Evaluation of a Digital Diabetes Self-Management Education and Support Program
Primary Purpose
Type 2 Diabetes
Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Online Diabetes Self-Management Education and Support (DSMES) Program
Standard of Care
Sponsored by
About this trial
This is an interventional treatment trial for Type 2 Diabetes
Eligibility Criteria
Inclusion Criteria:
- 18 years or older
- Lives in the United States and has a valid mailing address
- Speaks, reads, and understands English as the primary language
- Be willing and able to provide written, signed, and dated informed consent
- Has a self-reported diagnosis of type 2 diabetes prior to enrollment for at least 6 months
- Self-reports HbA1c value ≥8.0% or do not know HbA1c level from most recent test taken within the past 6 months
Treatment regimen includes diet and exercise alone, oral glucose lowering medication, non-insulin injectable medications, basal insulin and/or combination of basal insulin plus oral medications. No more than 15% of the total sample may be on combination basal insulin/oral medication.
a. If the regimen is basal insulin with oral medications, the participant must have initiated basal insulin in addition to oral medication at least 6 months prior to enrollment.
- Currently on medication regimen for at least 3 months prior to enrollment
- HbA1c greater than or equal to 8.0% as demonstrated by laboratory HbA1c at secondary screening
- Average daily Time in Range between 70 and 180 mg/dL [TIR 70-180] using a 14 day blinded CGM (with at least 3 days of usable data) after enrollment prior to randomization < 60%
- Has a compatible smartphone running either Android OS 5.0 or higher, or iPhone 7 or later, running iOS 11 or higher with an on-going data plan
- Is willing to set up an online account using the Omada Health Program/app and LibreLink app, and agree to share their CGM data with designated health care providers connected to the study.
- Must be willing to complete all study tasks as specified by the protocol
- Must report being compliant with their diabetes management plan and must be willing to adhere to their medication regimen throughout the study.
- Not currently in another clinical trial
Exclusion Criteria:
- Type 1 diabetes or a history of diabetic ketoacidosis
- Self-reported HbA1c < 8.0%
- Self-reported condition leading to life expectancy < 12 months
- Pregnant, is attempting to conceive or is not willing and able to practice birth control during the study duration (applicable to female participants only)
- Currently has self-reported skin lesions, scarring, redness, infection or edema at the application sites that could interfere with device placement or the accuracy of interstitial glucose measurements. This includes known allergy to medical grade adhesive or isopropyl alcohol used to disinfect skin
- Has X-ray, MRI or CT appointment scheduled during the study periods of CGM measurement with the FreeStyle Libre Pro, and the appointment(s) cannot be rescheduled
- Currently using mealtime bolus injections of insulin, premixed insulin formulations or a continuous subcutaneous infusion of insulin
- Visual impairment that would prohibit ability to view sensor data or use the Omada platform
Has had any of the following in the past 3 months:
- Transient ischemic attack or stroke
- Heart attack (myocardial infarction)
- Hospitalization for congestive heart failure
- Cardiac surgery (such as coronary artery bypass grafting (CABG), coronary artery stenting)
- If it has been > 3 months since any of the above, applicant must be medically cleared by their primary physician to exercise
- Bariatric/gastric bypass surgery, including gastric sleeve, gastric balloon within the past 6 months
- Participation in other research studies involving medication or device within 1 month prior to enrollment
- Organ transplant (kidney, liver, etc.) within the past 6 months
- Recent (within the last 6 months) or planned cancer treatment (chemotherapy, radiation, bone marrow transplant, cancer-related surgery - not including hormonal chemotherapy, such as tamoxifen)
- Self-reported renal impairment, defined as estimated glomerular filtration rate <30 mL/min/1.73 m2
- Language barriers precluding comprehension of study activities and informed consent
- Currently on a routine regimen of glucocorticoids or psychotropic medications
- Self-reported alcohol or substance abuse issue or dependency
Sites / Locations
- Evidation Health
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Integrated Solution
Standard of Care
Arm Description
Outcomes
Primary Outcome Measures
Change in HbA1c
Non-fasting venous blood sample
Secondary Outcome Measures
Change in daily Time in Range [70-180] mg/dL
Derived from continuous glucose monitor
Change in body weight
Measured with a digital weight scale in stocking feet
Change in resting blood pressure
Collected with an automated, calibrated blood pressure monitor with self-inflating cuff
Change in diabetes distress
The Diabetes Distress Scale, a 17-item self-report questionnaire, that captures four dimensions: emotional burden, regimen distress, interpersonal distress and physician distress related to diabetes and diabetes self-care
Full Information
NCT ID
NCT05368454
First Posted
May 5, 2022
Last Updated
August 16, 2023
Sponsor
Omada Health, Inc.
