Steno2tech - Continuous Glucose Monitoring and Type 2 Diabetes.
Type 2 Diabetes Treated With Insulin

About this trial
This is an interventional treatment trial for Type 2 Diabetes Treated With Insulin focused on measuring Type 2 diabetes, Continuous glucose monitoring, Insulin-treated, RCT
Eligibility Criteria
Inclusion Criteria:
- Type 2 diabetes according to clinical definitions
- Treated with insulin injections at least once daily on top of diet and exercise recommendations. Insulin therapy has been used for at least 12 months. Can be additionally treated with one or more different oral antidiabetic drugs (except sulfonylurea), and/or glucagon-like-peptide 1 (GLP-1) analogues
- Attending the outpatient clinic at Steno Diabetes Center Copenhagen for at least 12 months
- Age ≥ 18 years
- HbA1c > 58 mmol/mol (7.5%) at two consecutively measurements over at least 3 months
- Willing to use possible interventions; to perform self-monitoring of blood glucose (SMBG) as requested by the investigators AND to use CGM continuously without calibration for a 12-month period.
- Willing to intensify non-medical and medical treatment to achieve better glucose control.
Exclusion Criteria:
- Inability to understand the patient information and give informed consent
- Not speaking and understanding Danish
- Treatment with sulfonylurea (SU) during the last 3 months before study start
- New antidiabetic treatment the last three months
- Use of systematic corticosteroids
- Visual impairment
- Severe skin allergy for adhesive tape to the patch of CGM or other skin condition that inhibits the use of a CGM device
- Comorbidity which does not allow lowering of HbA1c to 53 mmol/mol (7.0%)
- Hypoglycemic unawareness
- Impaired renal disease with eGFR < 45 ml/min/1.73m2
- Conditions that impact the stability of a HbA1c measurement (chronic liver disease, haemoglobinopathy, anemia etc.)
- Known or suspected alcohol or drug abuse
- Already using Flash glucose monitoring (Libre) or CGM
- Enrolled in another clinical study
- Pregnancy, intend to become pregnant, breastfeeding or not using adequate contraceptive methods
Sites / Locations
- Steno Diabetes Center Copenhagen
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
Group A, CGM
Group B, CGM + peer-support
Group C, SMBG
Addition of a calibration free real-time CGM in 12 months in persons with type 2 diabetes treated with insulin. The participants will participate in a training course that will include the influence of different food items and exercise on glucose levels, how to measure SMBG correctly. Furthermore, participants in group A (intervention) will, in similarity to the HCPs, receive a CGM-education and training session led by the study investigator and will be interactive and hands-on, using case studies. The training session will include spoken and written instructions on how to insert and wear the CGM device and how to interpret the CGM information to better understand the relation between participants blood glucose and their diabetes self-management.
Addition of a calibration free real-time CGM in 12 months in persons with type 2 diabetes treated with insulin plus 3 sessions of peer-support in groups of 6 participants. The participants will participate in a training course that will include the influence of different food items and exercise on glucose levels, how to measure SMBG correctly. Furthermore, participants in group B (intervention incl. peer-support) will, in similarity to group A, receive a CGM-education and training session. The training and CGM-course for participants in group B are similar to the course for group A with the addition of three peer-support sessions. The approach will be participatory and adaptable to allow flexibility in the content of the peer-support sessions and involving customized use of participatory methods i.e. dialogue tools and exercises.
Standard self-monitoring of blood glucose according to standard guidelines, in 12 months. The participants will participate in a training course that will include the influence of different food items and exercise on glucose levels, how to measure SMBG correctly.