AzTrials
AzTrials

Type 1 Diabetes MellitusWISDMNCT03240432

Wireless Innovation for Seniors With Diabetes Mellitus

A study testing Dexcom CGM in people with Type 1 Diabetes Mellitus, run by Jaeb Center for Health Research at 22 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The primary objective of the study is to determine if CGM can reduce hypoglycemia and improve quality of life in older adults with T1D. Read more about this study

Who is it for?
Ages 60 years and olderHealthy volunteers can take part
Conditions the study is for
Type 1 Diabetes Mellitus
What is being tested?
Dexcom CGM
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
200 participants
Where
22 sitesUnited States
Study dates
26 Sep 2017to 10 Sep 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 60 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • To be eligible for the study, all participants must meet the following criteria:
  • Clinical diagnosis of insulin dependent presumed autoimmune type 1 diabetes by the investigator and meeting at least one of the following criteria:
  • Age > 6 months and < 10 years old at diagnosis OR ii. Positive pancreatic autoantibodies at any time (GAD-65, IA-2, ICA or ZnT8) or positive anti-insulin autoantibody at diagnosis only (within 10 days of starting insulin) OR iii. Presence of 2 or more of the following clinical indicators suggestive of type 1 diabetes:
  • Age at diagnosis < 40 years
  • Non-obese at diagnosis according to BMI (< 95th percentile pediatric and < 30 kg/m2 adult)
  • Diabetic ketoacidosis (DKA) at any time,
Show all 15Show fewer
  • Plasma C-peptide level < 0.8 ng/ml (with blood glucose > 80 mg/dL if available) at any time
  • Family history of type 1 diabetes in a first degree relative (parent, sibling, or child).
  • Age ≥60 years
  • HbA1c <10.0% at screening or within 30 days prior to screening visit (the upper limit was selected as a surrogate measure of likelihood of adherence to the protocol with the belief that those with higher HbA1c levels are generally noncompliant with diabetes management and thus not good candidates for the trial)
  • Insulin regimen involves either use of an insulin pump (a minimum of 40% of study population) or multiple daily injections of insulin (minimum of 40% of study population).
  • Participant is able to manage his/her diabetes with respect to insulin administration and glucose monitoring (which may include assistance from spouse or other caregiver)
  • Participant understands the study protocol and agrees to comply with it
  • Participant comprehends written and spoken English
  • At least 240 hours (10 out of 14 days) of sensor glucose data with appropriate number of calibrations from the blinded CGM pre-randomization phase

Who cannot join

  • Individuals meeting any of the following exclusion criteria at baseline will be excluded from study participation.
  • Use of unblinded CGM, outside of a research study, as part of real-time diabetes management in the last 3 months
  • At least 10% of time spent with sensor glucose levels < 54 mg/dl during the blinded CGM screening period AND a severe hypoglycemic event in the past 6 months (a severe hypoglycemic event that required assistance of another person due to altered consciousness, and required another person to actively administer carbohydrate, glucagon, or other resuscitative actions (see section 8.1).
  • Extreme visual or hearing impairment that would impair ability to use real-time CGM assessed at screening visit
  • Known adhesive allergy or skin reaction during the blinded CGM pre-randomization phase that would preclude participation in the randomized trial
  • Plans to begin non-insulin medication for blood glucose lowering during the course of the study
Show all 13Show fewer
  • Stage 4 or 5 renal disease or most recent GFR < 30 ml/min/m2 from local lab within the past 6 months
  • The presence of a significant medical or psychiatric condition or use of a medication that in the judgment of the investigator may affect completion of any aspect of the protocol, or is likely to be associated with life expectancy of <1 year.
  • Clinical diagnosis of dementia (cognitive impairment that is mild and not considered sufficient for diagnosis of dementia is acceptable)
  • Need for use of acetaminophen or acetaminophen-containing products on a regular basis during the 6 months of the trial (unless stipulation no longer required with use of newer generation sensors)
  • Inpatient psychiatric treatment in the past 6 months
  • Participation in an intervention study (including psychological studies) in past 6 weeks.
  • Expectation that participant will be moving out of the area of the clinical center during the next 6 months, unless the move will be to an area served by another study center.

Trial locations and contacts

22 sites in 1 country.

