A Study to Compare Insulin Intensification of Biphasic Insulin Aspart 30 and Insulin Analogues (Insulin Glargine and Insulin Aspart) in Insulin naïve Type 2 Diabetic Patients
A 32-week Randomised, Multinational, Treat-to-target, Open Label, Parallel Group Comparison of Stepwise Insulin Intensification of Biphasic Insulin Aspart (BIAsp) 30 and Basal-bolus Therapy With Insulin Glargine and Insulin Aspart in Insulin naïve Type 2 Diabetic Patients Inadequately Controlled on Oral Anti-diabetic Therapy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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New South Wales
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Broadmeadow, New South Wales, Australia, 2292
- Novo Nordisk Investigational Site
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Coffs Harbour, New South Wales, Australia, 2450
- Novo Nordisk Investigational Site
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Queensland
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Ipswich, Queensland, Australia, 4305
- Novo Nordisk Investigational Site
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Victoria
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Fitzroy, Victoria, Australia, 3065
- Novo Nordisk Investigational Site
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Melbourne, Victoria, Australia, 3004
- Novo Nordisk Investigational Site
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Petrich, Bulgaria, 2850
- Novo Nordisk Investigational Site
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Sliven, Bulgaria, 8800
- Novo Nordisk Investigational Site
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Sofia, Bulgaria, 1431
- Novo Nordisk Investigational Site
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Sofia, Bulgaria, 1606
- Novo Nordisk Investigational Site
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Sofia, Bulgaria, 1202
- Novo Nordisk Investigational Site
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Budapest, Hungary, 1032
- Novo Nordisk Investigational Site
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Budapest, Hungary, 1042
- Novo Nordisk Investigational Site
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Nyíregyhaza, Hungary, 4400
- Novo Nordisk Investigational Site
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New Delhi, India, 110001
- Novo Nordisk Investigational Site
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Andhra Pradesh
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Hyderabad, Andhra Pradesh, India, 500003
- Novo Nordisk Investigational Site
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Karnataka
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Bangalore, Karnataka, India, 560060
- Novo Nordisk Investigational Site
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Maharashtra
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Mumbai, Maharashtra, India, 400008
- Novo Nordisk Investigational Site
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Mumbai, Maharashtra, India, 400058
- Novo Nordisk Investigational Site
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Tamil Nadu
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Madurai, Tamil Nadu, India, 625 020
- Novo Nordisk Investigational Site
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Vellore, Tamil Nadu, India, 632004
- Novo Nordisk Investigational Site
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West Bengal
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Kolkata, West Bengal, India, 700032
- Novo Nordisk Investigational Site
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Seoul, Korea, Republic of, 03722
- Novo Nordisk Investigational Site
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Seoul, Korea, Republic of, 02447
- Novo Nordisk Investigational Site
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Seoul, Korea, Republic of, 138-736
- Novo Nordisk Investigational Site
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Seoul, Korea, Republic of, 135710
- Novo Nordisk Investigational Site
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Belgrade, Serbia, 11000
- Novo Nordisk Investigational Site
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Belgrade, Serbia, 11080
- Novo Nordisk Investigational Site
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Nis, Serbia, 18000
- Novo Nordisk Investigational Site
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Bangkok, Thailand, 10400
- Novo Nordisk Investigational Site
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Bangkok, Thailand, 10330
- Novo Nordisk Investigational Site
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Bangkoknoi, Bangkok, Thailand, 10700
- Novo Nordisk Investigational Site
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Khon Kaen, Thailand, 40002
- Novo Nordisk Investigational Site
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Antalya, Turkey, 07058
- Novo Nordisk Investigational Site
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Istanbul, Turkey, 34303
- Novo Nordisk Investigational Site
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Istanbul, Turkey, 34752
- Novo Nordisk Investigational Site
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Malatya, Turkey, 44280
- Novo Nordisk Investigational Site
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Rize, Turkey, 53020
- Novo Nordisk Investigational Site
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Ajman, United Arab Emirates, 21499
- Novo Nordisk Investigational Site
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Dubai, United Arab Emirates, 22241
- Novo Nordisk Investigational Site
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Ras Al Khaimah, United Arab Emirates, 4727
- Novo Nordisk Investigational Site
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Umm Al Quwain, United Arab Emirates, 24
- 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:
- Informed consent obtained before any trial-related activities. Trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial
- Male or female, age at least 18 years at the time of signing informed consent
- Type 2 diabetes subjects clinically diagnosed at least 6 months prior to screening
