Clinical trial NCT05453357: Feasibility and Acceptability of a Remote Glucose Monitoring Program for Pregnant Marshallese Women
Official title: Feasibility and Acceptability of a Remote Glucose Monitoring Program for Pregnant Marshallese Women with Pregnancies Complicated by Diabetes
Study type: OBSERVATIONAL
Overall status: WITHDRAWN
Conditions: Diabetes, Gestational
Diabetes Mellitus Type 2 Pre-Existing
Lead sponsor: University of Arkansas
Sponsor class: OTHER
Collaborators: name: National Center for Advancing Translational Sciences (NCATS)
First posted: 2022-07-12
Enrollment: 0
Sex: FEMALE
Minimum age (years): 18
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Twenty Marshallese women with pregestational or gestational diabetes.

Brief summary: The overall objective is to test the feasibility and acceptability of a remote glucose monitoring program among Marshallese women with PGDM (pre-gestational diabetes mellitus) or GDM (gestational diabetes mellitus) and with limited English proficiency.

Detailed description: iGlucose Remote Monitoring System. iGlucose is a remote patient monitoring system. The iGlucose monitor works by analyzing a small amount of blood placed on a strip that is inserted into the monitor, similar to a standard glucometer. The iGlucose monitor will show the patient their glucose reading and will automatically send the patient's glucose reading to a database via cellular networks when the patient removes the strip from the device. The iGlucose monitor does not require any recording on the part of the patient. The iGlucose data is managed through a HIPAA-compliant Amazon Web Services (AWS) database maintained by Smartmeter. The data is available to the provider to monitor the patient's blood glucose levels accurately and in a timely manner, allowing for treatment to be adjusted. The data is available for the physician during every patient contact for review and discussion.

Patients will be provided with the iGlucose monitor at the baseline data collection. A trained bilingual research assistant will review the iGlucose guide with the participant, provide training on the use of the monitor, taking a blood glucose reading with the monitor, and the patient will use the iGlucose monitor once in front of the research assistant. The patient will receive a packet of information in their language of choice (English and/or Marshallese). The packet will include information on how to use the monitor (including the iGlucose Guide) and contact information if there are any problems with the monitor during the study. The patient will use the monitor as instructed by their healthcare team to monitor their blood glucose. The patient will return the equipment at the completion of the study.

The participant will provide their physician's information as part of the study, so that the investigators may provide access to the iGlucose blood glucose readings through the electronic guidebook and contact the physician post-intervention to complete a survey.

Eligibility criteria: Inclusion Criteria:

* Women who self-identify as Marshallese
* 18 years of age or older
* ≤30 weeks pregnant
* Receive prenatal care at University of Arkansas for Medical Sciences (UAMS) and partner clinics and hospitals
* Have used a paper log for at least two weeks
* Have a diagnosis of PGDM (pre-gestational diabetes mellitus) or GDM (gestational diabetes mellitus).

Exclusion Criteria:

* Women who are unable to use a glucometer by themselves
* Have not used a paper log
* Have a continuous glucose monitor
* More than 30 weeks pregnant

