Minimizing Hypoglycemia in Adults with Type 1 Diabetes through an Integrated Mobile Health and Continuous Glucose Monitoring System

通过集成移动健康和连续血糖监测系统最大限度地减少 1 型糖尿病成人的低血糖

• 批准号: 10455619
• 负责人: YU KUEI LIN
• 金额: $ 19.61万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10455619
• 关键词: Address; Adult; Applications Grants; Arrhythmia; Award; Behavior; Behavior Therapy; Behavioral Research; Behavioral Sciences; Belief; Blood Glucose; Cardiac; Cessation of life; Clinical; Clinical Trials; Complex; Confusion; Control Groups; Dangerousness; Data; Development; Devices; Diabetes Mellitus; Endocrinologist; Environment; Event; Face; Future; Glucose; Goals; Health; Health Technology; Hyperglycemia; Hypoglycemia; Impaired cognition; Insulin-Dependent Diabetes Mellitus; Intervention; Interview; K-Series Research Career Programs; Knowledge; Lead; Life; Link; Medical emergency; Mentors; Methods; National Institute of Diabetes and Digestive and Kidney Diseases; Outcome; Patients; Persons; Prevention; Qualitative Research; Recording of previous events; Research; Research Methodology; Research Personnel; Research Project Grants; Resources; Risk; Self Management; Structure; Surveys; System; Techniques; Technology; Text Messaging; Time; Training; Work; arm; behavior change; behavioral clinical trial; behavioral health intervention; career; career development; cognitive function; design; diabetes self-management; evidence base; experience; glucose monitor; group intervention; improved; innovation; insight; intervention program; mHealth; meetings; mortality; novel; patient oriented; pilot test; prevent; primary outcome; programs; randomized trial; recruit; research and development; skills; tailored messaging; text messaging intervention; therapy development; time use

Project Summary / Abstract Level 2 hypoglycemia (blood glucose <54 mg/dL) is a medical emergency that can lead to confusion, cardiac arrhythmias, and even death. This dangerous condition occurs frequently in patients with type 1 diabetes (T1D), including those using continuous glucose monitoring systems (CGMs). In prior studies of patients not using CGMs, researchers identified patient beliefs that interfere with hypoglycemia treatment. However, treatment interfering beliefs in CGM users remain to be evaluated, and an intervention to impactfully address these beliefs among CGM users is needed. The goal of this project is to comprehensively evaluate beliefs that interfere with hypoglycemia treatment in adult T1D CGM users, and to develop a novel behavioral intervention program to address these beliefs and minimize hypoglycemia. Mixed methods techniques can guide identification of hypoglycemia treatment interfering beliefs, and determine those predictive of level 2 hypoglycemia for targeted intervention development. Mobile health (mHealth) technology can be linked to CGM data to develop widely accessible, patient-centered, real-time interventions to address treatment interfering beliefs. Central hypothesis: An mHealth-CGM behavioral intervention program can mitigate beliefs that interfere with hypoglycemia treatment and reduce hypoglycemia in T1D CGM users. Aims: (1) Acquire an in-depth understanding of CGM users’ beliefs that interfere with hypoglycemia treatment; (2) Develop an mHealth text messaging program that generates automated, real-time behavioral interventions to mitigate beliefs that interfere with hypoglycemia treatment; (3) Assess the feasibility, acceptability and preliminary efficacy of the mHealth-CGM behavioral intervention program in reducing hypoglycemia in a pilot behavioral clinical trial. Candidate: Yu Kuei Lin, MD is an endocrinologist and early career investigator with the career goal of becoming an independent investigator, identifying and developing interventions to mitigate barriers to hypoglycemia management and prevention in diabetes patients. He has a successful history of designing and conducting hypoglycemia survey studies and biomedical clinical trials, but needs more training in advanced behavioral science research. This K-23 award will provide him with unique skills necessary to identify barriers to managing or preventing hypoglycemia, and to develop and evaluate patient-centered, targeted intervention programs delivered through mHealth aimed at optimizing hypoglycemia management and prevention. Training Objectives: (1) Acquire skills in conducting qualitative and mixed methods research; (2) Gain skills in developing mHealth behavioral interventions; (3) Develop expertise in conducting behavioral clinical trials. Dr. Lin’s training will be supported by highly experienced, complementary mentors and advisors, advanced didactic coursework, and participation in research and career development seminars and meetings within a resourceful, enriching training environment. An NIDDK K-23 award will provide Dr. Lin the protected time and training needed to help all patients with diabetes minimize hypoglycemia and improve health outcomes.

项目摘要 /摘要 2级低血糖（血糖<54 mg/dl）是医疗紧急情况，会导致心脏混乱 心律不齐，甚至死亡。这种危险病经常发生在1型糖尿病患者中 （T1D），包括使用连续葡萄糖监测系统（CGM）的那些。在先前对患者的研究中 研究人员使用CGMS确定了干扰低血糖治疗的患者信念。然而， 在CGM用户中干扰信念的治疗仍有待评估，并有效地解决了一种干预措施 这些相信在CGM用户中需要这些相信。该项目的目的是全面评估，认为 干扰成人T1D CGM使用者的低血糖治疗，并开发新的行为干预 解决这些信念并最大程度地减少低血糖症的计划。混合方法技术可以指导 鉴定低血糖治疗干扰信念，并确定那些预测2级的信念 低血糖用于靶向干预措施。移动健康（MHealth）技术可以链接到 CGM数据以开发广泛访问，以患者为中心的实时干预措施来解决治疗 干扰信念。中心假设：MHealth-CGM行为干预计划可以减轻信念 干扰低血糖治疗并减少T1D CGM使用者中低血糖症的干扰。目的：（1）获取 深入了解CGM用户干扰低血糖治疗的信念； （2）发展 MHealth文本消息传递程序，生成自动化的实时行为干预措施以减轻 认为干扰低血糖治疗； （3）评估可行性，可接受性和初步 MHealth-CGM行为干预计划在降低飞行员行为中低血糖症方面的效率 临床试验。候选人：医学博士Yu Kuei Lin是职业生涯的内分泌学家和早期职业调查员 成为独立调查员的目标，确定和制定干预措施，以减轻障碍 糖尿病患者的低血糖管理和预防。他有一个成功的设计历史 进行低血糖调查研究和生物医学临床试验，但需要对高级培训进行更多培训 行为科学研究。该K-23奖将为他提供确定障碍所需的独特技能 管理或预防低血糖症，并开发和评估以患者为中心的有针对性干预 通过MHealth提供的计划旨在优化低血糖管理和预防。训练 目标：（1）获得进行定性和混合方法研究的技能； （2）获得技能 制定MHealth行为干预措施； （3）在进行行为临床试验方面发展专业知识。博士 林的培训将得到经验丰富，完成者和顾问的支持 教学课程，并参与研究和职业发展的半手赛和会议 足智多类，丰富的培训环境。 NIDDK K-23奖将为Lin博士提供受保护的时间和 需要培训，以帮助所有糖尿病患者最大程度地减少低血糖并改善健康结果。