DiabetesNCT06775288
Hypoglycemia Prevention and Awareness Program
A study testing Hypoglycemia prevention and awareness program (HypoPAP) in people with Diabetes and Hypocalcemia, run by Merve DerviAYoAYlu at 1 site in Turkey (Türkiye).
Trial summary
The aim of this project is to examine the effects of the Hypoglycemia Prevention and Awareness Program (HypoPAP) on patient outcomes, including metabolic, psychological, social, and economic parameters, in individuals with type 2 diabetes and impaired hypoglycemia awareness. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Diabetes, Hypocalcemia, Telehealth
- What is being tested?
- Hypoglycemia prevention and awareness program (HypoPAP)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 62 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Nov 2024to 15 Apr 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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
- Being 18 years of age and older
- Being able to communicate in Turkish
- Being diagnosed with type 2 diabetes
- Having used insulin for at least one year
- Having reduced hypoglycemia awareness
- Being willing to participate in the study
- Having and being able to use information technology products (telephone, computer).
Who cannot join
- Having visual, auditory, cognitive impairment
- Having a condition that prevents communication
- Not being able to use information technology products
- Having chronic renal failure, chronic vascular disease, chronic liver disease, cancer
- Pregnancy
- Endocrine and eating disorders
- Individuals who do not agree to participate in the study
- Do not meet the inclusion criteria will not be included.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effect of Hypoglycemia Prevention and Awareness Program (HypoPAP) on Patient Outcomes: Randomized Controlled Trial
The aim of this project is to examine the effects of the Hypoglycemia Prevention and Awareness Program (HypoPAP) on patient outcomes, including metabolic, psychological, social, and economic parameters, in individuals with type 2 diabetes and impaired hypoglycemia awareness.
Through the interventions provided to participants, the study aims to achieve the following improvements:
Read more
- Physiological parameters: Enhanced glycemic control, reduced hypoglycemia frequency, improved hypoglycemia awareness, and optimized HbA1c levels.
- Psychological parameters: Reduced fear of hypoglycemia, increased hypoglycemic confidence, and improved attitudes toward hypoglycemia management.
- Social parameters: Decreased social withdrawal due to fear of hypoglycemia, as assessed through relevant items in validated scales.
- Economic parameters: Reduced frequency of hospitalizations and emergency department visits.
Overall, the program seeks to enhance participants' ability to prevent and manage hypoglycemia, thereby improving their overall well-being.
Read the detailed description
Optimal diabetes management is a delicate balance between treating hyperglycemia and avoiding the risk of sudden hypoglycemia. Hypoglycemia is a common, recurring, feared, and neglected complication among endocrine emergencies in individuals with diabetes. Intensive glycemic control is very important in preventing microvascular and macrovascular complications of diabetes. However, hypoglycemia is a significant obstacle to effective treatment. Individuals with diabetes experience many chronic microvascular and macrovascular complications. The most challenging and frightening complication for individuals with diabetes and their families is hypoglycemia. Diabetics are afraid of experiencing hypoglycemia, and fear of hypoglycemia is a significant obstacle to achieving normoglycemia. Hypoglycemia in individuals with type 2 diabetes often occurs due to errors in self-management. Hypoglycemia limits the physical activities and daily living activities of individuals with diabetes. Hypoglycemia, which negatively affects the physiological and psychological health of individuals with diabetes, also reduces the quality of life of patients and their families. Hypoglycemia is also the most important limitation of diabetes treatment. As the severity of hypoglycemia increases, the quality of life of patients decreases. Approximately 25% of patients with type 2 diabetes treated with insulin for more than five years experience severe hypoglycemia. Impaired awareness of hypoglycemia is the weakening of the ability to perceive warning signs during hypoglycemia. Impaired awareness of hypoglycemia is associated with a 6- to 9-fold increase in the risk of severe hypoglycemia. Recurrent hypoglycemia, defined as the occurrence of more than one hypoglycemic event, increases the risk of severe hypoglycemia, and this also reduces hypoglycemia awareness. Before implementing strategies to help increase hypoglycemia awareness in individuals with diabetes, it is important to identify individuals who are at risk for severe hypoglycemia or have decreased hypoglycemia awareness. The risk of severe hypoglycemia is highest in individuals who have had a severe hypoglycemic episode in the past or in patients with reduced awareness of hypoglycemia. Comprehensive interventions need to be developed to increase hypoglycemia awareness in diabetic patients. While structured and comprehensive hypoglycemia awareness training is limited even for individuals with type 1 diabetes in the literature, there is no training program specifically developed for type 2 diabetes. In line with this information, it is necessary to develop a structured training program for individuals with type 2 diabetes and reduced hypoglycemia awareness and evaluate its effectiveness. Therefore, the aim of this study is to examine the effect of the hypoglycemia prevention and awareness program (HypoPAP) on patient outcomes in individuals with type 2 diabetes with decreased hypoglycemia awareness. The study was planned as a randomized controlled study.
