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Type1 Diabetes MellitusPOWER2DMECNCT03588104

"POWER2DM Evaluation Campaign"

A study testing POWER2DM system in people with Type1 Diabetes Mellitus and Type2 Diabetes Mellitus, run by Leiden University Medical Center at 2 sites in 2 countries.

Completed

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

Official record
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Trial summary

Rationale: Hyperglycaemia is an important cause of long-term macro-and microvascular complications in all patients with diabetes mellitus. However, only a small fraction of the patients with diabetes reaches the set target of glycemic control. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
POWER2DM system
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
222 participants
Where
2 sitesin 2 countries
Study dates
3 Dec 2018to 31 Dec 2020
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosed T2DM or T1DM
  • Able to self-monitor and work with computer and smart phone with internet connections (as assessed by researcher)

Who cannot join

  • Severe renal insufficiency (eGFR<30ml/min)
  • Serious/severe comorbidity that interferes with diabetes outcomes or diabetes self-management including but not limited to: psychiatric diseases, chronic hepatopathy, active malignancy, chronic obstructive pulmonary disease (COPD), disease of the digestive tract, endocrine disorders, cerebrovascular disease with disability
  • For female participants: pregnancy or wanting to become pregnant in the coming 9 months
  • Concurrent participation in other clinical trials
  • Any other situation in which the investigator identifies a potential risk of not being able to perform the study.

Trial locations and contacts

2 sites in 2 countries.

2 sites in 2 countries

Netherlands1 site
  • Leiden University Medical Centre

    Leiden, South Holland, 2333 ZA

Other trials in Netherlands

Spain1 site
  • Reina Sofia University Hospital

    Córdoba, 14004

Other trials in Spain

About this study

Official title: Evaluation of the POWER2DM Diabetes Self-Management Support System Compared With Usual Care for Patients With Diabetes

Rationale: Hyperglycaemia is an important cause of long-term macro-and microvascular complications in all patients with diabetes mellitus. However, only a small fraction of the patients with diabetes reaches the set target of glycemic control. Problems with adequate self-management usually underlie problems to maintain glycaemic control. Thus, patients need more support in order to reduce the burden and increase the effectiveness of their diabetes self-management. One way to do this is by using integrated technologies and personalized plans for diabetes care. For this purpose, the POWER2DM support system was developed to give patients insight into their condition and support diabetes patients and their health care professionals in setting and achieving self-management goals using predictive computer model simulations and behavioural action plans.

Objective: To provide proof of concept that POWER2DM is safe and effective in improving glycaemic control, improving behavioural/psychosocial and lifestyle markers, and to assess the cost-effectiveness of the approach and to highlight any potential issues that may impede implementation.

Read more

Study design: This is a pragmatic randomised controlled trial with 9 months follow-up in which patients will be randomised 1:1 to either Power2DM support (Power2DM group) or usual care (usual care group). There will be evaluation moments at baseline, after 11 weeks, 22 weeks and 37 weeks.

Study population: 230 patients with diabetes (N=115 type 1 diabetes (T1D), N=115 type 2 diabetes (T2D)) recruited from out-patient clinics in the Netherlands (Leiden University Medical Centre and affiliating teaching hospitals N=115) and Córdoba, Spain (Reina Sofia University Hospital N=115).

Intervention: The POWER2DM support group will receive access to the prototype 2 of the POWER2DM system. This system consists of two components: 1) the web-based Shared Decision Making Dashboard, used to set self-management goals together with a health care professional with the use of both short- and long-term predictive computer simulation models, and 2) the POWER2DM Self-Management Support System as a mobile application and webpage, used to support behavioural change in DM self-management. The system is fed with data from an activity tracker, a glucose monitor and manual data entry.

Main study parameters/endpoints: Change in glucose regulation as measured by %HbA1c before and after the intervention compared between the intervention and control group.

