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在一项针对强化胰岛素治疗的糖尿病患者的动态血糖监测设备结构化教育与治疗方案的评估研究中,使强化胰岛素治疗组与常规治疗组之间产生差异:一项随机对照试验的研究方案。

Makes FLASH the difference between the intervention group and the treatment-as-usual group in an evaluation study of a structured education and treatment programme for flash glucose monitoring devices in people with diabetes on intensive insulin therapy: study protocol for a randomised controlled trial.

作者信息

Schipfer Melanie, Albrecht Carmen, Ehrmann Dominic, Haak Thomas, Kulzer Bernd, Hermanns Norbert

机构信息

Research Institute Diabetes Academy Bad Mergentheim (FIDAM GmbH), Johann-Hammer-Str. 24, 97980, Bad Mergentheim, Germany.

Diabetes Center Bad Mergentheim, Theodor-Klotzbücherstr. 12, 97980, Bad Mergentheim, Germany.

出版信息

Trials. 2018 Feb 5;19(1):91. doi: 10.1186/s13063-018-2479-9.

Abstract

BACKGROUND

People with diabetes on intensive insulin therapy need sufficient glycaemic control to prevent the onset or progression of diabetic complications. The burden of multiple daily blood glucose self-testing can be lessened by novel diabetes technology like flash glucose monitoring systems which provide more information compared to self-monitoring of blood glucose. Despite this delivered additional information studies are showing no significant effect on HbA reduction, but a reduced time spent in a hypoglycaemic glucose range. We assume that users of these devices need additional education and training to integrate the delivered information into treatment decisions. Therefore, FLASH, an education and treatment programme, was developed. The programme evaluation follows herein.

METHODS/DESIGN: Patients are recruited through 40 diabetes outpatient study centres located across Germany. They will be randomly assigned to participate in the education and treatment programme (intervention group) or to obtain treatment as usual (control group). All patients have to give blood samples and to answer a bench of questionnaires during baseline assessment, at the end of the intervention, and 6 months after the end of the intervention. Physicians will be asked to declare some additional clinical data (such as details of the diabetes therapy) for every patient at every one of the three assessment points.

DISCUSSION

This study is conducted as a randomised controlled trial to test the hypothesis that the newly developed education and treatment programme combined with the use of a flash glucose monitoring device (intervention group) is superior to reduce HbA compared to the use of flash glucose monitoring alone (control group). The first results will be expected in 2018.

TRIAL REGISTRATION

ClinicalTrials.gov, ID: NCT03175315 . Registered on 2 May 2017.

摘要

背景

接受强化胰岛素治疗的糖尿病患者需要充分控制血糖,以预防糖尿病并发症的发生或进展。新型糖尿病技术,如闪光葡萄糖监测系统,可提供比自我血糖监测更多的信息,从而减轻每日多次自我血糖检测的负担。尽管有这些额外信息,但研究表明,其对糖化血红蛋白(HbA)降低并无显著影响,不过可减少处于低血糖血糖范围的时间。我们认为,这些设备的使用者需要额外的教育和培训,以便将所提供的信息纳入治疗决策。因此,开发了FLASH教育和治疗计划。本文将对该计划进行评估。

方法/设计:通过德国各地的40个糖尿病门诊研究中心招募患者。他们将被随机分配参加教育和治疗计划(干预组)或照常接受治疗(对照组)。所有患者在基线评估时、干预结束时以及干预结束后6个月都必须采集血样并回答一系列问卷。在三个评估点的每一个点,都将要求医生申报每位患者的一些额外临床数据(如糖尿病治疗细节)。

讨论

本研究作为一项随机对照试验进行,以检验以下假设:与仅使用闪光葡萄糖监测(对照组)相比,新开发的教育和治疗计划结合使用闪光葡萄糖监测设备(干预组)在降低糖化血红蛋白方面更具优势。预计2018年得出初步结果。

试验注册

ClinicalTrials.gov,标识符:NCT03175315。于2017年5月2日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47bb/5800040/1211f693c64a/13063_2018_2479_Fig1_HTML.jpg

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