INSUlin Regimens and VASCular Functions (INSUVASC)

February 20, 2013 updated by: Assistance Publique - Hôpitaux de Paris

Effects of Different Insulin Regimens on Artery Compliance, Endothelium Function and Autonomic Cardiac Function in Patients With Poorly Controlled Type 2 Diabetes: a Pilot Study

Vago-sympathetic activity, arterial stiffness and endothelial function are integrators of cardiovascular risk. The aim of this pilot study is, in type 2 diabetic patients now requiring insulin, to compare the effects of improving glycemic control on these parameters with 3 different insulin regimens which will act especially at fasting or in post-prandial periods or both. Non invasive explorations will be performed before randomization and after 4 to 5 weeks of insulin therapy, at fasting and each hour after a standardized breakfast.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Vago-sympathetic activity, arterial stiffness and endothelial function are integrators of cardiovascular risk. The effect of controlling fasting or post-prandial blood glucose or both on these parameters has not been studied in type 2 diabetic patients.

The aim of this pilot study is to compare the effects of improving fasting or post-prandial blood glucose glycemic control or both with 3 different insulin regimens for 4 to 5 weeks, on vago-sympathetic activity, arterial stiffness and endothelial function.

Patients will be recruited in the department of Endocrinology-Diabetology-Nutrition of Jean VERDIER hospital, AP-HP, and the department of Endocrinology and Metabolism of AVICENNE hospital, BOBIGNY, AP-HP, France. After an half day of cardiovascular explorations, 42 patients will be randomized in 3 groups determining their treatment for the following 4-5 weeks : insulin therapy with detemir at dinner or bed time, or with aspart at each meal, or with both of them.

Investigations will be performed in the morning 1) at the time of randomisation and 2) 4-5 weeks after the beginning of insulin therapy. We will evaluate at fasting and each hour after a standardized breakfast biological and metabolic parameters, arterial stiffness, endothelial function and nervous autonomic system with non-invasive devices: Sphygmocor®, Finapres®, laser-doppler et Endopat2000®. Body composition will be evaluated with impedance maestri and BodPod®.

Study Type

Interventional

Enrollment (Actual)

42

Phase

  • Not Applicable

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

  • France
      • Bondy, France, 93140
        • Jean Verdier hospital, Department of Endocrinology-Diabetology-Nutrition

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

30 years to 72 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Consent patient
  • Adults from 30 to 72 years old
  • type 2 diabetic patients for at least 1 year
  • able to self measure capillary blood glucose
  • body mass index 20-37 kg/m²,
  • HbA1c 7.1-12% under Metformin and SULFUNYREAS therapy for at least 2 months
  • anti-hypertensive treatment or dyslipidemic treatment unchanged for 3 months

Exclusion criteria:

  • pregnancy
  • other antidiabetic medication in the previous 2 months,
  • anti-hypertensive or lipid-lowering therapies having been changed in the previous 2 months,
  • insulin allergy,
  • uncontrolled preproliferative or proliferative diabetic retinopathy
  • uncontrolled hypertension
  • renal failure(creatinin clearance <40 ml/min)
  • hepatocellular deficiency (prothrombin time <70%)
  • anemia
  • peripheral occlusive arterial disease
  • cardiac arrhythmia

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: detemir
Insulin detemir at dinner or bedtime
Drug: Insulin
For diabetes treatment: metformin continued with insulin (according to arms)
Other Names:
  • LEVEMIR
  • NOVORAPID
Active Comparator: aspart
Insulin aspart before each meal
Drug: Insulin
For diabetes treatment: metformin continued with insulin (according to arms)
Other Names:
  • LEVEMIR
  • NOVORAPID
Active Comparator: detemir and aspart
Drug: Insulin
For diabetes treatment: metformin continued with insulin (according to arms)
Other Names:
  • LEVEMIR
  • NOVORAPID

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Vago-sympathetic activity, arterial stiffness, endothelial function
Time Frame: 4-5 Weeks
4-5 Weeks

Collaborators and Investigators

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

Sponsor

Assistance Publique - Hôpitaux de Paris

Investigators

  • Principal Investigator: Paul Valensi, Pr, CHU Jean VERDIER
  • Study Chair: Emmanuel Cosson, MD, PhD, CHU-Jean Verdier

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.

General Publications

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

January 1, 2010

Primary Completion (Actual)

July 1, 2011

Study Completion (Actual)

July 1, 2011

Study Registration Dates

First Submitted

November 30, 2009

First Submitted That Met QC Criteria

November 30, 2009

First Posted (Estimate)

December 1, 2009

Study Record Updates

Last Update Posted (Estimate)

February 21, 2013

Last Update Submitted That Met QC Criteria

February 20, 2013

Last Verified

February 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P090303

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.

Clinical Trials on Type 2 Diabetes

Clinical Trials on Insulin

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Liberia

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe