- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT00922402
Heart & Diabetes - Feasibility Study
Studienübersicht
Status
Bedingungen
Intervention / Behandlung
Detaillierte Beschreibung
Heart failure is a common disease (prevalence worldwide: 22 million; incidence worldwide: 2 million; prevalence in Italy: 750.000; incidence in Italy: 170.000), affecting 1-2% of overall population and accounting for a significant proportion of healthcare costs. Recurrent hospital admissions represent the majority of the disease-related cost. About 15-25% of patients with HF are diabetics: the presence of diabetes significantly worsens prognosis in patients with heart failure and increases the risk of death by 30% compared to subject without diabetes.
The intensive control of glycemia during acute heart failure is an objective of primary importance, which can be obtained only with a proper strategy of patient management and with a considerable organizational effort. In a shared protocol aimed at a tight control of glycemia, the use of Continuous Glucose Monitoring (CGM) is expected to allow an easier management of the patient and a more accurate implementation of the protocol.
The main purpose of this study is to validate an intensive protocol of insulin infusion and subsequent subcutaneous insulin administration with the support of continuous glucose monitoring, in addition to reference finger-stick values.
Studientyp
Phase
- Unzutreffend
Kontakte und Standorte
Studienorte
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-
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Catania, Italien
- Garibaldi Nesima Hospital
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Pavia, Italien
- Policlinico S. Matteo
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria (all of the following inclusion criteria must be met for the patient to be enrolled in the study):
- acute heart failure, defined according to current ESC Guidelines
- HbA1c > 7.5% at admission in Cardiology Unit
- glycemia > 180 mg/dL at admission in Cardiology Unit
- the patients signed the Informed Consent
Exclusion Criteria (if any of the following criteria are met, patients cannot be enrolled in the study):
- heart failure in acute infarction or cardiogenic shock
- creatinemia > 3.5 mg/dL at admission or in hemodialytic therapy
- cirrhosis
- acute infective pathology
- cardiac revascularization during the hospitalization or in the preceding 3 months
- life expectance < 12 months
- age < 18 years
- pregnant women
- informed consent not signed
- subject included in other protocols
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Nicht randomisiert
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
---|---|
Experimental: Treatment
All patients will be submitted to a shared intensive protocol of insulin infusion supported by continuous glucose monitoring
|
The intensive control of glycemia is obtained with a shared in-hospital insulin infusion protocol, supported by the use of a continuous glucose monitoring system (Medtronic Guardian REAL Time). Any sudden variation of glycemia levels and/or alarms, as indicated by the device, has to be confirmed with a finger-stick before any therapy modification. In-hospital management is subdivided in a 2-day intensive and a 3-day post-intensive phase. |
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
---|---|
Average time to glycemic target (90-130 mg/dL)
Zeitfenster: Within two days after enrollment
|
Within two days after enrollment
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
---|---|
Number of patient-days without deviations from the protocol
Zeitfenster: Within two days after enrollment
|
Within two days after enrollment
|
Average glycemia in the first 6 hours
Zeitfenster: Within six hours after enrollment
|
Within six hours after enrollment
|
Slope of decremental curve of glycemia in the first 6 hours
Zeitfenster: Within six hours after enrollment
|
Within six hours after enrollment
|
Median number of glycemia controls/patient in the first 12 hours
Zeitfenster: Within twelve hours after enrollment
|
Within twelve hours after enrollment
|
Percentage of patients in glycemic range during the first 6 hours of infusion
Zeitfenster: Within six hours after enrollment
|
Within six hours after enrollment
|
Number of hypoglycemia episodes in the first 5 days
Zeitfenster: Within five days after enrollment
|
Within five days after enrollment
|
Number of medical interventions and/or therapy variations based on blood glucose monitoring (finger-sticks) and/or suggested by interstitial continuous glucose monitoring glucose monitoring in the first 5 days
Zeitfenster: Within five days after enrollment
|
Within five days after enrollment
|
HbA1c at 3 months and variation with respect to baseline
Zeitfenster: Within three months after enrollment
|
Within three months after enrollment
|
Number of hypoglycemia episodes in the follow-up
Zeitfenster: Within three months after enrollment
|
Within three months after enrollment
|
Evaluation of the number of finger-stick measurement and CGM readings
Zeitfenster: Within five days after enrollment
|
Within five days after enrollment
|
Evaluation of the correlation between finger-stick measurement and CGM readings
Zeitfenster: Within five days after enrollement
|
Within five days after enrollement
|
Number of times that therapy was changed after finger-stick confirmation when CGM values or alarms were indicating a therapy adjustment needs to be made
Zeitfenster: Within five days after enrollment
|
Within five days after enrollment
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Number of times that finger-stick overruled CGM readings or alarms not to do any therapy adjustment
Zeitfenster: WIthin five days after enrollment
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WIthin five days after enrollment
|
Evaluation of healthcare resource consumption
Zeitfenster: Within three months after enrollment
|
Within three months after enrollment
|
Evaluation of organizational impact
Zeitfenster: Within three months after enrollment
|
Within three months after enrollment
|
Mitarbeiter und Ermittler
Sponsor
Ermittler
- Studienstuhl: Riccardo Vigneri, MD, Garibaldi-Nesima Hospital - Catania - Italy
- Studienstuhl: Maddalena Lettino, MD, Policlinico S. Matteo - Pavia - Italy
- Studienstuhl: Michele Gulizia, MD, Garibaldi-Nesima Hospital - Catania - Italy
- Studienstuhl: Luigi Magnani, MD, Policlinico S. Matteo - Pavia - Italy
- Studienstuhl: Luigi Tavazzi, MD, Ospedale Villa Maria Cecilia - Gruppo Villa Maria - Cotignola (Ravenna) - Italy
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Schätzen)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
- Heart & Diabetes
Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .
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