A Comparison of Two Initial Dosing Formulas

August 23, 2013 updated by: Allen B. King, MD, Diabetes Care Center

A Comparison of Two Initial Dosing Formulas for Basal Insulin in Type 2 Diabetes Mellitus

This study will evaluate two methods of starting basal insulin to see which method may achieve a faster-to-goal titration.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The current recommended starting dose of basal insulin in type 2 diabetes is either a fixed dose, e.g. 10 U, or a weight-based formulas, 0.1-0.2 U/kg. The estimate of eventual titration dose to attempt to reach a fasting glucose goal is 0.49 U/kg. Those many weeks of dosage upward titration are required. The investigators propose to compare the current recommended weight based, 0.1 U/kg to a correction factor derived formula. Starting with an insulin tolerance test estimation of basal dose, one would arrive at the eventual titrated basal insulin dose in significantly less days than starting at a starting dose estimate of 0.1 U/kg. Further, there would be no significant increase in overall reported hypoglycemia.

Study Type

Interventional

Enrollment (Actual)

20

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

  • United States
    • California
      • Salinas, California, United States, 93901
        • Diabetes Care Center

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 and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Type 2 diabetes
  2. Age 18 years and above
  3. Concurrently on ± sulfonylureas ± thiazolidinedione ± DDP IV inhibitors ± metformin ± glinides
  4. A1c ≥ 7.0% but ≤ 10%
  5. Capable of self monitoring glucose ≥4/day
  6. Previously compliant with clinical recommendations
  7. Fasting blood glucose ≥ 150 mg/dl
  8. BMI ≤ 45 kg/m2

Exclusion Criteria:

  1. Urinary ketosis
  2. Currently or expected alteration in insulin sensitivity such as major surgery, infection, renal failure (creatinine >1.5 mg/dl), glucocorticoid treatment, recent (within 2 weeks) serious hypoglycaemic episode (requires assistant of another)
  3. Currently participating in another clinical trial
  4. Known or suspected allergy to insulin determir
  5. Using insulin
  6. Pregnancy or nursing or the intention of becoming pregnant or not using adequate
  7. Significant liver or heart failure.

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
Other: Insulin determir
Drug: Insulin detemir
Subjects will be randomized to weight based method of 0.1 U/kg for basal insulin or a starting dose based upon an insulin challenge. Subject will record morning fasting blood sugar daily. Using a three day average, the subject will titrate the dose of basal insulin either increasing or lowering by three units based upon target blood glucose of 110 mg/dl.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Days to reach the titration target
Time Frame: 12 weeks
The number of days for the subject to reach the titration target blood sugar of 110 ml/dl
12 weeks

Secondary Outcome Measures

Outcome Measure
Time Frame
The frequency of reported and documented (<70 mg/dl) hypoglycemic events per 24 hour period
Time Frame: 12 weeks
12 weeks

Collaborators and Investigators

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

Sponsor

Diabetes Care Center

Investigators

  • Principal Investigator: Allen B King, MD, Diabetes Care Center

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

June 1, 2011

Primary Completion (Actual)

December 1, 2011

Study Completion (Actual)

December 1, 2011

Study Registration Dates

First Submitted

June 17, 2011

First Submitted That Met QC Criteria

June 20, 2011

First Posted (Estimate)

June 21, 2011

Study Record Updates

Last Update Posted (Estimate)

August 27, 2013

Last Update Submitted That Met QC Criteria

August 23, 2013

Last Verified

August 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • DCC 03-11

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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