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Insulin Dose Titration System Using a Short Messaging Service (SMS) Automatically Produced by a Knowledge Matrix

H

Hallym University

Status

Completed

Conditions

Diabetes Mellitus, Type 2

Treatments

Other: Insulin dose titration system using a SMS

Study type

Interventional

Funder types

Other

Identifiers

NCT00948584
2007-I038

Details and patient eligibility

About

The investigators designed the system in type 2 diabetic patients treated with long acting insulin to produce an automatic adjustment of insulin dose based on real time glucose level data and to provide to the patients the needed insulin dose by using a short message service (SMS) and apply to the clinical practice.

Full description

Most patients with type 2 diabetes will, in time, need insulin therapy. Starting insulin poses considerable challenges. Also, improving glycemic control with insulin therapy often requires periodic dose adjustments based on glycemic response. Therefore, how to adjust their insulin doses are very important for improvement of glycemic control. Long acting insulin offers the benefit of a more consistent pharmacological dynamic with less hypoglycemia. Therefore, long acting insulin dose adjustments are widely used by patients based on simplified insulin dosing algorithms.

In the management of diabetes, it is important to maintain an intimate and continuous doctor-patient relationship. To achieve an optimal glucose level and to prevent diabetic complications, frequent contact with a medical doctor is recommended, but this causes an increased amount of medical expense. In recent years, web and phone delivery of self-management programs have emerged as popular approaches to the management of diabetes. The major focus of the system was support for blood glucose monitoring with substantive feedback from expert to help interpret results of glucose-level values. Moreover, with this system the patients could be advised to determine the amount of insulin required. However, despite of using these programs, it can take a significant amount of effort and time for physicians to look over each patient's data, formulate an appropriate message, and send it to the patients. Accordingly, computerized, knowledge-based medical treatment advice systems will provide more abundant medical advices, also can be more economic than the previous systems, in which medical personnel were required for the same process.

Recently we designed an Internet-based diabetic patient management using short message service (SMS) that was automatically produced by a knowledge matrix. Moreover, we reported this unique system has shown the great efficacy in glucose control. In this study, we designed the system in patients treated with long acting insulin to produce an automatic adjustment of insulin dose based on real time glucose level data and to provide to the patients the needed insulin dose by using a SMS and apply to the clinical practice with diabetic patients.

Enrollment

100 patients

Sex

All

Ages

18 to 70 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • patients with type 2 diabetes suboptimally controlled on their previous antidiabetic treatment were included
  • age ≥ 18 years
  • on antidiabetic treatment (any oral and/or insulin therapy) for > 6 months
  • A1C levels > 7.0 and < 12.0%
  • BMI values < 35 kg/m2

Exclusion criteria

  • type 1 diabetes
  • renal dysfunction (defined as creatinine blood level > 2.0 mg/dL)
  • hepatic dysfunction (defined as alanine aminotransferase and/or aspartate aminotransferase blood level > 2.5 times the upper normal limit)
  • hypoglycemic unawareness
  • pregnancy
  • severe retinopathy
  • illiteracy
  • elderly over than 70 yrs

Trial design

Primary purpose

Supportive Care

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

100 participants in 1 patient group

insulin titration by specialized system
Experimental group
Description:
Insulin dose titration system by using a SMS automatically produced by a knowledge matrix
Treatment:
Other: Insulin dose titration system using a SMS

Trial contacts and locations

0

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Data sourced from clinicaltrials.gov

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