Primary outcomes:
measure: Overall Acceptability of Remote Glucose Monitoring
timeFrame: Change in baseline glucose monitoring satisfaction score at two weeks postpartum
measure: Overall Feasibility of Remote Glucose Monitoring
timeFrame: Retention at two weeks postpartum
Secondary outcomes:
measure: Changes in patient-physician communication
timeFrame: Change in baseline Assessment of Care for Chronic Conditions+ (ACC+) score at two weeks postpartum
measure: Changes in self-efficacy
timeFrame: Change in baseline self-efficacy score at two weeks postpartum
Other outcomes:
Locations:
Study officials:
affiliation: University of Arkansas
name: Jennifer A Andersen, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: McElfish PA, Rowland B, Long CR, Hudson J, Piel M, Buron B, Riklon S, Bing WI, Warmack TS. Diabetes and Hypertension in Marshallese Adults: Results from Faith-Based Health Screenings. J Racial Ethn Health Disparities. 2017 Dec;4(6):1042-1050. doi: 10.1007/s40615-016-0308-y. Epub 2016 Nov 11.
citation: Bogdanet D, Egan A, Reddin C, Kirwan B, Carmody L, Dunne F. ATLANTIC DIP: Despite insulin therapy in women with IADPSG diagnosed GDM, desired pregnancy outcomes are still not achieved. What are we missing? Diabetes Res Clin Pract. 2018 Feb;136:116-123. doi: 10.1016/j.diabres.2017.12.003. Epub 2017 Dec 15.
citation: Alexopoulos AS, Blair R, Peters AL. Management of Preexisting Diabetes in Pregnancy: A Review. JAMA. 2019 May 14;321(18):1811-1819. doi: 10.1001/jama.2019.4981.
citation: Sushko K, Menezes HT, Strachan P, Butt M, Sherifali D. Self-management education among women with pre-existing diabetes in pregnancy: A scoping review. Int J Nurs Stud. 2021 May;117:103883. doi: 10.1016/j.ijnurstu.2021.103883. Epub 2021 Jan 20.
citation: American Diabetes Association. 14. Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020 Jan;43(Suppl 1):S183-S192. doi: 10.2337/dc20-S014.
citation: Berger H, Gagnon R, Sermer M, Basso M, Bos H, Brown RN, Bujold E, Cooper SL, Gagnon R, Gouin K, McLeod NL, Menticoglou SM, Mundle WR, Roggensack A, Sanderson FL, Walsh JD. Diabetes in Pregnancy. J Obstet Gynaecol Can. 2016 Jul;38(7):667-679.e1. doi: 10.1016/j.jogc.2016.04.002. Epub 2016 May 12.
citation: Schaefer-Graf U, Napoli A, Nolan CJ; Diabetic Pregnancy Study Group. Diabetes in pregnancy: a new decade of challenges ahead. Diabetologia. 2018 May;61(5):1012-1021. doi: 10.1007/s00125-018-4545-y. Epub 2018 Jan 22.
citation: Goyal S, Cafazzo JA. Mobile phone health apps for diabetes management: current evidence and future developments. QJM. 2013 Dec;106(12):1067-9. doi: 10.1093/qjmed/hct203. Epub 2013 Oct 8.
citation: Guo H, Zhang Y, Li P, Zhou P, Chen LM, Li SY. Evaluating the effects of mobile health intervention on weight management, glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus. J Endocrinol Invest. 2019 Jun;42(6):709-714. doi: 10.1007/s40618-018-0975-0. Epub 2018 Nov 7.
citation: Andersen JA, Scoggins D, Michaud T, Wan N, Wen M, Su D. Racial Disparities in Diabetes Management Outcomes: Evidence from a Remote Patient Monitoring Program for Type 2 Diabetic Patients. Telemed J E Health. 2021 Jan;27(1):55-61. doi: 10.1089/tmj.2019.0280. Epub 2020 Apr 17.
citation: Mora P, Buskirk A, Lyden M, Parkin CG, Borsa L, Petersen B. Use of a Novel, Remotely Connected Diabetes Management System Is Associated with Increased Treatment Satisfaction, Reduced Diabetes Distress, and Improved Glycemic Control in Individuals with Insulin-Treated Diabetes: First Results from the Personal Diabetes Management Study. Diabetes Technol Ther. 2017 Dec;19(12):715-722. doi: 10.1089/dia.2017.0206. Epub 2017 Oct 13.
citation: Diamond L, Izquierdo K, Canfield D, Matsoukas K, Gany F. A Systematic Review of the Impact of Patient-Physician Non-English Language Concordance on Quality of Care and Outcomes. J Gen Intern Med. 2019 Aug;34(8):1591-1606. doi: 10.1007/s11606-019-04847-5. Epub 2019 May 30.