- Conditions
- Diabetes, Hypocalcemia, Telehealth, Nursing Care, Nursing Education
- Being tested
- Hypoglycemia prevention and awareness program (HypoPAP)
- Keywords
- hypoglycemia awareness, , telehealth, hypoglycemia, type 2 diabetes, nursing care
- Medical subject headings
- Diabetes Mellitus, Hypocalcemia, Hypoglycemia, Diabetes Mellitus, Type 2
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Hypoglycemia prevention and awareness program (HypoPAP)Other
Online hypoglycemia prevention and awareness training Supporting the prevention of hypoglycemia with the use of evidence-based diabetes-friendly plates Encouraging physical activity and supporting glycemic control with a pedometer Filling in a weekly problem-solving notebook Conducting weekly online problem-solving meetings Online counseling service when needed
| Study group | Role | What they receive |
|---|---|---|
| Experimental Group | Experimental | 3 months Hypoglycemia Prevention and Awareness Program Receives: Other: Hypoglycemia prevention and awareness program (HypoPAP) |
| Control Group | No intervention | 3 months follow-up |
What is being measured
The primary outcome is the main question the study is designed to answer.
Hypoglycemic Confidence Scale
The Hypoglycemic Confidence Scale is a nine-item self-report scale developed by William Polonsky and colleagues in 2017 that examines the degree to which diabetic patients feel safe and comfortable about their ability to protect themselves from hypoglycemia-related problems. It was developed for use in adults with diabetes (Type 1 and Type 2 using insulin). The Hypoglycemic Confidence Scale focuses on three areas: 1. Self-confidence (e.g., confidence in recognizing and managing hypoglycemia before blood sugar drops too low) 2. Confidence in avoiding hypoglycemia at critical times (e.g., while driving, exercising, and sleeping) 3. An estimate of the confidence of the spouse/partner. The Hypoglycemic Confidence Scale items are scored between 1 and 4 (1; Not at all confident 2; Somewhat confident 3; Moderately confident 4; Very confident). The ninth scale item for diabetic individuals with a spouse was interpreted as: 1; Not at all confident 2; Somewhat confident 3; Moderately confident
Measured: 1 month
Hypoglycemia Fear Scale
The Hypoglycemia Fear Survey-HFS, was used to determine the fear of hypoglycemia in diabetic individuals. This scale consists of two subgroups, behavior and anxiety, and a total of 33 items. The behavior subgroup of this scale consists of 15 items. In the behavior subgroup; diabetic individuals are asked questions about what they have done in their daily lives to prevent their blood glucose levels from falling in the last 6 months. The anxiety subgroup consists of 18 items, and individuals are asked how often they have worried about the items given due to low blood glucose levels in the last 6 months. The answers vary between; "0 points: never; 1 point: rarely; 2 points: sometimes; 3 points often; 4 points: always". A high score indicates a high fear of hypoglycemia.
