A Study Called SMART-Finder to Look for People With Increased Amounts of Albumin in the Urine (UACR Level) in a Group of Type 2 Diabetes Mellitus Patients

Study Overview
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Brief Summary
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This is an observational study in which data from people with type 2 diabetes mellitus (T2DM) in Germany who use the medical app myTherapy are studied. In observational studies, only observations are made without specified advice or interventions. In people with T2DM, the body does not make enough of a hormone called insulin or does not use insulin well enough. The resulting high blood sugar level can cause damage to the kidneys over time. As a result, chronic kidney disease (CKD) can occur as a complication of T2DM. Kidneys filter extra water and waste out of the blood and make urine. CKD is a long-term, progressive decrease in the kidneys' ability to properly filter the blood. Abnormal amounts of proteins such as albumin in the urine are a sign of kidney damage, as proteins are normally kept in the blood. The amount of albumin in the urine is measured as so-called urine-albumin-creatinine-ratio (UACR) in this study. Studies in people with T2DM and CKD in a real-world care setting are limited, particularly those that look at the number of people concerned over time. The main purpose of this study is to learn how many people with T2DM have also increased amounts of albumin in the urine (UACR level) in users of the medical app myTherapy in Germany. In addition, researchers want to learn how these albumin levels change over time. To answer this, the researchers will collect the participant's UACR level at start of the study and about 12 months later. The UACR is measured by the participant's physician during routine care using urine dip-sticks. All participants of this study are already receiving or will receive one of the available T2DM treatments prescribed by their doctors according to the approved use or are regularly using devices to check their blood sugar levels. And they use the myTherapy app to support and track their T2DM therapy. The data collected includes both participant-reported data and physician-provided lab values. All data are entered into the myTherapy app by the participant. They will be collected from October 2022 to December 2024 and cover a period of up to 15 months per participant. Besides this data collection, no further tests or examinations are planned in this study.

Official Title
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SMART-Finder - Identification of Patients With Elevated UACR Levels in a T2DM Cohort

Conditions
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Type 2 Diabetes Mellitus, Chronic Kidney Disease

Intervention / Treatment
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* Drug: Finerenone (Kerendia, BAY94-8862)
* Drug: Type 2 DM drugs


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients participating in the Chronic Kidney Disease (CKD) awareness program within myTherapy App Patient self-reported diagnosis of Type 2 Diabetes Mellitus Patients tracking their adherence for at least one of the following drug containing medical products/devices within myTherapy App: Metformin, Acarbose, Dipeptidyl peptidase (DDP)-4 inhibitors, Glucagon-like peptide (GLP) inhibitors, RAS inhibitors, Sodium-dependent glucose transporters 2 (SGLT2) inhibitors, Basal insulin, Finerenone (once available in Germany), Sulfonylurea, Glucose test strips Adult (≥ 18 years) female, male or diverse patient Signed informed consent Exclusion Criteria: Patient self-reported diagnosis of Type 1 Diabetes Mellitus Patients tracking their adherence for at least one of the following medical products: Insulin pump

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Type 2 Diabetes Mellitus patients<br>MyTherapy App users with Self-reported Type 2 Diabetes Mellitus who had been prescribed drugs for their T2DM. | Drug: Finerenone (Kerendia, BAY94-8862)<br>* Following the physicians' decision.<br>Drug: Type 2 DM drugs<br>* Following the physicians' decision<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with Urine albumin-creatinine ratio (UACR) values between 30 and 299 mg/g and above 300 mg/g | The urine albumin-creatinine ratio (UACR) measured by a healthcare professional and provided to the patient | Up to 15 months after the date the initial UACR test took place | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients changing their UACR values regarding their baseline Albumin-Creatinine-Ratio (ACR) classification. |  | Up to 15 months after the date the initial UACR test took place | 
| Number of patients with hypertension and nephrotoxic co-medication |  | 12 month previous informed consent date until end of observation | 
| Mean EuroQol-5 Dimensions (EQ-5D) |  | Up to 15 months after the date the initial UACR test took place | 
| Diabetes Treatment Satisfaction Questionnaire (DTSQ) |  | Up to 15 months after the date the initial UACR test took place | 
| Number of patients with CKD, Hypertension, Type 2 Diabetes Mellitus and tobacco use |  | Up to 15 months after the date the initial UACR test took place | 
| Adherence - number of patients compliant and persistent in the observation period | Patients included: documenting at least 80% of the expected medication tracked in myTherapy App (compliance), and not stopping using their medication (persistence). | 12 month previous informed consent date until end of observation | 
| Number of Health Care Professionals (HCPs) providing UACR to patients |  | Up to 15 months after the date the initial UACR test took place | 
| Location of HCP |  | Up to 15 months after the date the initial UACR test took place |