Collaborators
Abbott Diabetes Care, Evidation Health
1. Study Identification
Unique Protocol Identification Number
NCT05368454
Brief Title
Evaluation of a Digital Diabetes Self-Management Education and Support Program
Official Title
Randomized Controlled Trial to Evaluate the Efficacy of an Integrated Lifestyle Management Solution With Continuous Glucose Monitoring for Type 2 Diabetes
Study Type
Interventional
2. Study Status
Record Verification Date
August 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 31, 2022 (Actual)
Primary Completion Date
January 31, 2024 (Anticipated)
Study Completion Date
January 31, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Omada Health, Inc.
Collaborators
Abbott Diabetes Care, Evidation Health
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The goal of this study is to examine the efficacy of an integrated solution, defined as a combination of the Abbott FreeStyle Libre 14-day CGM sensor and the Omada care team's receipt of real-time, continuous glucose data from the sensor and incorporation of this data into their care delivery within the context of the Omada for Diabetes program for adults with Type 2 Diabetes (T2D). This randomized control trial will test the impact of the integrated solution on HbA1c, CGM-derived metrics and other relevant diabetes management outcomes over six months compared to the current standard of care.
Detailed Description
Type 2 diabetes (T2D) contributes substantially to morbidity and mortality in the US. Lifestyle management is a fundamental component of care for T2D. This includes self-management education and support, medical nutrition therapy, physical activity, smoking cessation counseling, and psychosocial care for the person with diabetes. Diabetes self-management education and support (DSMES) specifically pertains to helping people acquire the knowledge, skills, and ability for diabetes self-care, and assisting people to engage in the health-related behaviors needed to manage this condition on an ongoing basis. Research has shown that DSMES programs that target behavioral changes with intensive counseling and support lead to improved glucose control.
In recent years, technology-enabled platforms have been developed to deliver self-management support and education virtually, and commercial products are common. These platforms allow people with chronic diseases to access self-management support and education through their personal mobile devices (e.g., smartphones, tablets, laptops) and eliminate the need to travel to physical facilities for diabetes education sessions. The increased convenience brings potential to increase access, availability, and acceptability.
The development of Continuous Glucose Monitoring (CGM) has further advanced care and management of T2D. In particular, real-time CGM allows the person to view real-time glucose readings and patterns over time, without the need for painful finger sticks. While the majority of studies of CGM have been conducted with people with T2Ds using insulin, some clinical trials have shown that the use of real-time CGM is associated with improvements in glycemic control in people with T2D not using insulin.
The current standards of care for diabetes recommend CGM use for people with Type 1 and 2 diabetes when it is coupled with "robust diabetes education, training and support". However, there is a lack of well-integrated solutions that combine the potential benefit of both digitally delivered DSMES and CGM in a seamless way. Therefore, the purpose of this study is to examine the efficacy of a novel integrated solution of a digitally delivered T2D self-management education and support program with a continuous glucose monitor (CGM) built into the digital platform. The randomized control trial will test the impact of the novel solution for improving HbA1c and related CGM-derived outcomes and relevant diabetes management outcomes over six months related to the current standard of care.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 2 Diabetes
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Investigator
Allocation
Randomized
Enrollment
200 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Integrated Solution
Arm Type
Experimental
Arm Title
Standard of Care
Arm Type
Active Comparator
Intervention Type
Behavioral
Intervention Name(s)
Online Diabetes Self-Management Education and Support (DSMES) Program
Intervention Description
An online program for Diabetes Self-Management, Education and Support (DSMES) that includes personal coaching by a certified Diabetes Care and Education Specialist (CDCES), tracking tools, and FreeStyle Libre CGMs, a wearable sensor with data scanning ability accessed through the smartphone app.
Intervention Type
Behavioral
Intervention Name(s)
Standard of Care
Intervention Description
All participants randomized to the standard of care/control arm will be asked to continue with their current care plan and care team for management of their diabetes.
