16 weeks
Title
Number of hypoglycemic events
Description
Number of hypoglycemic events (blood glucose less than 70 mg/dL)
Time Frame
16 weeks
Title
Percentage of patients with adverse events
Description
Percentage of patients with adverse events (other than hypoglycemia)
Time Frame
16 week
Title
Assessment of emotional well-being using WHO-5 well-being index
Description
Assessment of emotional well-being using WHO-5 well-being index. The World Health Organisation- Five Well-Being Index (WHO-5) is a short self-reported measure of current mental wellbeing.
Time Frame
16 week

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have type 2 diabetes Greater than 18 years and up to 75 years of age Use of basal insulin once a day or candidate for basal insulin once a day based on% HbA1c according to international guidelines and doctor's criteria HbA1c > 7% in patients aged 18 to 65 years HbA1c > 7.5% in patients older than 65 years Patients who use basal insulin twice a day or premix with diagnosed hypoglycemia and who are candidates for switching from therapy to a basal insulin of one application per day Have a Smartphone Informed consent signature Exclusion Criteria: Refuse to participate in the study. Age younger than 18 years old and over 75 years old. Diabetes type 1 or gestational (other than type 2 diabetes mellitus). Patients with the following chronic complications of diabetes: retinopathy and chronic kidney disease with a glomerular filtration rate <30 ml / min. The MyDose Coach tool is not appropriate for the patient or the use of the application is contraindicated (in the opinion of the Researcher, for example, patients with terminal illness, patients with cognitive or neurological disorders that are detailed below, patients who live alone and they do not have support from the family, patients with carpal tunnel who are not recommended to use a mobile phone, patients with musculoskeletal injuries in their hands, etc.) Patients who use insulin during the meal (short-acting analogue, regular human insulin or insulin premix) for more than 10 days in the last 3 months before the screening visit. Patients with severe hypoglycemia in the last 90 days. Hospitalization in the last 30 days (whatever the reason for hospitalization) In the last 3 months prior to the screening period: history of myocardial infarction, unstable angina, acute coronary syndrome, revascularization procedure, cerebrovascular accident requiring hospitalization. Severe or uncontrolled congestive heart failure (functional classification III and IV of the New York Heart Association [NYHA]). Use of systemic glucocorticoids (excluding topical application or inhaled forms) for a week or more within 90 days prior to the time of the test. Unable to meet specific protocol requirements (for example, inability to perform blood glucose measurements, administer your own insulin dose, or consider it unlikely that you will administer the titration safely according to your physician's guidance). Patients with cognitive disorders, dementia or any neurological disorder that affects the patient's ability to participate in the study, including the inability to understand the requirements of the study or to provide complete information about the adverse symptoms. Pregnant or breast-feeding women or women who intend to become pregnant during the study period.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hector Eloy Tamez, PhD
Phone
5218183483220
Email
hectoreloytp@gmail.com
Facility Information:
Facility Name
Clínica Nova
City
San Nicolás De Los Garza
State/Province
Nuevo León
Country
Mexico
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hector Eloy Tamez, PhD
Phone
5218183483220
Email
hectoreloytp@gmail.com
First Name & Middle Initial & Last Name & Degree
David Soni, MD
First Name & Middle Initial & Last Name & Degree
Oscar Cantu, MD
First Name & Middle Initial & Last Name & Degree
Rosalinda Gonzalez, BN

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Use of the MyDose Coach Digital Tool for Self-titration of Insulin in Patients With Type 2 Diabetes

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