During this study, we propose to assess the utility of Continuous Glucose Measurements (CGM) in a group of Type 1 diabetic patients treated with an implanted insulin pump. Patients will participate in two period of 3 months separated by a 3 months washout. During one period, they will use CGM to adapt their insulin therapy while during the other period, they will manage their diabetes with their usual capillary blood glucose meter. We except to observe an increase of time spent in glucose safe range when using CGM.
Glucose control and quality of life of patients with type 1 diabetes with high glucose variability can be improve with use of an implanted pump which delivers insulin by the intra-peritoneal route. Some patients however still have difficulties to achieve their glycemic goal despite this therapy. Continuous Glucose Measurements (CGM) has proven to be able to improve glucose control (HbA1c, time spent in hypoglycaemia) of patients treated with an external insulin pump. No trial has been performed yet to assess the utility of CGM on patients using an intra-peritoneal insulin delivery. During this study, we propose to assess the influence of CGM use on type 1 diabetic subject treated with implanted insulin pump. It is a prospective, randomized cross-over study. After a 2 weeks run-in period with CGM followed by a 4 weeks break, subjects will participate at two experimental periods of 3 months separated with a 3 month washout. During the intervention phase, patient will use a CGM system (Abbott Freestyle Navigator II) to adapt their insulinotherapy. During the control period, patients will based their insulinotherapy upon their usual care and capillary glucose measurements. The order of the periods will be randomized. The main endpoint will be the time spent in glucose interval 70-180mg/dL during the last 20 days of each period. The control arm will wear a blinded sensor during this phase to allow comparison.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Patients will manage their diabetes with the help of Continuous Glucose Measurements (Abbott Freestyle Navigator II).
Chu de Nancy
Nancy, Vandoeuvre-les-nancy, France
CHU de Bordeaux
Bordeaux, France
CH Sud Francilien
Corbeil-Essonnes, France
CHU de Dijon
Dijon, France
Time spent with glucose
Time spent with glucose between 70-180mg/dL
Time frame: last 20 days of intervention period
HbA1c
HbA1c
Time frame: last 20 days of intervention period
Time spent in hypoglycaemia
Time spent in hypoglycaemia (\<70mg/dL)
Time frame: last 20 days of intervention period
Time spent in hyperglycemia
Time spent in hyperglycemia (\>180mg/dL)
Time frame: last 20 days of intervention period
Time spent in glucose range
Time spent in glucose range \[70-180\] and \[80-140\] mg/dL
Time frame: last 20 days of intervention period
Glucose mean and standard deviation
Glucose mean and standard deviation
Time frame: last 20 days of intervention period
Low Blood Glucose Index (LBGI)
Low Blood Glucose Index (LBGI)
Time frame: last 20 days of intervention period
High Blood Glucose Index (HBGI)
High Blood Glucose Index (HBGI)
Time frame: last 20 days of intervention period
Glucose Variability
Glucose Variability: MARD : Mean Absolute Relative Difference
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Enrollment
15
CHRU de Lille
Lille, France
AP - Hôpitaux de Marseille
Marseille, France
UHMontpellier
Montpellier, France
AP - Hôpitaux de Paris
Paris, France
CHRU de Strasbourg
Strasbourg, France
Chu de Toulouse
Toulouse, France
Time frame: last 20 days of intervention period
Glucose Variability
Glucose Variability: MAGE : Mean Amplitude of Glucose Excursions -MODD : Mean Of daily blood Glucose Difference
Time frame: last 20 days of intervention period
Glucose Variability
Glucose Variability: MODD : Mean Of daily blood Glucose Difference
Time frame: last 20 days of intervention period
Number of symptomatique hypoglycaemia, severe et non severe
Number of symptomatique hypoglycaemia, severe et non severe
Time frame: last 20 days of intervention period
Number of pump programmation
Number of pump programmation
Time frame: last 20 days of intervention period
Percentage of sensor use
Percentage of sensor use
Time frame: last 20 days of intervention period
Score of Quality of Life questionnaire (IDSRQ)
Score of Quality of Life questionnaire (IDSRQ)
Time frame: last 20 days of intervention period