Toujeo Versus NPH Self-titration Study

August 2, 2021 updated by: Elaine Chow

A Pilot Study to Describe the Glycaemic Variability of Insulin Glargine 300U/ml Versus NPH (Neutral Protamine Hagedorn) in the Insulin-naïve Type 2 Diabetes Patients Following a Patient-adjusted Insulin Algorithm in Hong Kong

This is a 24 week, multicentre, prospective, randomized, controlled, parallel-designed (1:1) pilot study.The study will compare glycemic variability in patients treated with insulin glargine U300/ml insulin versus conventional (NPH) insulin using a self titration algorithm.50 type 2 diabetes patients who are newly started on insulin will be recruited. They will be randomly allocated to either insulin glargine U300 or NPH insulin for 26 weeks. All subjects will follow a insulin-self titration algorithm. The study will consist of 9 visits over 26 weeks. Blood glucose variability will be collected by CGM for 7 consecutive days at baseline (week -1) and at week 24.Secondary endpoints other than data on glycemic variability, including HbA1c, fasting plasma glucose, inflammatory markers will be measured during three periods (week 0, week 12 and week 24).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

50

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 Locations

    • Shatin
      • Hong Kong, Shatin, Hong Kong
        • Prince of Wales Hospital

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 75 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Type 2 diabetic suboptimally controlled on their previous antidiabetic treatment

    • 18 ≤ age ≤ 75
    • Stable dose of oral antidiabetic treatment for > 8 weeks
    • The number of OADs that the patients used should be "3" or less
    • HbA1c level > 7.0% and < 10%
    • Fasting plasma glucose > 8mmol/L and <15mmol
    • BMI < 40 kg/m2
    • Patient who is capable and willing to perform regular SMBG
    • Patient who is capable and willing for insulin injection
    • Confirmed written consent
    • Insulin naïve

Exclusion Criteria:

  • Participation in a clinical trial with any investigational drug used with curative intent and within 30 days prior to study entry
  • Patient known to have hypoglycaemia unawareness or recurrent major hypoglycaemia
  • Any product containing prandial insulin
  • Concomitant medication known to interface with glucose metabolism (such as systematic steroids)
  • Change in dose of non-insulin anti-diabetic treatment or initiation of new anti-diabetic medications in the last 8 weeks prior to screening
  • Patients treated with steroid or nonsteroidal anti-inflammatory drugs
  • Patient who had experienced an acute concurrent illness during the 3-month period before the investigation
  • Patient with hepatic disease and end-stage renal disease
  • Patients unable to comply with follow-up visits
  • Pregnant or breastfeeding women

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Active
Insulin glargine 300U/ml
Self titration of insulin glargine U300
Active Comparator: Control
Neutral Protamine Hagedorn insulin
Self titration of NPH insulin

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Glycemic variability
Time Frame: 24 weeks
Standard deviation of glucose from continuous glucose monitoring
24 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Glycemic variability
Time Frame: 24 weeks
Mean Amplitude of Glycemic excursions and Means of Daily Differences
24 weeks
Percentage time in target
Time Frame: 24 weeks
Percentage of time <3.0mmol/L and >10.0mmol/L
24 weeks
Glycated haemoglobin
Time Frame: 24 weeks
HbA1c
24 weeks
Fasting blood glucose
Time Frame: 24 weeks
FPG
24 weeks
Incidence of hypoglycemia
Time Frame: 24 weeks
Overall incidence of hypoglycemia and nocturnal hypoglycemia
24 weeks
Proportion of patients achieving HbA1c <7.0%
Time Frame: 24 weeks
Proportion of patients achieving HbA1c <7.0% at week 24 without confirmed hypoglycemia
24 weeks
Treatment satisfaction
Time Frame: 24 weeks
ITSQ questionnaire
24 weeks
Inflammatory markers
Time Frame: 24 weeks
change in hs C reactive protein
24 weeks
Heart rate variability
Time Frame: 24 weeks
Change in heart rate variability
24 weeks

Collaborators and Investigators

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

Sponsor

Collaborators

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

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)

January 1, 2018

Primary Completion (Actual)

December 17, 2019

Study Completion (Actual)

May 1, 2020

Study Registration Dates

First Submitted

December 26, 2017

First Submitted That Met QC Criteria

December 26, 2017

First Posted (Actual)

January 3, 2018

Study Record Updates

Last Update Posted (Actual)

August 3, 2021

Last Update Submitted That Met QC Criteria

August 2, 2021

Last Verified

August 1, 2021

More Information

Terms related to this study

Other Study ID Numbers

  • GLARGL08588

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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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