Safety and Efficacy of Insulin Degludec/Insulin Aspart in Patients With T2DM

A Multicenter, Randomized, Open, Parallel-controlled Clinical Trial to Compare the Efficacy and Safety of IDegAsp BID and IDegAsp QD+2IAsp in Patients With Type 2 Diabetes Mellitus

In this multicenter, randomized, open-label, parallel-controlled, non-inferiority clinical trial, the efficacy and safety of insulin degludec/insulin aspart (IDegAsp) twice daily will be compared with degludec/insulin aspart (IDegAsp) once daily plus insulin aspart (IAsp) twice daily after 16weeks of treatment in patients with type 2 diabetes mellitus. This trial will enable primary assessment of the clinically relevant endpoint of a change in HbA1c.

Study Overview

• Status: Completed
• Conditions: Type 2 Diabetes Mellitus
• Intervention / Treatment: Drug: Insulin Degludec and Insulin Aspart Injection; Drug: Insulin Aspart Injection

Detailed Description

The objective of the current study is to investigate the efficacy and safety of IDegAsp twice daily compared with IDegAsp once daily plus IAsp twice daily for 16 weeks in patients with type 2 diabetes mellitus. The primary endpoint in this study is the change from baseline in HbA1c. Patients with type 2 diabetes who meet the entry criteria are planned for inclusion in this trial. Approximately 224 patients will be enrolled in the study. Patients who qualify will be randomized to IDegAsp group or IDegAsp + IAsp group. Duration of treatment includes 3-week screening period, 16-week treatment observation period and 1-week follow-up.

• Study Type: Interventional
• Enrollment (Actual): 218
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Beijing, China
    • Beijing Hospital
  • Beijing, China
    • Peking University Shougang Hospital
  • Beijing, China
    • Beijing Boai Hospital
  • Beijing, China
    • Aerospace general hospital
  • Hebei
    • Shijiazhuang, Hebei, China
      • Hebei General Hospital
  • Jilin
    • Changchun, Jilin, China
      • Jilin University Sino-Japanese Friendship Hospital
  • Shaanxi
    • Xi'an, Shaanxi, China
      • The Second Affiliated Medical College of Xi'an Jiaotong University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• 1. Informed consent has been obtained before any trial-related activities;
• 2. Patients aged 18~75 years old (including 18 years old and 75 years old);
• 3. Clinical diagnosis of type 2 diabetes ≥ 6 months according to WHO diagnostic criteria before screening;
• 4. Use basal insulin once a day with or without other hypoglycemic drugs for at least 3 months before randomization;
• 5. Glycated hemoglobin between 7.0%~10.0% within 3 month before randomization (including the critical value);
• 6. Body mass index (BMI)≤40.0kg/m2;

Exclusion Criteria:

• 1. Suffering from type 1 diabetes, or special type of diabetes;
• 2. Known premixed insulin or IDegAsp used 3 month before randomization;
• 3. Changes in concomitant medications that are expected to significantly interfere with glucose metabolism;
• 4. Known or suspected subjects are allergic to test drugs, excipients or related similar products and excipients;
• 5. Cardiovascular and cerebrovascular disease, defined as: congestive heart failure (NYHA class III-IV), diagnosis of unstable angina pectoris, stroke and/or myocardial infarction within 6 months before screening; or planned/coronary artery , carotid artery, peripheral artery revascularization;
• 6. According to the judgment of the investigator, repeated hypoglycemia perception impairment and severe hypoglycemia events occurred before screening;
• 7. Abnormal and clinically significant hemoglobin laboratory test results;
• 8. Hepatic insufficiency, defined as alanine aminotransferase (ALT) or aspartate aminotransferase (AST) ≥ 2.5 times the upper limit of the normal range at screening; renal insufficiency, defined as (but not limited to) serum creatinine Levels ≥1.5mg/dL (132umol/L, men) and ≥1.4mg/dL (123umol/L, women), or massive proteinuria (>2 g/day);
• 9. Uncontrolled/untreated hypertension (systolic blood pressure ≥160mmHg or diastolic blood pressure ≥100mmHg) before randomization;
• 10. Two or more events of ketoacidosis or hyperglycemia and hyperosmolar state requiring hospitalization within 6 months prior to screening, or significant diabetic complications, such as symptomatic autonomic neuropathy, diabetic gastric mildew paralysis, proliferative retinopathy, etc. occured;
• 11. According to the judgment of the investigator, significant changes in lifestyle are expected during the trial period, such as shift work (including persistent night/evening shift work) and highly irregular diet and living habits;
• 12. Pregnant or breastfeeding women; those who have a pregnancy plan during the entire trial period and are unwilling to take one or more non-drug contraceptive measures (such as complete abstinence, contraceptive ring, partner ligation, etc.) during the trial;
• 13. Participate in any clinical trial within the past 3 months;
• 14. Those who are not suitable to participate in the trial according to the investigator's judgment, or any clinically significant disease or condition that the investigator believes may affect the results of the trial, such as: a history of hemolytic anemia or sickle cell anemia, a previous history of tumor or cancer Patients with a medical history, patients with a known history of alcohol, drug or drug abuse, blood transfusions or severe blood loss within the first 3 months of screening, or patients with poor adherence in the judgment of the investigator.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: IDegAsp group; IDegAsp twice daily	Drug: Insulin Degludec and Insulin Aspart Injection; To evaluate the efficacy and safety of the IDegAsp BID in T2DM; Other Names: Ryzodeg®
Active Comparator: IDegAsp + IAsp group; IDegAsp once daily plus IAsp twice daily	Drug: Insulin Degludec and Insulin Aspart Injection; To evaluate the efficacy and safety of the IDegAsp BID in T2DM; Other Names: Ryzodeg®; Drug: Insulin Aspart Injection; To evaluate the efficacy and safety of the IDegAsp QD plus IAsp BID in T2DM; Other Names: NovoRapid®