22 sites in 1 country

United States22 sites
  • University of Michigan

    Ann Arbor, Michigan, 48105

  • Atlanta Diabetes Associates

    Atlanta, Georgia, 30318

  • University of Colorado - Barbara Davis Center

    Aurora, Colorado, 80045

  • University of Southern California

    Beverly Hills, California, 90211

  • University of North Carolina

    Chapel Hill, North Carolina, 27517

  • Northwestern University

    Chicago, Illinois, 60611

  • University of Chicago

    Chicago, Illinois, 60637

  • Henry Ford Health System

    Detroit, Michigan, 48202

  • Scripps Whittier Diabetes Institute

    La Jolla, California, 92037

  • University of Miami

    Miami, Florida, 33136

  • International Diabetes Center

    Minneapolis, Minnesota, 55416

  • Icahn School of Medicine at Mount Sinai

    New York, New York, 10029

  • Columbia University - Naomi Berrie Diabetes Center

    New York, New York, 10032

  • Florida Hospital Diabetes Institute

    Orlando, Florida, 32804

  • University of Pennsylvania

    Philadelphia, Pennsylvania, 19104

  • Oregon Health & Science University

    Portland, Oregon, 97239

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • University of Washington Diabetes Care Center

    Seattle, Washington, 98105

  • Washington University

    St Louis, Missouri, 63110

  • SUNY Upstate Medical University

    Syracuse, New York, 13210

  • Iowa Diabetes and Endocrinology Research Center

    West Des Moines, Iowa, 50265

  • University of Massachusetts

    Worcester, Massachusetts, 01655

Other trials in United States

About this study

Official title: Wireless Innovation for Seniors With Diabetes Mellitus (WISDM)

The primary objective of the study is to determine if CGM can reduce hypoglycemia and improve quality of life in older adults with T1D.

Read the detailed description

Reducing hypoglycemia is an important aspect of management of T1D in older adults, many of whom have hypoglycemic unawareness, cognitive impairment, or both. CGM offers the opportunity to reduce hypoglycemia and its related complications such as fractures from falls and hospitalizations and improve quality of life including reducing hypoglycemic fear and diabetes distress. Despite these potential benefits, CGM is used by only a small proportion of older adults with T1D. Previous studies assessing CGM efficacy have included only a small number of adults ≥ 60 years of age, excluded patients most prone to severe hypoglycemia, focused on improving HbA1c rather than hypoglycemia, and used older generation CGM sensors. These studies are not generalizable to the population of older adults with T1D. The potential benefit of CGM in reducing hypoglycemia in the older adult population has not been well studied. The goal of this study is to assess the potential benefits and risks of CGM in older adults with T1D.

Being tested
Dexcom CGM
Medical subject headings
Diabetes Mellitus, Type 1

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dexcom CGMDevice

    CGM group will be instructed on how to utilize the CGM data for diabetes management. Participants will be encouraged to use CGM values for making diabetes management decisions and will be provided guidelines for when to confirm with a study BGM fingerstick.

Study groups in NCT03240432
Study groupRoleWhat they receive
Continuous Glucose Monitor groupActive comparatorCGM group participants will be asked to use a Dexcom CGM sensor on a daily basis, inserting a new sensor as needed. Participants will be instructed to use the sensor according to FDA labeling. In addition, participants will be advised to check the blood glucose when symptoms or expectations do not match the CGM reading. Participants will have clinic visits at 10 days, 4 weeks, 8 weeks, 16 weeks, and 26 weeks.
Receives: Device: Dexcom CGM
Blood Glucose Meter groupNo interventionBGM group participants will be asked to use a study blood glucose meter with test strips for a fingerstick blood glucose check with a recommendation of 4 times a day. Participants will be permitted to check a fingerstick glucose as many times a day as they choose. Participants will have a phone visits at 10 days and clinic visits at 4 weeks, 8 weeks, 16 weeks, and 26 weeks. In addition to the in-clinic study visits, the BGM group will have blinded sensor placement visits one week prior to each of the 8, 16, and 26 week visits.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Time spent with glucose level <70 mg/dL

    The primary outcome will be a treatment group comparison of the percentage of sensor values in the hypoglycemic range (<70 mg/dL), adjusted for the baseline values and factors used to stratify randomization in a regression model. Residual values will be examined for an approximate normal distribution. If values are highly skewed, then a transformation or non-parametric methods will be used instead. The BGM Group will be wearing a blinded CGM for one week at 3 time points in the study (in addition to baseline). For analysis, sensor data from the CGM Group will be used from these same time periods to match up with the blinded CGM placed for the BGM Group. The CGM data will be pooled across each time point of CGM data collection for the primary analysis.

    Measured: 6 months (26 weeks) from baseline

Secondary outcomes (10)
  1. Change in HbA1c

    Mean ± SD values for the change in HbA1c from baseline to 26-weeks with 95% confidence intervals or percentiles appropriate to the distribution will be computed for each randomization group and compared in a regression model adjusted for baseline level and factors used to stratify randomization.

    Measured: 6 months (26 weeks) from baseline

  2. Change in QOL: Preferring Hypoglycemia Scale

    Mean ± SD values for the change in total score from baseline to 26-weeks with 95% confidence intervals or percentiles appropriate to the distribution will be reported for each randomization group, and compared in linear regression models adjusted for baseline level and factors used to stratify randomization.

