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Sleep and Glycemic Control in Type 2 Diabetes Adolescents
NCT04213547 · Children's Hospital of Philadelphia
In plain English
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Official title
Sleep Duration and Glycemic Control in Adolescents With Type 2 Diabetes Mellitus
About this study
Aim 1 will be a cross-sectional study design utilizing actigraphy watch devices to estimate sleep duration. Participants will be recruited either before or after a routine outpatient clinic visit and asked to complete intake questionnaires. They will then be provided an actigraphy watch device which will be worn for 14 days to estimate sleep duration, and Libre continuous glucose monitor (CGM) to estimate glycemic control. After their visit, clinical data will be extracted from the electronic medical record.
Aim 2 will be an interventional study design utilizing Fitbit to perform a loss-framed incentive intervention designed to motivate participants to increase their sleep duration. Glycemic control will be measured via laboratory testing of hemoglobin A1c and Libre continuous glucose monitoring (CGM) for 2 weeks pre- and post-intervention.
A focus group will be conducted prior to this intervention with patients ineligible for the intervention in order to determine appropriate text messaging.
Eligibility criteria
Inclusion Criteria:
Aim 1 for child:
1. Subjects age 12-20
2. Diagnosed with T2DM by standard laboratory criteria without pancreatic autoimmunity
3. Low probability of obstructive sleep apnea (OSA) assessed via validated sleep survey
4. Subjects will be included if they are taking T2DM treatments (i.e., diet modification, Metformin and/or insulin)
5. Parental/guardian permission and child assent
Aim 1 for parent:
1\. Parent or legal guardian of child that meets inclusion criteria for Aim 1.
Aim 2 for child:
1. Completed Aim 1 evaluation
2. Average sleep duration \< 8 hours per night as determined by actigraphy in Aim 1
3. HbA1c ≤ 10% as HbA1c \>10 correlates to poor adherence
4. Adherence \> 80%
Focus group for child:
1. Subjects aged 12-20
2. Diagnosed with type 2 diabetes without pancreatic autoimmunity
Exclusion Criteria:
Aim 1 for child:
1. Non-English speaking subject (as questionnaires used are validated in English)
2. Institutionalized patients as sleep duration will not be of their own accord, and therefore is not generalizable to the rest of the adolescent T2DM population.
3. Patients with other forms of Diabetes Mellitus (e.g. Type 1 Diabetes)
4. Behavioral disorders that may affect data collection (e.g. autism spectrum disorder) will be determined on a case-by-case basis. These include patients that are unable to answer questionnaires on their own, participate in a sleep diary, wear devices and/or understand incentives.
5. Oral or IV steroid treatment within the past month
6. Females with known pregnancies as these patients will not be generalizable to the rest of the adolescent T2DM population and pregnancy may alter sleep duration.
7. Subjects with known hyperthyroidism, pain syndrome, or serious medical condition that can affect sleep.
8. Subjects with hemoglobinopathies that affect hemoglobin A1c measurement.
9. Unable to obtain point-of-care hemoglobin A1c in clinic on date of recruitment
10. Known diagnosis of obstructive sleep apnea or other sleep disorder
Aim 1 for Parent:
1. Non-English speaking subject (as questionnaires used are validated in English)
2. Parent/guardians with cognitive disorders that may affect data collection (determined on a case-by-case basis)
Aim 2 for child:
1\. Do not own a smart phone or tablet
Focus group for child:
1. Non-English speaking subject (as focus group will be conducted in English)
2. Lack of access to a computer, tablet or smartphone that can accommodate participation in video conferencing
Study design
Enrollment target: 90 participants
Allocation: na
Masking: none
Age groups: child, adult
Timeline
Starts: 2020-09-16
Estimated completion: 2026-06-01
Last updated: 2026-04-03
Interventions
Behavioral: Loss frame sleep extension intervention
Primary outcomes
- • Sleep duration (for Aim 2) (13 weeks)
- • Hemoglobin A1c (for Aim 1) (baseline)
- • BMI (for Aim 1) (baseline)
Sponsor
Children's Hospital of Philadelphia · other
With: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Contacts & investigators
ContactTalia Hitt, MD/MPH · contact · hittt@chop.edu · 215-590-3174
ContactBeth Schwartzman · contact · schwartzmann@chop.edu · 215-590-3174
InvestigatorTalia A Hitt, MD/MPH · study_director, Children's Hospital of Philadelphia
All locations (1)
Children's Hospital of PhiladelphiaRecruiting
Philadelphia, Pennsylvania, United States