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
HbA1c	the change from baseline in HbA1c after 16 weeks of treatment in all patients	16 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
HbA1c response	the percentage of patients with HbA1c < 7.0% in patients without definite hypoglycemia after 16 weeks of treatment	16 weeks
Body weight	the body weight change from baseline after 16 weeks of treatment	16 weeks
Fasted Blood Glucose	the change from baseline in fasting blood glucose after 16 weeks of treatment	16 weeks
7-Point Self-monitoring Blood Glucose	the change from baseline in 7-point self-monitoring blood glucose profile after 16 weeks of treatment	16 weeks
Continuous Glucose Monitoring	the change from Baseline in Mean Glucose of CGM at Weeks 14-16 of Treatment	14-16 weeks
Percentage of Time In Range	the change from Baseline in Percentage of Readings in Target Range for Blood Glucose Values at Weeks 14-16 of Treatment	14-16 weeks
Percentage of Time Below Range	the change from Baseline in Percentage of Readings below Target Range for Blood Glucose Values at Weeks 14-16 of Treatment	14-16 weeks
Percentage of Time Above Range	the change from Baseline in Percentage of Readings above Target Range for Blood Glucose Values at Weeks 14-16 of Treatment	14-16 weeks
Glucose Management Indicator	the change from Baseline in estimated HbA1c at Weeks 14-16 of Treatment	14-16 weeks
Glucose Variability	Change from Baseline in Glucose Variability (Coefficient of Variation) of CGM at Weeks 14-16 of Treatment	14-16 weeks
Time In Range	the change from Baseline of time in Target Range for Blood Glucose Values at Weeks 14-16 of Treatment	14-16 weeks
Time Below Range	the change from Baseline of time below Target Range for Blood Glucose Values at Weeks 14-16 of Treatment	14-16 weeks
Time Above Range	the change from Baseline of time above Target Range for Blood Glucose Values at Weeks 14-16 of Treatment	14-16 weeks

Collaborators and Investigators

• Sponsor: Beijing Hospital

Study record dates

Study Major Dates

• Study Start (Actual): March 23, 2023
• Primary Completion (Actual): August 15, 2025
• Study Completion (Actual): August 15, 2025

Study Registration Dates

• First Submitted: June 8, 2022
• First Submitted That Met QC Criteria: June 9, 2022
• First Posted (Actual): June 14, 2022

Study Record Updates

• Last Update Posted (Estimated): December 3, 2025
• Last Update Submitted That Met QC Criteria: November 26, 2025
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Endocrine System Diseases; Metabolic Diseases; Glucose Metabolism Disorders; Diabetes Mellitus; Nutritional and Metabolic Diseases; Diabetes Mellitus, Type 2; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Peptide Hormones; Peptides; Amino Acids, Peptides, and Proteins; Insulins; Pancreatic Hormones; Insulin, Short-Acting; Insulin Aspart; insulin degludec, insulin aspart drug combination
• Other Study ID Numbers: MLD-C-21003

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: We plan not to make individual participant data (IPD) available to other researchers.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No