Comparison of NN1250 With Insulin Glargine in Type 1 Diabetes (BEGIN™)
A 26-week Trial Investigating the Dosing Flexibility, Efficacy and Safety of NN1250 in Subjects With Type 1 Diabetes With a 26-week Extension (Begin™: Flex T1)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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Aalst, Belgium, 9300
- Novo Nordisk Investigational Site
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Arlon, Belgium, 6700
- Novo Nordisk Investigational Site
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Bonheiden, Belgium, 2820
- Novo Nordisk Investigational Site
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Brussels, Belgium, 1070
- Novo Nordisk Investigational Site
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Leuven, Belgium, 3000
- Novo Nordisk Investigational Site
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Bad Kreuznach, Germany, 55545
- Novo Nordisk Investigational Site
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Falkensee, Germany, 14612
- Novo Nordisk Investigational Site
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Hamburg, Germany, 22607
- Novo Nordisk Investigational Site
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Hamburg, Germany, 21073
- Novo Nordisk Investigational Site
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Hamburg, Germany, 22391
- Novo Nordisk Investigational Site
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Hohenmölsen, Germany, 06679
- Novo Nordisk Investigational Site
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Rehburg-Loccum, Germany, 31547
- Novo Nordisk Investigational Site
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Rehlingen-Siersburg, Germany, 66780
- Novo Nordisk Investigational Site
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St. Ingbert, Germany, 66386
- Novo Nordisk Investigational Site
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Völklingen, Germany, 66333
- Novo Nordisk Investigational Site
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Athens, Greece, GR-11527
- Novo Nordisk Investigational Site
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Athens, Greece, 151 23
- Novo Nordisk Investigational Site
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Athens, Greece, GR-10552
- Novo Nordisk Investigational Site
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Thessaloniki, Greece, GR-57001
- Novo Nordisk Investigational Site
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Thessaloniki, Greece, 54001
- Novo Nordisk Investigational Site
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Bergen, Norway, 5021
- Novo Nordisk Investigational Site
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Elverum, Norway, 2408
- Novo Nordisk Investigational Site
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Hamar, Norway, 2317
- Novo Nordisk Investigational Site
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Kongsvinger, Norway, 2212
- Novo Nordisk Investigational Site
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Stavanger, Norway, 4011
- Novo Nordisk Investigational Site
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Ålesund, Norway, 6003
- Novo Nordisk Investigational Site
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Bialystok, Poland, 15-435
- Novo Nordisk Investigational Site
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Lublin, Poland, 20-538
- Novo Nordisk Investigational Site
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Poznan, Poland, 60-834
- Novo Nordisk Investigational Site
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Warszawa, Poland, 02-507
- Novo Nordisk Investigational Site
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Belfast, United Kingdom, BT16 1RH
- Novo Nordisk Investigational Site
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Bristol, United Kingdom, BS10 5NB
- Novo Nordisk Investigational Site
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Guildford, United Kingdom, GU2 7XX
- Novo Nordisk Investigational Site
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Hull, United Kingdom, HU3 2JZ
- Novo Nordisk Investigational Site
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Inverness, United Kingdom, IV2 3JH
- Novo Nordisk Investigational Site
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Ipswich, United Kingdom, IP4 5PD
- Novo Nordisk Investigational Site
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Newcastle, United Kingdom, NE4 6BE
- Novo Nordisk Investigational Site
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Rugby, United Kingdom, CV22 5PX
- Novo Nordisk Investigational Site
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Southall, United Kingdom, UB1 3HW
- Novo Nordisk Investigational Site
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Stevenage, United Kingdom, SG1 4AB
- Novo Nordisk Investigational Site
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Swansea, United Kingdom, SA6 6NL
- Novo Nordisk Investigational Site
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Welwyn Garden City, United Kingdom, AL7 4HQ
- Novo Nordisk Investigational Site
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California
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Encino, California, United States, 91436
- Novo Nordisk Investigational Site
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Fresno, California, United States, 93720
- Novo Nordisk Investigational Site
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Huntington Beach, California, United States, 92648
- Novo Nordisk Investigational Site
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Long Beach, California, United States, 90806
- Novo Nordisk Investigational Site
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Redondo Beach, California, United States, 90277
- Novo Nordisk Investigational Site
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Walnut Creek, California, United States, 94598
- Novo Nordisk Investigational Site
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Colorado
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Aurora, Colorado, United States, 80045
- Novo Nordisk Investigational Site
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Denver, Colorado, United States, 80209
- Novo Nordisk Investigational Site
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Florida
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DeLand, Florida, United States, 32720
- Novo Nordisk Investigational Site
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Hollywood, Florida, United States, 33021
- Novo Nordisk Investigational Site
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Miami, Florida, United States, 33136
- Novo Nordisk Investigational Site
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Georgia
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Lawrenceville, Georgia, United States, 30046
- Novo Nordisk Investigational Site
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Roswell, Georgia, United States, 30076
- Novo Nordisk Investigational Site
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Idaho
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Nampa, Idaho, United States, 83686-6011
- Novo Nordisk Investigational Site
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Illinois
