Basal-bolus Insulin Therapy Versus Standard Therapy for the Inpatient Management of Type 2 Diabetes: the IDA2 Study

August 8, 2017 updated by: Merete Bechmann Christensen

Basal-bolus Insulin Therapy With Insulin Degludec and Insulin Aspart Versus Standard Therapy for the Inpatient Management of Type 2 Diabetes: the IDA2 Study

Hyperglycemia during admission is associated with increased rate of complications and longer hospital stays, thus insulin treatment is recommended for all diabetes patients with hyperglycemia. Inpatient studies of non-critically ill patients show better glycemic control with the use of basal-bolus insulin therapy compared to sliding scale insulin therapy, but increased rates of hypoglycemia. The investigators hypothesize that basal-bolus insulin therapy with a new ultra-long-action basal insulin can treat hyperglycemia more efficiently than sliding scale insulin, with few episodes of hypoglycemia.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

The aim of this study is to investigate and compare the efficacy and safety of basal-bolus insulin therapy using the insulin analogue, insulin degludec once daily and insulin aspart before meals versus standard therapy with sliding scale insulin in non-critical ill hospitalized patients with type 2 diabetes.

The design of the trial is an open, randomized controlled trial with two parallel arms (treatment arm and control arm). Randomization is 1:1.

Study Type

Interventional

Enrollment (Anticipated)

100

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 90 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • History of type 2 diabetes for at least 6 months
  • Age 18 - 90 years
  • Pre-meal plasma glucose in the range 10 - 22,2 mmol/L prior to inclusion
  • Expected hospital stay longer than 4 days

Exclusion Criteria:

  • Hyperglycemia without known history of type 2 diabetes
  • Type 1 diabetes mellitus
  • Severely impaired renal function (eGFR ≤ 30 mL/min/1,73 m2)
  • Severe hepatic disease
  • Cardiac disease defined as: Decompensated heart failure (NYHA class III-IV) and/or diagnosis of unstable angina pectoris and/or myocardial infarction within the last 6 months
  • Pregnant or lactating women or fertile female patients not using chemical, hormonal or mechanical contraceptives or not in menopause (i.e. must not have had regular menstrual bleeding for at least one year)
  • Planned treatment during hospital stay with intravenous glucose/ insulin for ≥ 12 hours
  • Treatment at admission or planned treatment during hospital stay with parenteral nutrition or enteral nutrition (i.e. gastroenteric tube feeding)
  • Treatment at admission or planned treatment during hospital stay with high dose glucocorticoids (>40 mg)
  • History or presence of malignancy (except basal skin cancer) unless a disease-free period exceeding five years
  • Presence of alcohol or drug abuse
  • Inability to understand the written information or incapability to provide informed consent

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Intervention
Basal-bolus insulin regime with Insulin Degludec and insulin aspart
Basal-bolus insulin regime
No Intervention: Standard
Standard treatment according to hospital guidelines with sliding scale insulin

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Difference in mean daily plasma glucose between the two groups
Time Frame: Duration of hospital stay, an expected average of 8 days
Difference in mean daily plasma glucose between the two groups, calculated by using the four daily pre-meal and bedside PG values per patient.
Duration of hospital stay, an expected average of 8 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mean number and rates of hypoglycemic events (PG ≤ 3.9 mmol/L)
Time Frame: Duration of hospital stay, an expected average of 8 days
Based on bedside PG measures and on CGM data
Duration of hospital stay, an expected average of 8 days
Time spent in glycemic range
Time Frame: Duration of hospital stay, an expected average of 8 days
Based on bedside PG measures and on CGM data
Duration of hospital stay, an expected average of 8 days
Time spent in hyperglycemic range
Time Frame: Duration of hospital stay, an expected average of 8 days
Based on bedside PG measures and on CGM data
Duration of hospital stay, an expected average of 8 days
Length of hospital stay
Time Frame: Duration of hospital stay, an expected average of 8 days
Mean duration of hospital stay
Duration of hospital stay, an expected average of 8 days
Difference in insulin dose between groups
Time Frame: Duration of hospital stay, an expected average of 8 days
Calculated as mean insulin dose during admission
Duration of hospital stay, an expected average of 8 days
Number of hospital acquired infections during admission
Time Frame: Duration of hospital stay, an expected average of 8 days
Data from hospital record
Duration of hospital stay, an expected average of 8 days
Number of post-discharge infections or re-admissions 1 month after discharge
Time Frame: 1 month
Data collected on follow-up 1 month after discharge
1 month

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Kirsten B Norgaard, DMSC, Hvidovre University Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 1, 2017

Primary Completion (Anticipated)

April 1, 2018

Study Completion (Anticipated)

April 1, 2018

Study Registration Dates

First Submitted

June 7, 2017

First Submitted That Met QC Criteria

August 8, 2017

First Posted (Actual)

August 9, 2017

Study Record Updates

Last Update Posted (Actual)

August 9, 2017

Last Update Submitted That Met QC Criteria

August 8, 2017

Last Verified

August 1, 2017

More Information

Terms related to this study

Other Study ID Numbers

  • U1111-1177-2744

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

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.

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