- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00542399
Comparing the Metabolic Control of Once to Twice-daily Insulin Detemir Injections
Comparing the Metabolic Control of Once to Twice-daily Insulin Detemir Injections in Children and Adolescence With Type 1 Diabetes Mellitus.
An open-label, treat to target, intervention study in order to compare the metabolic control of once to twice-daily insulin Detemir injections in children and adolescence with type 1 diabetes mellitus.
All eligible patients will be assigned to receive insulin Detemir once daily before breakfast. Short acting insulin analog, Novorapid, will be used for mealtime insulin. The starting dose of insulin Detemir will be individually determined.Based on self-measured fasting blood glucose levels, insulin doses will be titrated throughout the trial, aiming at pre-breakfast and premeal concentrations of 90-180 mg/dl for subjects aged 6-12 years and 80-130 mg/dl for subjects aged 13-18 years.Patients that after 4 weeks titration phase will not achieve the target blood glucose and up titration of insulin Detemir cannot be done, due to hypoglycemic episodes would be switched to treatment consist of twice daily insulin Detemir. If the target blood glucose are not achieved at the end of the 4 weeks titration phase, but further up titration is possible and patient does not suffer from hypoglycemic episodes, the titration period would be extended and patient would not be switched to treatment with 2 injections of insulin Detemir.When achieving blood glucose targets patient will continue until study end on the maintenance phase.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
An open label,treat to target, prospective, intervention study in order to compare the metabolic control of once to twice-daily insulin detemir injections in children and adolescence with type 1 diabetes mellitus.
Study objectives:
- To assess the efficacy and safety of insulin detemir therapy (once or twice daily) using a treat to target titration protocol for initiating and maintaining therapy in children and adolescents with type 1 diabetes.
- To evaluate the percentage of patients That will achieve a reduction of 0.5% of HbA1c from baseline to end of study evaluation.
- To evaluate Incidence of sever, nocturnal, symptomatic and asymptomatic hypoglycemia and glucose excursions of both hyper and hypoglycemia as measured by the area under the curve determined by the CGMS technique.
Treatment plan:
Patients will be assigned to receive insulin detemir once daily before breakfast. Short acting insulin analog , Novorapid, will be used for mealtime insulin. The starting dose of insulin detemir will be individually determined. Based on self-measured fasting blood glucose levels, insulin doses will be titrated throughout the trial, aiming at pre breakfast and premeal concentrations of 90-180 mg/dl for subjects aged 6-12 years and 80-130 mg/dl for subjects aged 13-18 years.
Patients that after 4 weeks titration phase will not achieve the target blood glucose and up titration of insulin Detemir cannot be done, due to hypoglycemic episodes, would be switched to treatment consist of twice daily insulin Detemir.
If the target blood glucose are not achieved at the end of the 4 weeks titration phase, but further up titration is possible and patient does not suffer from hypoglycemic episodes, the titration period would be extended and patient would not be switched to treatment with 2 injections of insulin Detemir.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Petach-Tikva, Israel
- Schneider Children's Medical Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Informed consent obtained before any trial related activity
- Children with type 1 diabetes who have been treated with insulin for at least 12 months prior to the study.
- Age > 6 years and < 18 years
- HbA1c > 7.7%
- Ability and willingness to accept the study conditions and to inject insulin detemir
Exclusion Criteria:
- Impaired renal function or current renal dialysis.
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis.
- Known hypoglycemia unawareness.
- Known or suspected allergy to trial products.
- Clinical evidence of active liver disease or impaired hepatic function
- Participation in another study (with study drug) within the last 3 months prior to this trial.
- Significant concomitant disease likely to interfere with glucose metabolism
- Proven eating disorders
- Malignancy within the last 5 years
- History of repeated severe hypoglycemia within the last year.
- Known diabetes retinopathy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: 1
once a day
|
Levemir once a day
|
Experimental: 2
twice a day
|
Levemir twice a day
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
HbA1C
Time Frame: at screening visit, at the middle of the study, at the end of the study and prior to sweetching to twice daily treatment
|
at screening visit, at the middle of the study, at the end of the study and prior to sweetching to twice daily treatment
|
SBGM
Time Frame: 4-8 times a day
|
4-8 times a day
|
CGMS
Time Frame: 72 hours prior to switching to twice daily treatment and at the end of study
|
72 hours prior to switching to twice daily treatment and at the end of study
|
Total daily basal and bolus insulin
Time Frame: will be calculated every visit
|
will be calculated every visit
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
documentation of hypoglycemic and hyperglycemic episodes
Time Frame: diary will be collected every visit
|
diary will be collected every visit
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Moshe Phillip, Professor, Schneider Children Medical Center
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- rmc004543ctil
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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