Clinical Assessment of an in-Patient Glucose Monitoring System (Accu-Chek Inform Cobas IT 1000)

The principal objective of this single-center 2-period study is to evaluate the glycemic control of in-patients in 3 hospital departments (Diabetology, Cardiology and Pulmonary Care) as the rate of capillary blood glucose measurements within a pre-define target range, and to compare results during the period I (warning of the Accu-Check Inform glucose meter on glucose levels not activated) and...

Date First Received: June 14, 2007

Last Updated: February 26, 2008

Verified by: University Hospital, Grenoble, February 2008

Clinical Trial Phase: N/A | Start Date: January 2007

Overall Status: Completed

Estimated Enrollment: 949

Brief Summary

Official Title: “Evaluation of the Implementation of the Accu-Chek Inform Cobas IT 1000 System in Three Medical Hospital Departments: Impact on the Management of Diabetes”

The principal objective of this single-center 2-period study is to evaluate the glycemic control of in-patients in 3 hospital departments (Diabetology, Cardiology and Pulmonary Care) as the rate of capillary blood glucose measurements within a pre-define target range, and to compare results during the period I (warning of the Accu-Check Inform glucose meter on glucose levels not activated) and period II (warning activated).

Study Type: Observational

Study Design: Case-Crossover, Prospective

Study Primary Completion Date: July 2007

Detailed Clinical Trial Description

The study is a 6-month large scale assessment of an information system consisting in a glucose meter with multiple alerts (Accu-Chek Inform) associated with a data base (Cobas IT 1000) in order to share the results of glucose monitoring using the hospital information network.

The appraisal of the glycemic control was based on the rate of capillary blood glucose measurements within a pre-defined target range (3.9-8.5 mMol/l) during each study period.

Whether the system implementation can improve the outcome related to the management of in-patients with diabetes is assessed in 3 hospital departments (Diabetology, Cardiology and Pulmonary Care) as follows: - principal objective, glycemic control of in-patients (Cardiology and Pulmonary Care) as the rate of capillary blood glucose (CBG) values within the pre-defined target range, and comparison of results observed during period I (meter warning not activated) and period II (warning of the meter on out-of-target glucose level activated). - the impact on the performance of quality controls of CBG measurements with (period II) or without (period I) activation of a warning on the meter related to inappropriate quality control frequency (all departments). - evaluate the traceability of CBG results and compare it with (period II) or without (period I) the activation of the automatic record of data ensured by the Accu-Chek Inform meter and Cobas IT 1000 data base (all departments). - during a sub-period of period II, the impact on patient glycemic control of the intervention of a diabetologist, determined by the activation of a warning sent to the physician in case of out of target CBG results via the Cobas IT 1000 data base (Cardiology and Pulmonary Care). - the impact of the above warning activation plus diabetologist intervention on the incidence of low CBG.

Intervention(s) in this Clinical Trial

  • Device: Accu Chek Inform and Cobas IT 1000
    • period II (warning activated)

Arms, Groups and Cohorts in this Clinical Trial

  • : 1
    • period I (warning of the Accu-Check Inform glucose meter on glucose levels not activated)
  • : 2
    • period II (warning activated).

Outcome Measures for this Clinical Trial

Primary Measures

  • compare glycemic control of patients hospitalized in 3 departments
    • Time Frame: hospitalisation period
      Safety Issue?: No

Secondary Measures

  • number of glycemia controls
    • Time Frame: hospitalisation period
      Safety Issue?: No
  • number of traceable glycemia readings
    • Time Frame: hospitalisation period
      Safety Issue?: No
  • number of hypoglycemia events and frequency of measures taken
    • Time Frame: hospitalisation period
      Safety Issue?: Yes
  • mean of % of glycemia for patients in warning phase with or without diabetologist intervention
    • Time Frame: hospitalisation period
      Safety Issue?: No

Criteria for Participation in this Clinical Trial

Inclusion Criteria:

  • In-patients,
  • Age > 18 years,
  • Requiring a monitoring of capillary blood glucose levels

Exclusion Criteria:

  • No glucose monitoring needed

Gender Eligibility for this Clinical Trial: Both

Minimum Age for this Clinical Trial: 18 Years

Maximum Age for this Clinical Trial: N/A

Are Healthy Volunteers Accepted for this Clinical Trial?: No

Clinical Trial Sponsor Information

Lead Sponsor: University Hospital, Grenoble

Overall Clinical Trial Officials and Contacts

NELLY WION, MD Principal Investigator University Hospital, Grenoble  

Related Publications

References

Kucher N, Koo S, Quiroz R, Cooper JM, Paterno MD, Soukonnikov B, Goldhaber SZ. Electronic alerts to prevent venous thromboembolism among hospitalized patients. N Engl J Med. 2005 Mar 10;352(10):969-77.

ACE/ADA Task Force on Inpatient Diabetes. American College of Endocrinology and American Diabetes Association Consensus statement on inpatient diabetes and glycemic control: a call to action. Diabetes Care. 2006 Aug;29(8):1955-62. No abstract available.

Inzucchi SE, Rosenstock J. Counterpoint: Inpatient glucose management: a premature call to arms? Diabetes Care. 2005 Apr;28(4):976-9. Review. No abstract available.

Clement S, Braithwaite SS, Magee MF, Ahmann A, Smith EP, Schafer RG, Hirsch IB; American Diabetes Association Diabetes in Hospitals Writing Committee. Management of diabetes and hyperglycemia in hospitals. Diabetes Care. 2004 Feb;27(2):553-91. Review. No abstract available. Erratum in: Diabetes Care. 2004 Mar;27(3):856. Hirsh, Irl B [corrected to Hirsch, Irl B]; dosage error in text. Diabetes Care. 2004 May;27(5):1255.

Halimi S. [Benefits of blood glucose self-monitoring in the management of insulin-dependent (IDDM) and non-insulin-dependent diabetes (NIDDM). Analysis of the literature: mixed results] Diabetes Metab. 1998 Nov;24 Suppl 3:35-41. Review. French.

King H, Aubert RE, Herman WH. Global burden of diabetes, 1995-2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998 Sep;21(9):1414-31.

Additional Information

Information obtained from ClinicalTrials.gov on September 05, 2008

Link to the current ClinicalTrials.gov record. http://clinicaltrials.gov/show/NCT00486681

Study ID Number: DCIC 05 51

ClinicalTrials.gov Identifier: NCT00486681

Health Authority: France: Afssaps - French Health Products Safety Agency

Clinical Trials Authorship and Review

Clinical Trials content is provided directly by the U.S. National Institutes of Health via ClinicalTrials.gov and is not reviewed separately by ClinicalTrialsFeeds.org. Every page of specific clinical trials information contains a unique identifier which can be used to find further details directly from the National Institutes of Health.