- Treatment with stable daily dose (for at least 90 days prior to screening) of: - Metformin (equal or above 1000 mg or maximum tolerated dose documented in the patient medical record) and - Sulfonylurea - and willing to discontinue any other oral antidiabetic drugs containing insulin secretagogues, DPP4i (dipeptidyl peptidase-4 inhibitor), SGLT2 (sodium glucose co-transporter 2), colesevelam, bromocriptin and/or combination products at randomisation
- Insulin-naïve. Short term insulin treatment for acute illnesses for a total of 14 days or less is allowed as is prior insulin treatment for gestational diabetes
- HbA1c (glycosylated haemoglobin) 7.0-9.5 % (both inclusive) analysed by central laboratory
- Willing to consume 3 main meals daily (morning, mid-day and evening) throughout the entire trial. The definition for 'main meal' will be according to the investigator's discretion
Exclusion Criteria:
- Anticipated initiation or change in concomitant medications known to affect weight or glucose metabolism, in excess of 14 days (i.e. sibutramine, orlistat, thyroid hormones, systemic corticosteroids and other weight loss/modifying agents)
- Impaired liver function, defined as ALT (alanine aminotransferase) at least 2.5 times upper limit of normal (central laboratory value measured at screening visit)
- Inadequately treated high blood pressure defined as Class 2 hypertension or higher (i.e. systolic blood pressure equal to or above 160 mm Hg or diastolic equal to or above 100 mm Hg) in accordance with the National High Blood Pressure Education Program, 7th Joint National Committee1 and ESH/ESC 2013 Guidelines2
- Within the past 180 days prior to randomisation, any of the following: Myocardial Infarction, stroke or hospitalization for unstable angina and /or transient ischemic attack
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Active Comparator: IGlar + IAsp
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Injected s.c./subcutaneously once daily at the same time every day, with the possibility of treatment intensification with insulin aspart (Basal-bolus arm) Subjects should continue their pre-trial metformin and sulfonylurea dosages all throughout the trial while other oral antidiabetic drugs will be discontinued.
Injected s.c./subcutaneously once daily.
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Experimental: BIAsp
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Injected s.c./subcutaneously once daily with the largest meal Subjects should continue their pre-trial metformin and sulfonylurea dosages all throughout the trial while other oral antidiabetic drugs will be discontinued.
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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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Change in HbA1c (Glycosylated Haemoglobin)
Time Frame: Week 0, week 32
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Change in HbA1c from baseline (week 0) to week 32.
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Week 0, week 32
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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HbA1c Below 7.0% Without Severe Hypoglycaemic Episodes
Time Frame: After 32 weeks of treatment (yes/no)
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Percentage of subjects with HbA1c below 7.0% after 32 weeks of randomised treatment without treatment emergent severe hypoglycaemic episodes during the last 12 weeks of treatment.
Subjects withdrawn before 32 weeks were handled as non-responders.
Severe hypoglycaemic episode was defined as an episode requiring assistance of another person to actively administer carbohydrate, glucagon, or take other corrective actions.
Plasma glucose (PG) concentrations may not be available during an event, but neurological recovery following the return of PG to normal is considered sufficient evidence that the event was induced by a low PG concentration.
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After 32 weeks of treatment (yes/no)
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Number of Treatment Emergent Hypoglycaemic Episodes Classified According to the American Diabetes Association (ADA) and the Novo Nordisk Definitions
Time Frame: Weeks 0-32
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Hypoglycaemic episodes were classified as severe, Asymptomatic, Documented symptomatic, Pseudo, and Probable symptomatic as per ADA classification.
As symptoms of hypoglycaemia occur below a PG level of 3.1 mmol/L, (56 mg/dL) Novo Nordisk classification included hypoglycaemia with plasma glucose (PG) levels below 3.1 mmol/L (56 mg/dL) in the definition of blood glucose confirmed hypoglycaemia.
Hence, Novo Nordisk classification included following types of hypoglycaemia in addition to ADA classification: Severe hypoglycaemia, Symptomatic blood glucose confirmed hypoglycaemia, Asymptomatic blood glucose confirmed hypoglycaemia, Severe or blood glucose confirmed symptomatic hypoglycaemia, Blood glucose confirmed hypoglycaemia, and Severe or blood glucose confirmed hypoglycaemia.
Reported data represents total of all hypoglycaemic episodes.
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Weeks 0-32
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Total Daily Insulin Dose
Time Frame: Weeks 0-32
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Total daily insulin dose in the basal bolus treatment group and in BIAsp 30 treatment group at each week of each treatment.
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Weeks 0-32
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Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
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
- Glucose Metabolism Disorders
- Metabolic Diseases
- Endocrine System Diseases
- Diabetes Mellitus
- Diabetes Mellitus, Type 2
- Hypoglycemic Agents
- Physiological Effects of Drugs
- Insulin
- Insulin, Globin Zinc
- Insulin Aspart
- Insulin, Long-Acting
- Insulin degludec, insulin aspart drug combination
- Insulin Glargine
- Biphasic Insulins
- Insulin aspart, insulin aspart protamine drug combination 30:70
Other Study ID Numbers
Other Study ID Numbers
- BIASP-4157
- 2014-003708-62 (EudraCT Number)
- U1111-1158-7280 (Other Identifier: WHO)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.