Measured: 1 month
Hypoglycemia Attitude and Behavior Scale
This scale was prepared for individuals with type 2 diabetes and consists of 14 items. It aims to measure hypoglycemia attitudes and behaviors of individuals with type 2 diabetes in three sub-dimensions: Avoidance (four items), confidence (five items) and anxiety (five items). Anxiety questions individuals' concerns about hypoglycemia. Avoidance questions the attitudes and behaviors adopted to avoid hypoglycemia. Confidence consists of questions aimed at determining the degree of comfort provided by not experiencing problems caused by hypoglycemia. The scale does not have a total score: While the avoidance and anxiety sub-dimensions are scored directly (1 = Strongly disagree, 5 = Strongly agree), the Confidence sub-dimension is scored inversely (1 = Strongly agree, 5 = Strongly disagree).
Measured: 1 month
Hypoglycemia Awareness Questionnaire
The Hypoglycemia Awareness Questionnaire includes questions that evaluate the hypoglycemia awareness of the individuals participating in the study, how often they experience hypoglycemia, the symptoms they experience during hypoglycemia, and how they intervene when these symptoms occur. In the study, the responses of individuals to the question "Can you feel low blood sugar?" are evaluated. Individuals are required to select one of the following responses: "always," "usually," "sometimes," or "never." Patients who only respond "always" are considered to have normal symptomatic awareness of hypoglycemia; those who respond "usually" are defined as having reduced hypoglycemia awareness, and those who respond "sometimes and never" are defined as having no hypoglycemia awareness. The questionnaire is one of the most frequently used assessment questionnaires in the literature for hypoglycemia awareness .
Measured: 1 month
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Jan 2025
- Study start1 Nov 2024
- Primary completion15 Dec 2024
- Study completion15 Apr 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for DiabetesStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Model description
- randomized controlled trial
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 62 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Merve DerviAYoAYlu
- Sponsor type
- University, hospital or other
- Collaborators
- The Scientific and Technological Research Council of Turkey
- Responsible party
- Sponsor-investigator, Merve DerviAYoAYlu, Dokuz Eylul University
- Investigators
- Merve M Dervişoğlu, MSc, Principal investigator, Dokuz Eylul University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06775288
- Sponsor's protocol ID
- DokuzEU-IHH-MD-01
- Status last verified
- Jan 2025
- First submitted
- 4 Jan 2025
- Last updated
- 15 Jan 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 15 Jan 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Hypoglycemia Prevention and Awareness Program (HypoPAP) on Patient Outcomes: Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT06775288
- Acronym / sponsor ID
- DokuzEU-IHH-MD-01
- Conditions
- Diabetes, Hypocalcemia, Telehealth, Nursing Care, Nursing Education
- Keywords
- hypoglycemia awareness, , telehealth, hypoglycemia, type 2 diabetes, nursing care
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 62 participants (estimated)
- Lead sponsor
- Merve DerviAYoAYluUniversity, hospital or other
- Collaborators
- The Scientific and Technological Research Council of Turkey
- Study start
- 1 Nov 2024 (actual)
- Primary completion
- 15 Dec 2024 (actual)
- Study completion
- 15 Apr 2025 (estimated)
- First posted
- 15 Jan 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this project is to examine the effects of the Hypoglycemia Prevention and Awareness Program (HypoPAP) on patient outcomes, including metabolic, psychological, social, and economic parameters, in individuals with type 2 diabetes and impaired hypoglycemia awareness.
Through the interventions provided to participants, the study aims to achieve the following improvements:
- Physiological parameters: Enhanced glycemic control, reduced hypoglycemia frequency, improved hypoglycemia awareness, and optimized HbA1c levels.
- Psychological parameters: Reduced fear of hypoglycemia, increased hypoglycemic confidence, and improved attitudes toward hypoglycemia management.
- Social parameters: Decreased social withdrawal due to fear of hypoglycemia, as assessed through relevant items in validated scales.