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Crystal Lake, Illinois, United States, 60012
- Novo Nordisk Investigational Site
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Iowa
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Des Moines, Iowa, United States, 50314-2610
- Novo Nordisk Investigational Site
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Des Moines, Iowa, United States, 50314
- Novo Nordisk Investigational Site
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Maryland
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Baltimore, Maryland, United States, 21204
- Novo Nordisk Investigational Site
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Missouri
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Jefferson City, Missouri, United States, 65109
- Novo Nordisk Investigational Site
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Springfield, Missouri, United States, 65807
- Novo Nordisk Investigational Site
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St. Louis, Missouri, United States, 63141
- Novo Nordisk Investigational Site
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Nebraska
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Omaha, Nebraska, United States, 68114
- Novo Nordisk Investigational Site
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New Hampshire
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Nashua, New Hampshire, United States, 03063
- Novo Nordisk Investigational Site
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New Jersey
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Flemington, New Jersey, United States, 08822-5763
- Novo Nordisk Investigational Site
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New York
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Smithtown, New York, United States, 11787
- Novo Nordisk Investigational Site
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Staten Island, New York, United States, 10301
- Novo Nordisk Investigational Site
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North Carolina
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Asheville, North Carolina, United States, 28803
- Novo Nordisk Investigational Site
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Chapel Hill, North Carolina, United States, 27517
- Novo Nordisk Investigational Site
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Greenville, North Carolina, United States, 27834
- Novo Nordisk Investigational Site
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Morehead City, North Carolina, United States, 28557
- Novo Nordisk Investigational Site
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South Carolina
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Greer, South Carolina, United States, 29651
- Novo Nordisk Investigational Site
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Tennessee
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Chattanooga, Tennessee, United States, 37411
- Novo Nordisk Investigational Site
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Memphis, Tennessee, United States, 38119
- Novo Nordisk Investigational Site
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Texas
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Arlington, Texas, United States, 76014
- Novo Nordisk Investigational Site
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Dallas, Texas, United States, 75230
- Novo Nordisk Investigational Site
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Dallas, Texas, United States, 75231
- Novo Nordisk Investigational Site
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Dallas, Texas, United States, 75246
- Novo Nordisk Investigational Site
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Houston, Texas, United States, 77095
- Novo Nordisk Investigational Site
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Round Rock, Texas, United States, 78681
- Novo Nordisk Investigational Site
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Washington
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Spokane, Washington, United States, 99208
- Novo Nordisk Investigational Site
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Type 1 diabetes for 12 months or longer, hereof the last 3 months with injection based therapies
- Current treatment with any basal insulin (e.g. insulin glargine, insulin detemir, NPH insulin) using one or two daily injections and with three or more daily meal-time insulin injections (e.g. insulin aspart, insulin lispro, insulin glulisine, human insulin) used as bolus insulin therapy
- HbA1c maximum 10.0 % by central laboratory analysis
- Body Mass Index (BMI) below or equal to 35.0 kg/m^2
- Ability to self-manage insulin therapy as assessed by confirmation (verbal confirmation at screening visit) of a changed insulin dose in the preceding two months prior to screening
- Ability and willingness to adhere to the protocol including performance of self measured plasma glucose (SMPG) profiles and self adjustment of insulin doses
Exclusion Criteria:
- Use within the last 3 months prior to Visit 1 of any antidiabetic glucose lowering drug other than insulin
- Cardiovascular disease, within the last 6 months prior to visit 1, defined as: stroke; decompensated heart failure New York Heart Association (NYHA) class III or IV; myocardial infarction; unstable angina pectoris; or coronary arterial bypass graft or angioplasty
- Uncontrolled treated/ untreated severe hypertension (systolic blood pressure above or equal to 180 millimetre (mm) mercury (Hg) and/or diastolic blood pressure above or equal to 100 mmHg)
- Pregnancy, breast-feeding, the intention of becoming pregnant or not using adequate contraceptive measures according to local requirements
- Cancer and medical history of cancer (except basal cell skin cancer or squamous cell skin cancer)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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EXPERIMENTAL: Flex + insulin aspart
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Injected subcutaneously (under the skin) once daily
At least three daily doses at meal-time
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EXPERIMENTAL: Fixed + insulin aspart
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Injected subcutaneously (under the skin) once daily
At least three daily doses at meal-time
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ACTIVE_COMPARATOR: IGlar + insulin aspart
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At least three daily doses at meal-time
Insulin glargine injected subcutaneously (under the skin) once daily
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Main Trial (Primary Endpoint): Change in Glycosylated Haemoglobin (HbA1c) After 26 Weeks of Treatment
Time Frame: Week 0, Week 26
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Change from baseline in HbA1c after 26 weeks of treatment
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Week 0, Week 26
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Extension Trial (Primary Endpoint): Rate of Confirmed Hypoglycaemic Episodes
Time Frame: Week 0 to Week 52 + 7 days follow up
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Rate of confirmed hypoglycaemic episodes per 100 patient years of exposure (PYE).
Confirmed hypoglycaemic episodes consisted of severe hypoglycaemia as well as minor hypoglycaemic episodes.
