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Insulin Exposure and Glucose Response to Meals in Type 1 Diabetic Subjects Administered Two Different Insulin Regimens Compared to the Endogenous Insulin Exposure and Glucose Response to Meals In Healthy Adult Controls

10 de diciembre de 2014 actualizado por: Steve Davis, Vanderbilt University

An Open-Label, Randomized, Two-Period, Crossover Study to Characterize the Insulin Exposure and Glucose Response to Meals in Type 1 Diabetic Subjects Administered Two Different Insulin Regimens Compared to the Endogenous Insulin Exposure and Glucose Response to Meals In Healthy Adult Controls

Intensive control of Type 1 Diabetes is critical in prevention of long term complications. Unfortunately, there is a three-fold increase in hypoglycemia with intensive control. Hypoglycemia is often the major limiting factor in achieving good control. Insulin treatment of diabetes is composed of some form of short acting insulin regimen in order to provide control of blood glucose excursions that are the result of glucose intake as well as a basal insulin regimen either in a continuous administration (as in continuous subcutaneous insulin infusion-"pump therapy"), once a day injection (insulin Glargine), twice a day (ultralente or NPH or lente insulin) or a premixed version that is combined with the short acting insulin (70/30 or 75/25). Often low blood sugars are the result of less physiologically absorbed insulins whose peak of action is earlier or later than the peak absorption of glucose from a meal.

Apidra (glulisine insulin) is a new short acting insulin analogue whose peak and duration of action are ideal in that it may be administered more appropriately prior to and even after a meal with evidence of good control of blood glucose excursions from a meal. The purpose of this study is to compare the effect of Apidra upon meal related blood glucose profile as compared to those treated with 70/30 insulin in patients with Type 1 Diabetes. The investigators also will study healthy volunteers as controls who will not be treated with insulin but will be evaluated for mealtime absorption and blood glucose profile during similar meal intake. The investigators will use a stable isotope tritiated glucose.

Descripción general del estudio

Estado

Terminado

Condiciones

Descripción detallada

Intensive control of Type 1 Diabetes is critical in prevention of long term complications. Unfortunately, there is a three-fold increase in hypoglycemia with intensive control. Hypoglycemia is often the major limiting factor in achieving good control. Insulin treatment of diabetes is composed of some form of short acting insulin regimen in order to provide control of blood glucose excursions that are the result of glucose intake as well as a basal insulin regimen either in a continuous administration (as in continuous subcutaneous insulin infusion-"pump therapy"), once a day injection (insulin Glargine), twice a day (ultralente or NPH or lente insulin) or a premixed version that is combined with the short acting insulin (70/30 or 75/25). Often low blood sugars are the result of less physiologically absorbed insulins whose peak of action is earlier or later than the peak absorption of glucose from a meal.

Apidra (glulisine insulin) is a new short acting insulin analogue whose peak and duration of action are ideal in that it may be administered more appropriately prior to and even after a meal with evidence of good control of blood glucose excursions from a meal. The purpose of this study is to compare the effect of Apidra upon meal related blood glucose profile as compared to those treated with 70/30 insulin in patients with Type 1 Diabetes. We also will study healthy volunteers as controls who will not be treated with insulin but will be evaluated for mealtime absorption and blood glucose profile during similar meal intake. We will use a stable isotope tritiated glucose.

Tipo de estudio

Intervencionista

Inscripción (Actual)

24

Fase

  • No aplica

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años a 55 años (Adulto)

Acepta Voluntarios Saludables

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Diabetic Subjects

    1. 12 adults (males or females) with Type 1 Diabetes, aged 18 to 55 years.
    2. C-peptide-negative
    3. Body mass index < 29.0 kg/m2
  • Healthy Subjects

    1. 12 non-smoking adults (males or females), aged 18 to 55 years
    2. Normal response to an oral glucose tolerance test (OGTT)
    3. Body mass index < 29.0 kg/m2

Exclusion Criteria:

  • Diabetic Subjects

    1. Hemoglobin A1c >9%
    2. Total daily insulin requirements >0.8 units/kg actual body weight
    3. History of hypoglycemia that required the subject to see medical attention (i.e., doctor's office visit, ER visit, or EMT/paramedic attention) within 6 months of the study.
    4. History of acute metabolic complications within 3 months of the study
    5. History of lipodystrophy.
    6. History of or suspected diabetic gastroparesis or current treatment with any drugs known to affect gastrointestinal motility.
    7. Inability or unwillingness to administer subcutaneous insulin injections in the abdomen.
    8. Any past or present clinically relevant abnormality, medical condition, or circumstance making the subject unsuitable for participation in the study.
    9. Active peptic ulcer disease or a history of gastrointestinal surgery within the last 6 months years.
    10. History of malignancy (except basal cell carcinoma and carcinoma in situ) within the last 5 years.
    11. Pregnant or lactating females or females of childbearing potential who are unwilling to abstain from sexual intercourse or use reliable, medically accepted methods of contraception.
    12. History of alcoholism or drug abuse within 12 months of the study.
    13. Is the investigator, sub-investigator, research assistant, pharmacist, study coordinator, other study staff, or relative thereof directly involved in the conduct of this protocol.
  • Healthy Subjects

    1. Hemoglobin A1c >6.0%
    2. Any past or present clinically relevant abnormality, medical condition, or circumstance making the subject unsuitable for participation in the study.
    3. Historical, clinical, or laboratory evidence of liver disease including but not limited to transaminase activity concentrations >2.5 times the upper limit of the reference range.
    4. Current treatment with any drugs known to affect gastrointestinal motility.
    5. Active peptic ulcer disease or a history of gastrointestinal surgery within the last 6 months.
    6. History of malignancy (except basal cell carcinoma and carcinoma in situ) within the last 5 years.
    7. Pregnant or lactating females or females of childbearing potential who are unwilling to abstain from sexual intercourse or use reliable, medically accepted methods of contraception.
    8. History of alcoholism or drug abuse within 12 months of the study.
    9. Is the investigator, sub-investigator, research assistant, pharmacist, study coordinator, other study staff, or relative thereof directly involved in the conduct of this protocol.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación cruzada
  • Enmascaramiento: Único

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Comparador activo: Apidra (insulin glulisine)
Administration of Apidra at three meals during a 24 hour period.
Dose injection of insulin glargine (Lantus®) given subcutaneously in the abdomen 1 hour prior to breakfast and a dose of insulin glulisine (Apidra®) at a dose based upon your (body wt.) carbohydrate intake for each of the three meals (breakfast, lunch and dinner).
Otros nombres:
  • Apidrá
Comparador activo: 70/30 insulin
Administration of 73/30 insulin at three meals during a 24 hour period.
Dose based on carbohydrate intake given subcutaneously in the abdomen prior to breakfast and dinner.
Otros nombres:
  • Humalog 70/30

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Periodo de tiempo
Insulin levels
Periodo de tiempo: 24 hours
24 hours

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Colaboradores

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de abril de 2005

Finalización primaria (Actual)

1 de abril de 2006

Finalización del estudio (Actual)

1 de diciembre de 2010

Fechas de registro del estudio

Enviado por primera vez

23 de junio de 2009

Primero enviado que cumplió con los criterios de control de calidad

24 de junio de 2009

Publicado por primera vez (Estimar)

25 de junio de 2009

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

11 de diciembre de 2014

Última actualización enviada que cumplió con los criterios de control de calidad

10 de diciembre de 2014

Última verificación

1 de diciembre de 2014

Más información

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

Ensayos clínicos sobre Diabetes tipo 1

Ensayos clínicos sobre Insulin glulisine

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