This study is a randomized, controlled, prospective trial with a 6-month follow- up. A newly developed psychoeducational treatment and education programme for diabetic patients on an insulin therapy who use flash glucose monitoring (FGM) will be tested compared to a waiting group. Primary outcome variable is the difference in glycemic control between baseline and the 6-month follow-up. Secondary outcome variables are: time-in-range, frequency and duration of hypo- and hyperglycemic episodes, diabetes-related distress, depressive symptoms, health-related quality of life, diabetes self-efficacy, self-care behavior, and hypoglycemia awareness.
The investigators developed a new psychoeducational treatment and education program - called FLASH - for diabetic patients on an intensive insulin therapy who use flash glucose monitoring (FGM). FLASH is a self-management-based treatment and education program. It is designed to empower patients to adequately use FGM in daily life and to train patients how to analyze their glucose data. FLASH consists of four lessons (90 minutes each). FLASH is tested in a randomized controlled trial (RCT) with a waiting-list control group since no certified and effective treatment and education program for FGM exists. This study is a multi-center study. Study centers are specialized diabetes practices throughout Germany. Patients will be approached by their respective practice and informed about the study. Study measurements as well as the conduct of FLASH will take place at the respective practice. Baseline measurement will take place prior to the beginning of FLASH. After completion of baseline measurement, all patients from one study center will be randomized centrally by the Research Institute of the Diabetes Academy Mergentheim (FIDAM). 2 weeks and 6 months after the completion of FLASH, follow-up measurements will be conducted at the respective study center. HbA1c as a marker of glycemic control will be analyzed in a central laboratory. Time-in-range and the frequency and duration of hypo- and hyperglycemic episodes will be assessed via stored glucose data on patients FGM devices. The other secondary outcome measures will be assessed via psychometrically tested questionnaires or via patient files.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
216
Treatment and education program based on the self-management theory of behavioral medicine. The program is delivered by certified and specially trained diabetes educators.
Diabetes und Stoffwechselpraxis Wetter
Wetter, Germany
Changes in Glycemic Control Measured by A1c
Difference between baseline A1c and A1c at the 6-month follow-up
Time frame: 6 months
Changes in "time-in-range"
Difference in the duration of glycemic values spent between 70 mg/dl and 180 mg/dl between baseline and the 6-month follow-up
Time frame: 6 months
Changes in hypoglycemic episodes
Differences between the frequency of hypoglycemic glucose values (\<70 mg/dl) (baseline vs. follow-up)
Time frame: 6 months
Changes in the duration of hypoglycemic episodes
Differences between the duration of hypoglycemic glucose values (\<70 mg/dl) (baseline vs. follow-up)
Time frame: 6 months
Changes in hyperglycemic episodes
Differences between the frequency of hyperglycemic glucose values (\>180 mg/dl) (baseline vs. follow-up)
Time frame: 6 months
Changes in the duration of hyperglycemic episodes
Differences between the duration of hyperglycemic glucose values (\>180 mg/dl) (baseline vs. follow-up)
Time frame: 6 months
Hypoglycaemia Awareness
The hypoglycemia awareness questionnaire provides a score indicating the severity of hypoglycaemia unawareness. This scale ranges from 0 (maximum hypoglycaemia awareness) to 7 (minimum hypoglycaemia awareness), where a score of 4 suggests reduced hypoglycaemia awareness.
Time frame: 6 months
Diabetes Empowerment
Empowerment is measured by a German version of the Diabetes Empowerment Scale, a measure of diabetes-related psychosocial self-efficacy.
Time frame: 6 months
Diabetes Distress
The Diabetes Distress Scale (DDS-28) assesses diabetes-related stressors due to living and treating diabetes. Different aspects of distress are covered such as hypoglycemia-related distress, physician-related distress
Time frame: 6 months
Problem Areas in Diabetes
The Problem Areas in Diabetes Scale (PAID) assesses the psychosocial adaptation to the burden of living with and treating diabetes.
Time frame: 6 months
Depressive symptoms
The presence and extent of typical depressive symptoms are assessed via self-report.
Time frame: 6 months
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