Being tested
POWER2DM system, Usual care
Keywords
Electronic Health (eHealth)
Medical subject headings
Diabetes Mellitus, Health Behavior

What participants receive

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

  • POWER2DM systemDevice

    This system consists of two components: 1) the web-based Shared Decision Making Dashboard, used to set self-management goals together with a health care professional with the use of both short- and long-term predictive computer simulation models, and 2) the POWER2DM Self-Management Support System as a mobile application and webpage, used to support behavioural change in DM self-management. The system is fed with data from an activity tracker, a glucose monitor and manual data entry. Power2DM support will be provided as an adjunct to usual care

  • Usual careOther

    Usual care as given to diabetes patients by the patient's diabetes care team.

Study groups in NCT03588104
Study groupRoleWhat they receive
POWER2DM support groupExperimentalParticipants in this group will receive access to the POWER2DM system as an adjunct to usual care. The participants have three intervention visits in which they will use the Shared Decision Making Dashboard to set self-management goals and will use the Self-Management Support system for trying to reach those goals in the periods after the intervention visits.
Receives: Device: POWER2DM system
Usual care groupActive comparatorParticipants in this group will follow their usual diabetes care with their own diabetes care team.
Receives: Other: Usual care

What is being measured

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

  1. Change in glycemic control

    Change in HbA1c before and after the intervention compared between the intervention and control group

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

Secondary outcomes (28)
  1. Amount hypoglycemia

    Amount of hypoglycemia measured by time spent in hypoglycaemia before and after treatment in the Power2DM group compared to the usual care control group

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  2. Hypo unawareness

    Hypo unawareness as measured by Clarke's hypo unawareness questionnaire, before and after treatment in the Power2DM group compared to the usual care control group

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  3. Incidence of adverse events

    Incidence of adverse events occurring during the study period including serious hypoglycemic events

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  4. Mean blood glucose (MBG)

    As derived from continuous glucose measurements by a flash glucose monitoring (FGM) device

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  5. Standard deviation of MBG (SDBG)

    As derived from continuous glucose measurements by a FGM device

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  6. Largest amplitude of glycemic excursions (LAGE)

    As derived from continuous glucose measurements by a FGM device

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  7. Mean amplitude of glycemic excursions (MAGE)

    As derived from continuous glucose measurements by a FGM device

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  8. Absolute means of daily differences (MODD)

    As derived from continuous glucose measurements by a FGM device

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  9. Time spent in range

    As derived from continuous glucose measurements by a FGM device

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  10. ADVANCE Cardiovascular risk

    The ADVANCE Cardiovascular Risk Engine, calculates the risk of major cardiovascular disease in patients with type 2 diabetes for the next 4 years (range 0-100%). This is defined as fatal or non-fatal myocardial infarction, stroke or cardiovascular death.

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  11. ADVANCE Kidney disease Risk

    The ADVANCE Kidney Risk Engine, calculates the risk of new-onset albuminuria and major kidney-related events in patients with type 2 diabetes for the next 5 years (range 0-100%). Major kidney-related events are defined as doubling of serum creatinin to >2.26mg/dL, renal replacement therapy, or renal death.

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  12. Major Outcomes T1D

    The Major Outcomes T1D risk score assess the 3, 5 and 7 year risk of a patient with type 1 diabetes on major outcomes (range 0-100%). These outcomes included major coronary heart disease, stroke, end-stage renal failure, amputations, blindness and all-cause death.

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  13. UKPDS risk score

    The UKPDS risk score calculated the risk a patient with type 2 diabetes will develop coronary heart disease, fatal coronary hear disease, stroke or fatal stroke (range 0-100%)

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  14. Q score

    The Q score is a single metric for a continuous glucose monitoring (CGM) profile which summarize the glucose profile using five factors: central tendency, hyperglycemia, hypoglycemia, intra- and inter daily variations.

