Establishing an International Diabetes Registry Using the DIabetes MONitoring Database (DIAMOND) Electronic Portal (HK012)(CN001)
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Quality diabetes care requires a team approach and informed decisions of patients and care providers. Several lines of evidence suggests that a protocol-driven care model delivered by trained staff with focus on periodic assessments, reinforcement of patient compliance and attainment of multiple treatment targets reduces risk of cardio-renal complications and early death in type 2 diabetes.
The investigators hypothesize that the use of state of the art information technology to record, manage and analyze the large amount of clinical information generated during various consultation visits will improve the effectiveness and efficiency in implementing these care protocols through decision support and regular feedback to both patients and care team.
Condition | Intervention |
---|---|
Diabetes |
Other: JADE Other: DIAMOND |
Study Type: | Interventional |
Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
Official Title: | A Multi-centre Demonstration Project to Evaluate the Effectiveness and Acceptability of the Joint Asia Diabetes Evaluation (JADE) and DIAbetes MONitoring Database (DIAMOND) Programs in Asian Type 2 Diabetic Patients |
- Percentage of patients who attain 2 or more of the 'ABC' targets [ Time Frame: 12 months ] [ Designated as safety issue: No ]
Percentage of patients who attain 2 or more of the following 3 targets:
- HbA1c <7%
- BP <130/80 mmHg
- LDL cholesterol <2.6 mmol/L
- New onset of all diabetes-related endpoints [ Time Frame: 12 months ] [ Designated as safety issue: No ]
This includes;
- cardiovascular endpoints (acute myocardial infarction, revascularisation procedures, heart failure or unstable angina or arrhythmia requiring hospital admissions, lower extremity amputation or foot ulcers)
- chronic kidney disease (eGFR<60 ml/min/1.73m2) and end stage renal disease (dialysis and/or eGFR<30 ; ml/min/1.73m2)
- visual impairment (corrected visual acuity of 20/200 or lower) or eye surgery;
- cancer
- any hospitalization due to complications related to diabetes and/or its treatment (such as hypoglycaemic attacks)
- death
- Quality of Life [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- Frequency of hypoglycaemia (in the last 3 months) [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- Behavioral changes (in the last 3 months) [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- Frequency of Self Blood Glucose Monitoring
- Adherence to balanced eating
- Adherence to regular exercise
- Adherence to recommended procedures (e.g. return for blood tests or education classes)
- Number of hospitalizations, follow up visits by doctors and other care professionals [ Time Frame: 12 months ] [ Designated as safety issue: No ]
- Default rates at end of study [ Time Frame: 12 months ] [ Designated as safety issue: No ]
Estimated Enrollment: | 3600 |
Study Start Date: | March 2010 |
Estimated Study Completion Date: | September 2013 |
Estimated Primary Completion Date: | March 2013 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
Experimental: JADE |
Other: JADE
Patients will receive comprehensive assessments at baseline and again after 12-months. In the interim between these two time points patients will receive protocol-driven diabetes care using a web-based disease management program (JADE), delivered by a trio-team comprising of a trained doctor, nurse and physician assistant.
|
Active Comparator: DIAMOND |
Other: DIAMOND
Patients will receive comprehensive assessments at baseline and again after 12-months. In the interim between these two time points patients will be managed according to 'usual care' procedures.
|
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Ages Eligible for Study: | 18 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Type 2 diabetic patients attending hospitals or affiliated clinics led by PIs of the JADE Program who are living in the area with an intention to have 'regular' follow-up
- Aged >18 years
- Patients can have newly diagnosed or established disease, treated with lifestyle or blood glucose lowering drugs including oral agents with or without insulin
- For newly diagnosed type 2 diabetic patients, their plasma glucose levels should be: a) Fasting plasma glucose (PG) >7.0 mmol/L on 2 or more occasions, and/or b) Random (or post-OGTT 2h) PG >11.1 mmol/L on 2 or more occasions, and/or c) HbA1c >6.5%
Exclusion Criteria:
- Type 1 diabetes defined as a history of ketosis at diagnosis [acute symptoms with heavy ketonuria (>3+) or ketoacidosis] or continuous requirement of insulin within one year of diagnosis
- Patients with reduced life expectancy (e.g. less than 6-months) due to recent diagnosis of advanced cancers (e.g. within last 2 years) and other life threatening conditions
- Patients with a mental condition rendering them unable to understand the nature, scope, and possible consequences of the study
- Patients actively enrolled in another intervention study
- Patients who are unwilling to return for regular follow up
Contact: Juliana Chan, MD | 852 - 2632 3138 | jchan@cuhk.edu.hk |
Contact: Nicola Brown, MSc | nicolabrown@adf.org.hk |
Hong Kong | |
Asia Diabates Foundation | Recruiting |
Shatin, Hong Kong |
Principal Investigator: | Juliana Chan, MD | Asia Diabetes Foundation |
Additional Information:
No publications provided
Responsible Party: | Asia Diabetes Foundation |
ClinicalTrials.gov Identifier: | NCT01274364 History of Changes |
Other Study ID Numbers: | CRE-2010-112 |
Study First Received: | January 9, 2011 |
Last Updated: | June 19, 2012 |
Health Authority: | Hong Kong: Joint CUHK-NTEC Clinical Research Ethics Committee |
Keywords provided by Asia Diabetes Foundation:
Diabetes Structured Care |
Additional relevant MeSH terms:
Diabetes Mellitus Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases |
ClinicalTrials.gov processed this record on October 18, 2012