- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT01171456
Early Intervention for Gestational Diabetes
Early Medical Intervention in Women at Risk for Gestational Diabetes
Gestational diabetes (GDM) represents a significant and growing source nationwide of morbidity and mortality for both mothers and infants. Between 5 and 10% of pregnancies are complicated by GDM. Infants exposed in utero to hyperglycemia from GDM have an increased risk of neonatal complications as well as an increased prevalence of a number of chronic diseases, including type 2 diabetes and schizophrenia. Recent research shows that treatment with metformin begun as soon as hyperglycemia is detected in pregnancy is safe and effective. Additional studies demonstrated that metformin is able to decrease the incidence of type 2 diabetes among individuals at risk for this disease. Based upon these findings, the investigators propose to test the hypothesis that metformin therapy for women at risk for gestational diabetes, started prior to conception and before the onset of hyperglycemia, both decreases the incidence of and improves the maternal and neonatal outcomes from GDM.
The investigators intend to conduct a prospective, randomized, double-blind placebo controlled range-finding study to measure the effects of early metabolic intervention with metformin in women at risk for GDM before the commencement of pregnancy or prior to completion of the first trimester. The target sample size for this pilot study is 100 women. The effect size observed will provide preliminary data for a subsequent study which will be sufficiently powered to detect small or moderate effects from early metabolic intervention in women at risk for GDM.
The specific aims of the proposed research consist of the following:
- Determine whether treating women at risk for GDM with metformin prior to conception and/or completion of the 1st trimester decreases the incidence of GDM at 26 weeks' gestation.
- Evaluate the effects on maternal and fetal pregnancy outcomes of pre-conception metabolic intervention with metformin in women at risk for GDM.
Use these pilot study results to:
- identify specific demographic characteristics associated with an intervention effect
- calculate effect size for specific outcomes
- provide range-finding data for a subsequent study design
Metformin therapy for women at risk for gestational diabetes, started prior to conception and before the onset of hyperglycemia, both decreases the incidence of and improves the maternal and neonatal outcomes from GDM.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Tipo de estudio
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
-
-
Utah
-
Murray, Utah, Estados Unidos, 84107
- Intermountain Medical Center
-
-
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
Women delivered >37 weeks gestation in the Intermountain Healthcare Urban Central Region within the last 18 months to ascertain those at risk for GDM in their next pregnancy because of:
- A history of gestational diabetes in their immediately prior pregnancy
- A family history (i.e. type 2 diabetes in a first or second degree relative) of type 2 diabetes
- Delivery of an infant > 4000 gms.
- B.M.I. > 30 six months postpartum
- Hemoglobin A1C > 6.1% six months postpartum
Exclusion Criteria:
Pre-conception exclusion criteria will include any of the following:
- History of >1 miscarriage or fetal demise
- No contraindication to metformin (prior metformin intolerance, metabolic acidosis, GI disease)
- Hypertension (BP >135/85)
- No other endocrine, metabolic, renal, or autommune medical disorders
- Prior preterm birth
- Prior delivery complicated by shoulder dystocia
- Prior delivery complicated by neonatal palsy
- Multifetal pregnancy, including first-trimester embryonic demise of one or more
- Uterine malformations
- Illicit drug or alcohol abuse during current pregnancy
- Intent to deliver elsewhere
- Non-availability for prospective specimen/data collection
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Prevención
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Triple
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
---|---|
Comparador activo: Metformina
|
Administration of Metformin or placebo prior to conception to prevent the onset of GDM.
|
Comparador de placebos: Metformin Placebo
|
Administration of Metformin or placebo prior to conception to prevent the onset of GDM.
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
---|---|
Effect of metformin versus placebo on the development of GDM
Periodo de tiempo: Pre-conception to delivery (at 8 week intervals)
|
Pre-conception to delivery (at 8 week intervals)
|
Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
---|---|
Effects on maternal and fetal pregnancy outcomes of pre-conception metabolic intervention with metformin.
Periodo de tiempo: Pre-conception until discharge from hospital after delivery (at 4 week intervals)
|
Pre-conception until discharge from hospital after delivery (at 4 week intervals)
|
Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Ware Branch, M.D., Intermountain Health Care, Inc.
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 1017118
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. .
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