Pilot Study of Glycemic Control in Diabetic Hemodialyzed Patients (GlyCEDIA)
tiistai 9. huhtikuuta 2013 päivittänyt: Centre Europeen d'Etude du Diabete
Glycemic Control Assessed by Continuous Glucose Monitoring in Hemodialyzed Patients With Diabetes Mellitus Treated Via the Basal-Bolus Detemir-Aspart Insulin Regimen: A Pilot Study
The purpose of the study is to evaluate the effect of the basal-bolus detemir-aspart insulin regimen coupled with continuous glucose monitoring (CGM) on glycemic control in hemodialyzed patients with diabetes
Tutkimuksen yleiskatsaus
Tila
Valmis
Ehdot
Interventio / Hoito
Yksityiskohtainen kuvaus
We conducted a pilot prospective multicenter study in five French centers (Strasbourg University Hospital, Strasbourg Sainte Anne Hospital, Colmar, Mulhouse, Valenciennes) designed to evaluate the feasibility and effects of a 3 month treatment regimen with rapid-acting insulin and basal long-acting insulin analogues (i.e., aspart and detemir, respectively) along with CGM on glucose level control in diabetic hemodialyzed patients.
All patients who were admitted to the nephrology departments and matched the inclusion criteria between January 1st, 2010, and June 30th, 2012, were consecutively included in the study. CGM was used to analyze blood glucose excursions at baseline and 1 and 3 months of treatment. It was started during the first dialysis session and then continued for the next two days at home under ambulatory conditions. The CGM was continued during the next dialysis session. Therefore, in total, CGM (Navigator®; Abbott, Rungis, France) was performed for 54 hours, including two consecutive hemodialysis sessions and at 0, 1, and 3 months of treatment. The probe for the system was subcutaneously inserted at the beginning of the first dialysis session to analyze interstitial glucose, and it was removed at the end of the second dialysis session. Due to the time required for CGM calibration, plasma glucose levels were only partially recorded during the first dialysis session.
Opintotyyppi
Interventio
Ilmoittautuminen (Todellinen)
38
Vaihe
- Vaihe 4
Yhteystiedot ja paikat
Tässä osiossa on tutkimuksen suorittajien yhteystiedot ja tiedot siitä, missä tämä tutkimus suoritetaan.
Opiskelupaikat
-
-
-
Colmar, Ranska, 68000
- Regional Hospital of Colmar
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Mulhouse, Ranska, 68100
- Regional Hospital of Mulhouse
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Strasbourg, Ranska, 67000
- University Hospital of Strasbourg
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Strasbourg, Ranska, 67000
- Sainte Anne Hospital
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Valenciennes, Ranska, 59300
- Regional Hospital of Valenciennes
-
-
Osallistumiskriteerit
Tutkijat etsivät ihmisiä, jotka sopivat tiettyyn kuvaukseen, jota kutsutaan kelpoisuuskriteereiksi. Joitakin esimerkkejä näistä kriteereistä ovat henkilön yleinen terveydentila tai aiemmat hoidot.
Kelpoisuusvaatimukset
Opintokelpoiset iät
18 vuotta - 83 vuotta (Aikuinen, Vanhempi Aikuinen)
Hyväksyy terveitä vapaaehtoisia
Ei
Sukupuolet, jotka voivat opiskella
Kaikki
Kuvaus
Inclusion Criteria:
- age between 18 and 83 years
- diagnosis of type 1 or type 2 diabetes
- treatment with insulin injections or oral hypoglycemic agents
- HbA1c ≥ 7% (i.e., 53 mmol/mol)
- on hemodialysis for more than three months
Exclusion Criteria:
- unstable anemia or blood transfusions within the two months prior to the beginning of the study
- a life expectancy of less than 1 year
- chronic inflammatory disease
- evolutive cancer requiring steroid treatment, chemotherapy, radiotherapy, or programmed surgery
- noncompliant patients
Opintosuunnitelma
Tässä osiossa on tietoja tutkimussuunnitelmasta, mukaan lukien kuinka tutkimus on suunniteltu ja mitä tutkimuksella mitataan.
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Ei käytössä
- Inventiomalli: Yksittäinen ryhmätehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
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Kokeellinen: Basal-bolus specific insulin regimen
Basal-bolus detemir-aspart insulin regimen in hemodialyzed diabetic patients
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After the first CGM was completed during the conventional anti-diabetic treatment, patients received a rapid-acting insulin analogue before each meal (i.e., aspart) and a basal long-acting insulin analogue (i.e., detemir) once or twice daily.
The analogues were titrated for optimal glycemic control.
After one month of the aspart and detemir regimen, a physician adapted the insulin doses according to the glucose values observed from the second CGM.
Muut nimet:
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Mean plasma glucose level measured 3 times just before the first hemodialysis session
Aikaikkuna: Baseline and at 3 months of treatment
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Determination by the glucose dehydrogenase method
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Baseline and at 3 months of treatment
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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HbA1c
Aikaikkuna: Baseline and at 3 months of treatment
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Measured by high-performance liquid chromatography
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Baseline and at 3 months of treatment
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Body weight
Aikaikkuna: Baseline and at 1 month and 3 months of treatment
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Baseline and at 1 month and 3 months of treatment
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|
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Insulin requirements
Aikaikkuna: Baseline and at 1 month and 3 months of treatment
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IU per day
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Baseline and at 1 month and 3 months of treatment
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Symptomatic hypoglycemia
Aikaikkuna: Baseline and at 1 month and 3 months of treatment
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Number of glycemia < 60 mg/dl per patient and per month
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Baseline and at 1 month and 3 months of treatment
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Continuous glucose monitoring parameters
Aikaikkuna: Baseline and at 1 month and 3 months of treatment
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Including: mean continuous glucose monitoring glucose values, within-subjects standard deviation (wSD) and coefficient of variation (wCV = wSD/mean), mean amplitude of glycemic excursion (MAGE), frequency of glucose values under 60 mg/dl, and frequency of glucose values higher than 180 mg/dl
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Baseline and at 1 month and 3 months of treatment
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Deaths and major cardiovascular events
Aikaikkuna: Baseline and at 3 months of treatment
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All-cause mortality Major cardiovascular events including: myocardial infarction, stroke, and peripheral vascular disease
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Baseline and at 3 months of treatment
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Yhteistyökumppanit ja tutkijat
Täältä löydät tähän tutkimukseen osallistuvat ihmiset ja organisaatiot.
Sponsori
Tutkijat
- Opintojohtaja: Laurence Kessler, PhD, University Hospital of Strasbourg
Julkaisuja ja hyödyllisiä linkkejä
Tutkimusta koskevien tietojen syöttämisestä vastaava henkilö toimittaa nämä julkaisut vapaaehtoisesti. Nämä voivat koskea mitä tahansa tutkimukseen liittyvää.
Yleiset julkaisut
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