- Economic parameters: Reduced frequency of hospitalizations and emergency department visits.
Overall, the program seeks to enhance participants' ability to prevent and manage hypoglycemia, thereby improving their overall well-being.
Detailed description
Optimal diabetes management is a delicate balance between treating hyperglycemia and avoiding the risk of sudden hypoglycemia. Hypoglycemia is a common, recurring, feared, and neglected complication among endocrine emergencies in individuals with diabetes. Intensive glycemic control is very important in preventing microvascular and macrovascular complications of diabetes. However, hypoglycemia is a significant obstacle to effective treatment. Individuals with diabetes experience many chronic microvascular and macrovascular complications. The most challenging and frightening complication for individuals with diabetes and their families is hypoglycemia. Diabetics are afraid of experiencing hypoglycemia, and fear of hypoglycemia is a significant obstacle to achieving normoglycemia. Hypoglycemia in individuals with type 2 diabetes often occurs due to errors in self-management. Hypoglycemia limits the physical activities and daily living activities of individuals with diabetes. Hypoglycemia, which negatively affects the physiological and psychological health of individuals with diabetes, also reduces the quality of life of patients and their families. Hypoglycemia is also the most important limitation of diabetes treatment. As the severity of hypoglycemia increases, the quality of life of patients decreases. Approximately 25% of patients with type 2 diabetes treated with insulin for more than five years experience severe hypoglycemia. Impaired awareness of hypoglycemia is the weakening of the ability to perceive warning signs during hypoglycemia. Impaired awareness of hypoglycemia is associated with a 6- to 9-fold increase in the risk of severe hypoglycemia. Recurrent hypoglycemia, defined as the occurrence of more than one hypoglycemic event, increases the risk of severe hypoglycemia, and this also reduces hypoglycemia awareness. Before implementing strategies to help increase hypoglycemia awareness in individuals with diabetes, it is important to identify individuals who are at risk for severe hypoglycemia or have decreased hypoglycemia awareness. The risk of severe hypoglycemia is highest in individuals who have had a severe hypoglycemic episode in the past or in patients with reduced awareness of hypoglycemia. Comprehensive interventions need to be developed to increase hypoglycemia awareness in diabetic patients. While structured and comprehensive hypoglycemia awareness training is limited even for individuals with type 1 diabetes in the literature, there is no training program specifically developed for type 2 diabetes. In line with this information, it is necessary to develop a structured training program for individuals with type 2 diabetes and reduced hypoglycemia awareness and evaluate its effectiveness. Therefore, the aim of this study is to examine the effect of the hypoglycemia prevention and awareness program (HypoPAP) on patient outcomes in individuals with type 2 diabetes with decreased hypoglycemia awareness. The study was planned as a randomized controlled study.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- randomized controlled trial
| Arm | Type | Receives |
|---|---|---|
| Experimental Group | Experimental | Other: Hypoglycemia prevention and awareness program (HypoPAP)3 months Hypoglycemia Prevention and Awareness Program |
| Control Group | No intervention | –3 months follow-up |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Being 18 years of age and older
- Being able to communicate in Turkish
- Being diagnosed with type 2 diabetes
- Having used insulin for at least one year
- Having reduced hypoglycemia awareness
Key exclusion criteria (8 listed)
- Having visual, auditory, cognitive impairment
- Having a condition that prevents communication
- Not being able to use information technology products
- Having chronic renal failure, chronic vascular disease, chronic liver disease, cancer
- Pregnancy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Hypoglycemia prevention and awareness program (HypoPAP)Online hypoglycemia prevention and awareness training Supporting the prevention of hypoglycemia with the use of evidence-based diabetes-friendly plates Encouraging physical activity and supporting glycemic control with a pedometer Filling in a weekly problem-solving notebook Conducting weekly online problem-solving meetings Online counseling service when needed | Other | Experimental Group |
Primary outcome
