On the next pages you will find a complete description of the Registry, its purpose, and what will happen if you decide to become a member. At the end, you can click a button to sign up.
If you agree to participate, you will then be asked to complete a very brief survey so that in the future we can invite you to participate in new projects that might be right for you. Please note that you must be 18 years or older to participate.
Your participation will help us to learn more about diabetes.
Please begin by clicking "Next"
What is the purpose of this consent? Dr. Edelman and the staff at Taking Control of Your Diabetes (TCOYD) are collaborating with the Behavioral Diabetes Institute (BDI) to conduct a series of research studies over the next few years. These studies are designed to lead to a better understanding of problems experienced by people with diabetes and their families. TCOYD and BDI want to know if you wish to learn about these new research studies when they are ready to begin. At that time, you can decide if you wish to participate in them. By clicking below, you will allow professional staff of TCOYD and BDI to share information about new studies with you in the future and to ask if you might wish to participate. You have no obligation to actually participate in any study.
What happens if I agree to be in this registry? If you agree to be in the registry, you are giving consent for the staff of TCOYD and BDI to record information in a confidential registry that you will provide in the brief online survey that follows this consent form. This survey will ask you for your name, street address, phone number, gender, diagnosis, date of birth, and other diabetes-related information, such as the type of diabetes you have and the type of medications you are taking. This information will be kept for a maximum of three years, unless you withdraw your permission, which you may do at any time by notifying TCOYD or BDI at the address below. If a study occurs that needs participants who fit the information you have provided, you may be contacted to ask if you would be interested in participating. You do not have to participate. Also, from time to time you may be contacted to update the personal information you have provided.
What happens if I don’t agree to be in the registry? Declining to participate will have no influence on your present or future status with respect to TCOYD. You will receive the same information about TCOYD educational and informational programs as any other individual with access to their website. There will be no penalty or loss of benefits to which you are otherwise entitled.
Are there any risks to my agreeing to be in the registry? Participation in the registry may involve some loss of privacy. However, your information will be handled as confidentially as possible. Access to your information will be limited to the research registry manager and those who operate the registry. The information will be stored on a secure, HIPAA-protected server. No information will be used for any purpose without your permission, and registry information will not be shared with anyone outside TCOYD or BDI.
Are there any financial considerations? There will be no cost or payment to you for just being in the registry. However, the research studies you elect to participate in may provide a financial payment to you.
What do I do if I have questions, now or later? You can talk with the research registry manager about any questions, concerns or complaints you have about registry. Contact the registry manager, Michelle DeFazio, at 858-336-8693 or michelled@behavioraldiabetes.org.
If you have questions about your rights as a research subject, to offer input, or to talk to someone other than registry staff, you can contact E&I Review Services (E&I), the review board that reviewed this project for subject rights, at 800-472-3241 (toll free) or by email at subject@eandireview.com.
You should print this page for your records.
You must scroll down to the end of the consent before continuing.
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Note: unlike a blood glucose meter, a CGM uses a tiny sensor placed under the skin to check glucose levels every few minutes.
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You have selected not to participate in the TCOYD Research Registry. If you ever decide you would like to participate, please return to this website.
Click here to go to the Behavioral Diabetes Institute home page.