    Measured: 6 months (26 weeks) from baseline

  3. Change in QOL: Blood glucose Monitoring Satisfaction Questionnaire

    Mean ± SD values for the change in total score from baseline to 26-weeks with 95% confidence intervals or percentiles appropriate to the distribution will be reported for each randomization group, and compared in linear regression models adjusted for baseline level and factors used to stratify randomization.

    Measured: 6 months (26 weeks) from baseline

  4. Change in QOL: Hypoglycemia Fear Survey

    Mean ± SD values for the change in total score from baseline to 26-weeks with 95% confidence intervals or percentiles appropriate to the distribution will be reported for each randomization group, and compared in linear regression models adjusted for baseline level and factors used to stratify randomization.

    Measured: 6 months (26 weeks) from baseline

  5. Change in QOL: Diabetes Distress Questionnaire

    Mean ± SD values for the change in total score from baseline to 26-weeks with 95% confidence intervals or percentiles appropriate to the distribution will be reported for each randomization group, and compared in linear regression models adjusted for baseline level and factors used to stratify randomization.

    Measured: 6 months (26 weeks) from baseline

  6. Change in QOL: PROMIS Measures for QOL

    Mean ± SD values for the change in total score from baseline to 26-weeks with 95% confidence intervals or percentiles appropriate to the distribution will be reported for each randomization group, and compared in linear regression models adjusted for baseline level and factors used to stratify randomization.

    Measured: 6 months (26 weeks) from baseline

  7. Change in QOL: NIH Cognitive Toolbox

    Mean ± SD values for the change in total score from baseline to 26-weeks with 95% confidence intervals or percentiles appropriate to the distribution will be reported for each randomization group, and compared in linear regression models adjusted for baseline level and factors used to stratify randomization.

    Measured: 6 months (26 weeks) from baseline

  8. Change in QOL: NIH Emotions Toolbox

    Mean ± SD values for the change in total and composite score from baseline to 26-weeks with 95% confidence intervals or percentiles appropriate to the distribution will be reported for each randomization group, and compared in linear regression models adjusted for baseline level and factors used to stratify randomization.

    Measured: 6 months (26 weeks) from baseline

  9. Time spent with glucose level <60 mg/dL

    Analyses will be similar to the primary objective.

    Measured: 6 months (26 weeks) from baseline

  10. Time spent with glucose level <54 mg/dL

    Analyses will be similar to the primary objective.

    Measured: 6 months (26 weeks) from baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Aug 2017
  2. Study start26 Sep 2017
  3. Primary completion6 Jun 2019
  4. Study completion10 Sep 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
200 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03240432
Sponsor's protocol ID
WISDM
Acronym
WISDM
Status last verified
Sep 2019
First submitted
26 Jul 2017
Last updated
12 Sep 2019
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes

Publications

  • Miller KM, Kanapka LG, Rickels MR, Ahmann AJ, Aleppo G, Ang L, Bhargava A, Bode BW, Carlson A, Chaytor NS, Gannon G, Goland R, Hirsch IB, Kiblinger L, Kruger D, Kudva YC, Levy CJ, McGill JB, O'Malley G, Peters AL, Philipson LH, Philis-Tsimikas A, Pop-Busui R, Salam M, Shah VN, Thompson MJ, Vendrame F, Verdejo A, Weinstock RS, Young L, Pratley R. Benefit of Continuous Glucose Monitoring in Reducing Hypoglycemia Is Sustained Through 12 Months of Use Among Older Adults with Type 1 Diabetes. Diabetes Technol Ther. 2022 Jun;24(6):424-434. doi: 10.1089/dia.2021.0503. Epub 2022 Apr 11.

    PubMed 35294272
  • Pratley RE, Kanapka LG, Rickels MR, Ahmann A, Aleppo G, Beck R, Bhargava A, Bode BW, Carlson A, Chaytor NS, Fox DS, Goland R, Hirsch IB, Kruger D, Kudva YC, Levy C, McGill JB, Peters A, Philipson L, Philis-Tsimikas A, Pop-Busui R, Shah VN, Thompson M, Vendrame F, Verdejo A, Weinstock RS, Young L, Miller KM; Wireless Innovation for Seniors With Diabetes Mellitus (WISDM) Study Group. Effect of Continuous Glucose Monitoring on Hypoglycemia in Older Adults With Type 1 Diabetes: A Randomized Clinical Trial. JAMA. 2020 Jun 16;323(23):2397-2406. doi: 10.1001/jama.2020.6928.

    PubMed 32543682

Questions about this trial

What is this clinical trial studying?

A study testing Dexcom CGM in people with Type 1 Diabetes Mellitus, run by Jaeb Center for Health Research at 22 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 15 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Sep 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 22 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Time spent with glucose level <70 mg/dL (time frame: 6 months (26 weeks) from baseline). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03240432, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Sep 2019.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in