Hypoglycemic Confidence Scale
Time frame: 1 month
The Hypoglycemic Confidence Scale is a nine-item self-report scale developed by William Polonsky and colleagues in 2017 that examines the degree to which diabetic patients feel safe and comfortable about their ability to protect themselves from hypoglycemia-related problems. It was developed for use in adults with diabetes (Type 1 and Type 2 using insulin). The Hypoglycemic Confidence Scale focuses on three areas: 1. Self-confidence (e.g., confidence in recognizing and managing hypoglycemia before blood sugar drops too low) 2. Confidence in avoiding hypoglycemia at critical times (e.g., while driving, exercising, and sleeping) 3. An estimate of the confidence of the spouse/partner. The Hypoglycemic Confidence Scale items are scored between 1 and 4 (1; Not at all confident 2; Somewhat confident 3; Moderately confident 4; Very confident). The ninth scale item for diabetic individuals with a spouse was interpreted as: 1; Not at all confident 2; Somewhat confident 3; Moderately confident
Hypoglycemia Fear Scale
Time frame: 1 month
The Hypoglycemia Fear Survey-HFS, was used to determine the fear of hypoglycemia in diabetic individuals. This scale consists of two subgroups, behavior and anxiety, and a total of 33 items. The behavior subgroup of this scale consists of 15 items. In the behavior subgroup; diabetic individuals are asked questions about what they have done in their daily lives to prevent their blood glucose levels from falling in the last 6 months. The anxiety subgroup consists of 18 items, and individuals are asked how often they have worried about the items given due to low blood glucose levels in the last 6 months. The answers vary between; "0 points: never; 1 point: rarely; 2 points: sometimes; 3 points often; 4 points: always". A high score indicates a high fear of hypoglycemia.
Hypoglycemia Attitude and Behavior Scale
Time frame: 1 month
This scale was prepared for individuals with type 2 diabetes and consists of 14 items. It aims to measure hypoglycemia attitudes and behaviors of individuals with type 2 diabetes in three sub-dimensions: Avoidance (four items), confidence (five items) and anxiety (five items). Anxiety questions individuals' concerns about hypoglycemia. Avoidance questions the attitudes and behaviors adopted to avoid hypoglycemia. Confidence consists of questions aimed at determining the degree of comfort provided by not experiencing problems caused by hypoglycemia. The scale does not have a total score: While the avoidance and anxiety sub-dimensions are scored directly (1 = Strongly disagree, 5 = Strongly agree), the Confidence sub-dimension is scored inversely (1 = Strongly agree, 5 = Strongly disagree).
Hypoglycemia Awareness Questionnaire
Time frame: 1 month
The Hypoglycemia Awareness Questionnaire includes questions that evaluate the hypoglycemia awareness of the individuals participating in the study, how often they experience hypoglycemia, the symptoms they experience during hypoglycemia, and how they intervene when these symptoms occur. In the study, the responses of individuals to the question "Can you feel low blood sugar?" are evaluated. Individuals are required to select one of the following responses: "always," "usually," "sometimes," or "never." Patients who only respond "always" are considered to have normal symptomatic awareness of hypoglycemia; those who respond "usually" are defined as having reduced hypoglycemia awareness, and those who respond "sometimes and never" are defined as having no hypoglycemia awareness. The questionnaire is one of the most frequently used assessment questionnaires in the literature for hypoglycemia awareness .
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Jan 2025.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Merve M Dervişoğlu, MSc principal investigator
Dokuz Eylul University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Hypoglycemia prevention and awareness program (HypoPAP) in people with Diabetes and Hypocalcemia, run by Merve DerviAYoAYlu at 1 site in Turkey (Türkiye).
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 7 inclusion and 8 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: under way, not looking for participants, as of the sponsor's last update on 15 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). 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?
This study is still under way. Results are not available in the source record yet.
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?
Hypoglycemic Confidence Scale (time frame: 1 month). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 15 Jan 2025.