Optimal Insulin Correction Factor in Post- High Intensity Exercise Hyperglycemia in Adults With Type 1 Diabetes (FIT) (FIT)

February 17, 2017 updated by: LMC Diabetes & Endocrinology Ltd.

Optimal Insulin Correction Factor in Post- High Intensity Exercise Hyperglycemia in Adults With Type 1 Diabetes: The FIT Study

The overall objective of this study is to investigate the glycemic response of a 0%, 50%, 100% and 150% bolus insulin correction (based on personal insulin correction factor) of post-exercise hyperglycemia in physically active adults with type 1 diabetes (T1D) using multiple daily injections (MDI) in a controlled, but clinically representative, experimental setting.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

FIT is an open-label, repeated measures cross-over study. The overall objective of this study is to investigate the glycemic response of a 0%, 50%, 100% and 150% bolus insulin correction (based on personal insulin correction factor) of post-exercise hyperglycemia in physically active adults with type 1 diabetes (T1D) using multiple daily injections (MDI) in a controlled, but clinically representative, experimental setting. Following a 2 week screening phase, patients will enter an 8 week transition to insulin glargine U300 (Toujeo®) if on another basal insulin, in order to optimize their insulin dose and determine their individual insulin correction factor. The final phase of the study is the intervention phase, which consists of 4 separate visits. At each visit, the patient will perform 15 minutes of high intensity exercise in the morning. If they become hyperglycemic following exercise (blood glucose >8.0 mmol/L), they will receive one of four insulin correction doses (0% 50%, 100%, or 150% of their usual correction factor) in a randomized order. They will be monitored in the clinical pharmacology unit by study staff for the rest of the day and overnight. The patient will wear a continuous glucose monitor (CGM) during each intervention visit. The primary outcome of the study is the greatest net reduction in plasma glucose (YSI) following a 50%, 100% and 150% bolus insulin correction of post-exercise hyperglycemia, compared to no bolus insulin correction. Key secondary outcomes include the mean time spent in post-exercise hyperglycemia (>8.0 mmol/L), post-exercise euglycemia (4.0-8.0 mmol/L) and post-exercise hypoglycaemia (≤ 3.9 mmol/L) within 180 minutes and 24 hours following bolus insulin correction.

Study Type

Interventional

Enrollment (Anticipated)

18

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

  • Canada
    • Ontario
      • Toronto, Ontario, Canada

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 55 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria

  • Male or female
  • Clinical diagnosis of presumed autoimmune T1D
  • Age 18-55 years, inclusive
  • Duration of T1D ≥ 6 months
  • Using MDI therapy for at least 6 months
  • Fasting C-peptide value of < 0.7 ng/mL (0.23 nmol/L) at screening visit
  • Patient must be willing to undergo an 8-week run-in phase prior to the study period where they will be required to use MDI therapy at least 4 times per day, and switch from their usual basal insulin to insulin glargine U300
  • Exercise regularly: i.e. ≥ 30 minutes of moderate or vigorous aerobic activity ≥ 3 times/week for a minimum of 90 minutes weekly
  • VO2peak ≥32 ml/kg/min for females and ≥ 35 ml/kg/min for males
  • HbA1c between 6.0-9.0% inclusive at screening visit.
  • Insulin total daily dose (TDD) ≥ 30 U/day
  • In good general health with no known conditions that could influence the outcome of the trial, and in the judgement of the Investigator is a good candidate for the study based on review of available medical history, physical examination and clinical laboratory evaluations
  • Willing to adhere to the protocol requirements for the duration of the study

Exclusion Criteria

  • Pregnant or lactating
  • Active diabetic retinopathy (proliferative diabetic retinopathy, or vitreous haemorrhage in past 6 months) that could potentially be worsened by the exercise protocol
  • Any evidence of unstable cardiovascular disease, disorders or abnormalities as per physician's discretion. .
  • Currently following a very low calorie or other weight-loss diet which may impact glucose control and mask the primary and secondary outcome measures
  • More than one episode of severe hypoglycemia with seizure, coma or requiring assistance of another person during the past 6 months
  • Known hypoglycemia unawareness
  • Use of acetaminophen (Tylenol) during the run-in phase or study period
  • Medications other than insulin that might impact outcome measures:
  • Beta blockers
  • Agents that affect hepatic glucose production such as beta adrenergic agonists and antagonists, xanthine derivatives
  • Pramlintide
  • Any non-insulin diabetes therapy

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: Crossover Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: 0% Bolus Insulin Correction
Other: 0% bolus insulin correction
Patients will receive no bolus insulin correction for post-exercise hyperglycemia
Active Comparator: 50% Bolus Insulin Correction
Drug: 50% bolus insulin correction
Patients will receive 50% of their usual bolus insulin correction for post-exercise hyperglycemia
Active Comparator: 100% Bolus Insulin Correction
Drug: 100% bolus insulin correction
Patients will receive 100% of their usual bolus insulin correction for post-exercise hyperglycemia
Active Comparator: 150% Bolus Insulin Correction
Drug: 150% bolus insulin correction
Patients will receive 150% of their usual bolus insulin correction for post-exercise hyperglycemia

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Reduction In Plasma Glucose (YSI)
Time Frame: 147 days
147 days

Secondary Outcome Measures

Outcome Measure
Time Frame
Investigate Glycemic Response of a 0%, 50%, 100% and 150% Bolus Insulin Correction of Post-exercise Hyperglycemia Compared to no Bolus Insulin Correction
Time Frame: 147 days
147 days

Collaborators and Investigators

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

Sponsor

LMC Diabetes & Endocrinology Ltd.

Collaborators

Sanofi

Investigators

  • Principal Investigator: Ronnie Aronson, MD, LMC Diabetes & Endocrinology

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

May 1, 2016

Primary Completion (Anticipated)

March 1, 2017

Study Completion (Anticipated)

March 1, 2017

Study Registration Dates

First Submitted

December 23, 2016

First Submitted That Met QC Criteria

February 17, 2017

First Posted (Actual)

February 20, 2017

Study Record Updates

Last Update Posted (Actual)

February 20, 2017

Last Update Submitted That Met QC Criteria

February 17, 2017

Last Verified

February 1, 2017

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • FIT

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Only overall study data will be shared

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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