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  15. Amount of steps

    Average amount of steps per day over a week measured by a step counter

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  16. Self-reported exercise time

    Exercise time per week as reported in the POWER2DM system

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  17. Frequency of self-monitoring of blood glucose (SMBG) measurements

    Frequency of SMBG measurements as reported by the glucose measurement device

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  18. Self-reported adherence to medication plan

    Self-reported adherence to medication plan as reported in the POWER2DM system

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  19. Weight

    Weight in kilograms measured on a scale

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  20. Body mass index (BMI)

    BMI in kg/m2, computed from height and weight

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  21. Diabetes Self-Management Questionnaire Revised (DSMQ-R)

    Subscales: Glucose Management, Dietary Control, Physical Activity, Health Care Use Transformed scale scores can vary between 0-10, with higher scores indicating more effective self-care

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  22. Patient utilities by EQ-5D

    No subscales: EQ-5D provides a general health index with higher scores indicating better general health. QALYs will be calculated from EQ-5D scores.

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  23. Problem Areas in Diabetes (PAID)

    The PAID provides a total diabetes distress score (0-100), with higher scores (> 40) indicating more distress.

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  24. Mood/Well-being by WHO-5 and Patient Health Questionnaire (PHQ-9)

    WHO-5 provides a total score (0-100) with higher scores indicating better wellbeing, PHQ-9 provides a total score (1-27) indicating a likelihood of depression, with higher scores indicating more depressive symptoms

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  25. Technology Acceptance Questionnaire (TAQ)

    The TAQ provides scores (1-7) on the following domains: Performance expectancy, Effort expectancy, Social influence, Facilitating conditions, Affect, Self-efficacy, Trust, Motivation and Behavioural intention. Higher scores indicate better acceptance of the system.

    Measured: 5 weeks and 37 weeks

  26. Cost-effectiveness

    Costs/quality adjusted life years (QALYs) Costs assessed via cost questionnaire and medication registry. QALYs based on patient utilities measured via EQ5D.

    Measured: Over 37 weeks

  27. Stress by perceived Stress Scale (PSS)

    The PSS provides a total perceived stress score (0-40), with higher scores indicating more perceived stress.

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

  28. Patient Assessment of Chronic Illness Care (PACIC)

    The PACIC measures the patient's perception of the care that they receive.

    Measured: 0 weeks, 11 weeks, 22 weeks and 37 weeks

Timeline

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

  1. First posted17 Jul 2018
  2. Study start3 Dec 2018
  3. Primary completion31 Oct 2020
  4. Study completion31 Dec 2020

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Pragmatic randomised trial
Masking
None (open label)
Enrolment
222 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03588104
Sponsor's protocol ID
P17.280
Acronym
POWER2DMEC
Status last verified
Mar 2024
First submitted
28 May 2018
Last updated
13 Mar 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Ruissen MM, Torres-Pena JD, Uitbeijerse BS, Arenas de Larriva AP, Huisman SD, Namli T, Salzsieder E, Vogt L, Ploessnig M, van der Putte B, Merle A, Serra G, Rodriguez G, de Graaf AA, de Koning EJP, Delgado-Lista J, Sont JK; POWER2DM Consortium. Clinical impact of an integrated e-health system for diabetes self-management support and shared decision making (POWER2DM): a randomised controlled trial. Diabetologia. 2023 Dec;66(12):2213-2225. doi: 10.1007/s00125-023-06006-2. Epub 2023 Sep 29.

    PubMed 37775611

Questions about this trial

What is this clinical trial studying?

A study testing POWER2DM system in people with Type1 Diabetes Mellitus and Type2 Diabetes Mellitus, run by Leiden University Medical Center at 2 sites in 2 countries.

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 2 inclusion and 5 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 13 Mar 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Netherlands, Spain. 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?

Change in glycemic control (time frame: 0 weeks, 11 weeks, 22 weeks and 37 weeks). 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 NCT03588104, which also lists 1 linked publication.

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 13 Mar 2024.

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