Primary Outcome Measure Information:
Title
Change in HbA1c
Description
Non-fasting venous blood sample
Time Frame
Baseline, 3 months, 6 months
Secondary Outcome Measure Information:
Title
Change in daily Time in Range [70-180] mg/dL
Description
Derived from continuous glucose monitor
Time Frame
Baseline, 3 months, 6 months
Title
Change in body weight
Description
Measured with a digital weight scale in stocking feet
Time Frame
Baseline, 3 months, 6 months
Title
Change in resting blood pressure
Description
Collected with an automated, calibrated blood pressure monitor with self-inflating cuff
Time Frame
Baseline, 3 months, 6 months
Title
Change in diabetes distress
Description
The Diabetes Distress Scale, a 17-item self-report questionnaire, that captures four dimensions: emotional burden, regimen distress, interpersonal distress and physician distress related to diabetes and diabetes self-care
Time Frame
Baseline, 3 months, 6 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA
18 years or older
Lives in the United States and has a valid mailing address
Speaks, reads, and understands English as the primary language
Be willing and able to provide written, signed, and dated informed consent
Has a self-reported diagnosis of type 2 diabetes prior to enrollment for at least 6 months
Self-reports HbA1c value ≥8.0% from most recent test taken within the past 6 months
Treatment regimen includes diet and exercise alone, oral glucose lowering medication, non-insulin injectable medications, basal insulin and/or combination of basal insulin plus oral medications. No more than 15% of the total sample may be on combination basal insulin/oral medication.
a. If the regimen is basal insulin with oral medications, the participant must have initiated basal insulin in addition to oral medication at least 6 months prior to enrollment.
Currently on medication regimen for at least 3 months prior to enrollment
HbA1c greater than or equal to 8.0% as demonstrated by laboratory HbA1c at secondary screening
Has a compatible smartphone running either Android OS 5.0 or higher, or iPhone 7 or later, running iOS 11 or higher with an on-going data plan
Is willing to set up an online account using the Omada Health Program/app and LibreLink app, and agree to share their CGM data with designated health care providers connected to the study.
Must be willing to complete all study tasks as specified by the protocol
Must report being compliant with their diabetes management plan and must be willing to adhere to their medication regimen throughout the study.
Not currently in another clinical trial
EXCLUSION CRITERIA
Type 1 diabetes or a history of diabetic ketoacidosis
Self-reported HbA1c < 8.0% or does not know their HbA1c level
Self-reported condition leading to life expectancy < 12 months
Pregnant, is attempting to conceive or is not willing and able to practice birth control during the study duration (applicable to female participants who are able to become pregnant only)
Currently has self-reported skin lesions, scarring, redness, infection or edema at the application sites that could interfere with device placement or the accuracy of interstitial glucose measurements. This includes known allergy to medical grade adhesive or isopropyl alcohol used to disinfect skin
Has X-ray, MRI or CT appointment scheduled during the study periods of CGM measurement with the FreeStyle Libre Pro, and the appointment(s) cannot be rescheduled
Currently using mealtime bolus injections of insulin, premixed insulin formulations or a continuous subcutaneous infusion of insulin
Visual impairment that would prohibit ability to view sensor data or use the Omada platform
Has had any of the following in the past 3 months:
Transient ischemic attack or stroke
Heart attack (myocardial infarction)
Hospitalization for congestive heart failure
Cardiac surgery (such as coronary artery bypass grafting (CABG), coronary artery stenting)
If it has been > 3 months since any of the above, applicant must be medically cleared by their primary physician to exercise
Bariatric/gastric bypass surgery, including gastric sleeve, gastric balloon within the past 6 months
Participation in other research studies involving medication or device within 1 month prior to enrollment
Organ transplant (kidney, liver, etc.) within the past 6 months
Recent (within the last 6 months) or planned cancer treatment (chemotherapy, radiation, bone marrow transplant, cancer-related surgery - not including hormonal chemotherapy, such as tamoxifen)
Self-reported renal impairment, defined as estimated glomerular filtration rate <30 mL/min/1.73 m2
Language barriers precluding comprehension of study activities and informed consent 16. Currently on a routine regimen of glucocorticoids or psychotropic medications 17. Self-reported alcohol or substance abuse issue or dependency
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sarah Linke, PhD
Organizational Affiliation
Omada Health, Inc.
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
David Kerr, MBChB, DM, FRCPE
Organizational Affiliation
Evidation Health
Official's Role
Principal Investigator
Facility Information:
Facility Name
Evidation Health
City
San Mateo
State/Province
California
ZIP/Postal Code
94401
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
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Evaluation of a Digital Diabetes Self-Management Education and Support Program
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