Severe hypoglycaemic episodes are defined as requiring assistance to administer carbohydrate, glucagon, or other resuscitative actions.
Minor hypoglycaemic episodes are defined as able to treat her/himself and plasma glucose below 3.1 mmol/L.
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Week 0 to Week 52 + 7 days follow up
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Extension Trial (Primary Endpoint): Rate of Nocturnal Confirmed Hypoglycaemic Episodes
Time Frame: Week 0 to Week 52 + 7 days follow up
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Rate of confirmed hypoglycaemic episodes per 100 patient years of exposure (PYE).
Confirmed hypoglycaemic episodes consisted of severe hypoglycaemia as well as minor hypoglycaemic episodes.
Severe hypoglycaemic episodes are defined as requiring assistance to administer carbohydrate, glucagon, or other resuscitative actions.
Minor hypoglycaemic episodes are defined as able to treat her/himself and plasma glucose below 3.1 mmol/L.
Nocturnal hypoglycaemic episodes are defined as occurring between 00:01 and 05:59 a.m.
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Week 0 to Week 52 + 7 days follow up
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Main Trial (Secondary Endpoint): Change in Fasting Plasma Glucose (FPG) After 26 Weeks of Treatment
Time Frame: Week 0, Week 26
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Change from baseline in FPG after 26 weeks of treatment
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Week 0, Week 26
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Extension Trial (Secondary Endpoint): Change in Glycosylated Haemoglobin (HbA1c) After 52 Weeks of Treatment
Time Frame: Week 0, Week 52
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Change from baseline in HbA1c after 52 weeks of treatment.
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Week 0, Week 52
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Extension Trial (Secondary Endpoint): Change in Fasting Plasma Glucose (FPG) After 52 Weeks of Treatment
Time Frame: Week 0, Week 52
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Change from baseline in FPG after 52 weeks of treatment.
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Week 0, Week 52
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Ratner RE, Gough SC, Mathieu C, Del Prato S, Bode B, Mersebach H, Endahl L, Zinman B. Hypoglycaemia risk with insulin degludec compared with insulin glargine in type 2 and type 1 diabetes: a pre-planned meta-analysis of phase 3 trials. Diabetes Obes Metab. 2013 Feb;15(2):175-84. doi: 10.1111/dom.12032. Epub 2012 Dec 3.
- Heller S, Mathieu C, Kapur R, Wolden ML, Zinman B. A meta-analysis of rate ratios for nocturnal confirmed hypoglycaemia with insulin degludec vs. insulin glargine using different definitions for hypoglycaemia. Diabet Med. 2016 Apr;33(4):478-87. doi: 10.1111/dme.13002. Epub 2015 Dec 13.
- Sorli C, Warren M, Oyer D, Mersebach H, Johansen T, Gough SC. Elderly patients with diabetes experience a lower rate of nocturnal hypoglycaemia with insulin degludec than with insulin glargine: a meta-analysis of phase IIIa trials. Drugs Aging. 2013 Dec;30(12):1009-18. doi: 10.1007/s40266-013-0128-2.
- Einhorn D, Handelsman Y, Bode BW, Endahl LA, Mersebach H, King AB. PATIENTS ACHIEVING GOOD GLYCEMIC CONTROL (HBA1c <7%) EXPERIENCE A LOWER RATE OF HYPOGLYCEMIA WITH INSULIN DEGLUDEC THAN WITH INSULIN GLARGINE: A META-ANALYSIS OF PHASE 3A TRIALS. Endocr Pract. 2015 Aug;21(8):917-26. doi: 10.4158/EP14523.OR. Epub 2015 Jun 29.
- Russell-Jones D, Gall MA, Niemeyer M, Diamant M, Del Prato S. Insulin degludec results in lower rates of nocturnal hypoglycaemia and fasting plasma glucose vs. insulin glargine: A meta-analysis of seven clinical trials. Nutr Metab Cardiovasc Dis. 2015 Oct;25(10):898-905. doi: 10.1016/j.numecd.2015.06.005. Epub 2015 Jun 18.
- Vora J, Seufert J, Solberg H, Kinduryte O, Johansen T, Hollander P. Insulin degludec does not increase antibody formation versus insulin glargine: an evaluation of phase IIIa trials. Diabetes Obes Metab. 2016 Jul;18(7):716-20. doi: 10.1111/dom.12621. Epub 2016 Feb 8.
- Mathieu C, Hollander P, Miranda-Palma B, Cooper J, Franek E, Russell-Jones D, Larsen J, Tamer SC, Bain SC; NN1250-3770 (BEGIN: Flex T1) Trial Investigators. Efficacy and safety of insulin degludec in a flexible dosing regimen vs insulin glargine in patients with type 1 diabetes (BEGIN: Flex T1): a 26-week randomized, treat-to-target trial with a 26-week extension. J Clin Endocrinol Metab. 2013 Mar;98(3):1154-62. doi: 10.1210/jc.2012-3249. Epub 2013 Feb 7.
Helpful Links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- NN1250-3770
- U1111-1112-8813 (OTHER: WHO)
- 2009-012923-27 (EUDRACT_NUMBER)
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