NCT04940897

Brief Summary

In this KARMA2 feasibility study the investigators are testing whether ambulance staff can reliably and safely identify patients at high risk of diabetic ketoacidosis using blood ketone meters and start fluid (saline) therapy before arriving at hospital. The investigators aim to include 800 patients in this stepped wedge control study and the results will help decide if a larger study is warranted.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
420

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Oct 2021

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 25, 2021

Completed
1 month until next milestone

First Posted

Study publicly available on registry

June 28, 2021

Completed
4 months until next milestone

Study Start

First participant enrolled

October 25, 2021

Completed
11 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 30, 2022

Completed
5 months until next milestone

Study Completion

Last participant's last visit for all outcomes

February 23, 2023

Completed
Last Updated

February 24, 2023

Status Verified

February 1, 2023

Enrollment Period

11 months

First QC Date

May 25, 2021

Last Update Submit

February 23, 2023

Conditions

Outcome Measures

Primary Outcomes (4)

  • Measure incidence of hyperglycaemia in study population

    Frequency count of capillary blood glucose level greater than 11mmol/L

    18 months

  • Measure incidence of diabetic ketoacidosis (DKA) in study population

    Frequency count of capillary blood ketone level equal to or greater than 3mmol/L

    18 months

  • Completeness of data capture by study clinicians

    Progression criteria requires full record completion for a minimum of 70 percent of participants

    18 months

  • Measure incidence of adverse events

    Progression criteria requires adverse event rate to be less than 1 percent of participants

    Maximum 18 months

Study Arms (1)

Intervention

EXPERIMENTAL

Usual care plus ketone meter and fluid therapy for identified high risk DKA patients

Other: Use of CareSens ketone meter

Interventions

Use of CareSens ketone meter to identify blood ketone levels and delivery of fluid therapy to those patients at high risk of DKA

Intervention

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Aged 18 years or more
  • Attended by study clinician
  • Informed or Proxy consent to participate
  • Blood glucose level greater than 11mmol/L or unwell with history of diabetes
  • If required will be transported to partner hospital

You may not qualify if:

  • Previously recruited to study

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

East of England Ambulance Service NHS Trust

Melbourn, Cambs, SG8 6EN, United Kingdom

Location

Related Publications (1)

  • Prothero LS, Strudwick T, Foster T, Lake AK, Boyle A, Clark A, Williams J, Rayman G, Dhatariya K. Ambulance clinician use of capillary blood ketone meters to improve emergency hyperglycaemia care: A stepped-wedged controlled, mixed-methods feasibility study. Diabet Med. 2024 Sep;41(9):e15372. doi: 10.1111/dme.15372. Epub 2024 Jun 9.

MeSH Terms

Conditions

Diabetic Ketoacidosis

Condition Hierarchy (Ancestors)

KetosisAcidosisAcid-Base ImbalanceMetabolic DiseasesNutritional and Metabolic DiseasesDiabetes ComplicationsDiabetes MellitusEndocrine System Diseases

Study Officials

  • Tom Davis

    East of England Ambulance Service NHS Trust

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Model Details: Stepped wedge control trial
Sponsor Type
OTHER GOV
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Head of Research

Study Record Dates

First Submitted

May 25, 2021

First Posted

June 28, 2021

Study Start

October 25, 2021

Primary Completion

September 30, 2022

Study Completion

February 23, 2023

Last Updated

February 24, 2023

Record last verified: 2023-02

Data Sharing

IPD Sharing
Will not share

Locations