Are the Continuous Glucose Monitoring Systems Able to Improve Long Term Glycaemic Control in Type 1 Diabetic Patients?
Type 1 Diabetes
About this trial
This is an interventional supportive care trial for Type 1 Diabetes focused on measuring Type 1 Diabetes, Real Time Continuous Glucose Monitoring System, HbA1c, Navigator®
Eligibility Criteria
Inclusion Criteria:
- Type 1 Diabetes for ≥ 12 months or more (including Cpeptide negative secondary diabetes)
- Children between 8 and 18 years old
- Adults between 18 and 60 years old
- Patients treated with basal-bolus insulin regimens, pump or multiple daily injection, only with analogs, for at least 6 months
- Performing at least 2 finger sticks glucose controls per day
- Able and motivated to use the device
- HbA1c ≥ 8% twice with HPLC method(DCA 2000 excluded)
- Written informed consent obtained prior to enrollment in the study
Exclusion Criteria:
- Blindness or impaired vision so the screen cannot be recognized
- Allergy to sensor
- Active proliferative retinopathy not stabilized by laser or vitrectomy occurence in the 6 months prior to visit 1, or any other unstable (rapidly progressing) retinopathy that may require photocoagulation or surgical treatment during study
- Treatment with systemic corticosteroid or medication known to influence insulin sensitivity in the 3 months prioir to visit 1
- Pregnancy
- Manifest psychiatric disturbance
- Presence of any conditions (medical, including clinically significant abnormal laboratory test, psychological, social or geographical) actuel or anticipated that the investigators feels would compromise the patient safety or limit his/her successful participation in the study.
- Hemoglobinopathy that interfers with HbA1c measurement
Sites / Locations
- CHU Sart Tilman Liège
- CHU Jean Minjoz
- CH SUD Francilien
- University Hospital Grenoble
- Hopital Edouard Herriot
- CHU Marseille Hôpitaux Sud
- Chu Montpellier
- CHU Hôpital Jeanne d'Arc
- CHU Nantes
- Hopital Hotel Dieu
- CHU La Pitié Salpetrière
- CHU Robert Debré
- Hopital Haut Leveque
- CHU de Reims-Hôpital Américain
- CHU de Reims-Hôpital Robert debré
- CHU Rennes
- Hopital Bellevue
- CHU Strasbourg
- CHU Toulouse
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Active Comparator
Placebo Comparator
Group1-patient
Group2-diabetologist
Group3-Control
The patient will be encouraged to use the Navigator® all the time and to modify his treatment according to the continous blood glucose measurements. The patients will follow an educational process in order to adapt insulin doses according to each sensor data.
The patient will follow the same educational process as group 1 concerning insulin dose adaptation. They will use the continous glucose monitoring device according to the diabetologist's prescription and they will receive precise instructions to make considering results. The duration of the use of the Navigator® will be increased if one of the following criteria is observed at the consultation each 3 months: HbA1c>=7.5% 1 severe hypoglycaemia or more More than 4 benign hypoglycaemia per week According to these criteria, every 3 months, the duration of the use of the monitoring system will be increased as following: step 1: 3 sensors per month step 2: 4 sensors per month step 3: 5 sensors per month step 4: continuous use
Usual follow up with self-monitoring blood glucose.