- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT00522210
Comparison of a Twice Daily Versus a Three Times Daily Insulin Regimen in Children With Type 1 Diabetes
A Comparison of Insulin Detemir in a BID Insulin Regimen Versus a TID Insulin Regimen in Children With Type 1 Diabetes: A Randomized Controlled Trial
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Children with type 1 diabetes (DM1) can only be treated with subcutaneous insulin at the present time in Canada. It has been shown that intensive insulin treatment using at least three times daily (TID) insulin injections achieves superior blood glucose control with less long term complications of diabetes than conventional insulin treatment using once daily (OD) or twice daily (BID) insulin injections. However, many patients find it difficult to adhere to TID insulin injections since it is an invasive and painful therapy, which results in frequent insulin omission.
This study is a randomized controlled open-labeled non-inferiority trial to compare the glycemic control as measured by HbA1c after 6 months of a BID insulin regimen using detemir insulin, or the currently used TID insulin with intermediate acting insulin (Novolin NPH or Humulin N). Patients will be randomized to either the active control group (standard TID regimen) or the treatment group (BID regimen with new long acting insulin analogue). A run-in period of 1 month will be used to facilitate the change in insulin regimen. Insulin doses will be adjusted by weekly phone contact with the research nurse for one month prior to baseline blood work. Patients will continue on the same diet and exercise routine as recommended by their usual diabetes team. They will also be seen every 3 months by the research nurse to review blood glucose, assess height and weight and arrange for blood work to be done in conjunction with their routine bloodwork. All patients will continue to be seen by their usual diabetologist, nurse, and dietician at their regularly scheduled clinic visits (every 3 months).
Outcomes include: HA1c between groups at 6 months (surrogate marker of metabolic control for diabetes measured through a venous or capillary blood sample), frequency of adverse events (severe hypoglycemia, mild hypoglycemia, episodes of diabetic ketoacidosis, weight gain), diabetes quality of life for youth (DQOL).
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
-
-
Alberta
-
Calgary, Alberta, Canada, T3B 6A8
- Alberta Children's Hospital
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Children with DM1 6-17 years old that are currently on a TID regimen of insulin with rapid acting insulin and intermediate acting insulin.
- Currently being followed at the Alberta Children's Hospital Diabetes Clinic.
- Duration of diabetes of at least 12 months.
Exclusion Criteria:
- Children younger than 6 years of age will be excluded since long-acting analogue has not been approved in children younger than 6 years old.
- Children with compromised metabolic control (HA1c greater than 10%).
- Children with other chronic underlying medical conditions that could affect glycemic control i.e. uncontrolled hypothyroidism, hyperthyroidism, celiac disease, etc.
- Language or psychosocial barrier preventing the family from completing the study.
- Diabetes duration of less than 12 months.
- Participation in other clinical trials with specified clinic visit schedule.
- Patients currently on insulin pump therapy or multiple daily injections of greater than three injections per day.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
---|---|
Expérimental: BID insulin with LA analogue
Treatment Group: BID Insulin Regimen with Long Acting Insulin Analogue (Detemir)
|
Patients will discontinue their usual bedtime dose of intermediate acting insulin and replace this with the same unit dose of detemir at supper time.
The detemir will not be mixed with the rapid acting insulin and will be given as a separate injection.
The patient's morning dose of intermediate acting insulin will be decreased by 20% to adjust for the longer duration of action of detemir.
Doses of rapid acting insulin will remain the same at breakfast and at supper.
Autres noms:
|
Comparateur actif: Standard TID insulin
Active Control Group: Usual TID Insulin Regimen (intermediate insulin- Humulin N or Novolin NPH)
|
Patients will continue on their usual insulin regimen of insulin three times per day.
Intermediate and rapid acting insulin at breakfast, rapid acting insulin at supper, and intermediate acting insulin at bedtime.
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Délai |
---|---|
Hémoglobine a1c
Délai: 6 mois
|
6 mois
|
Mesures de résultats secondaires
Mesure des résultats |
Délai |
---|---|
Number of episodes of hypoglycemia (severe and mild)
Délai: 6 months
|
6 months
|
Number of episodes of diabetic ketoacidosis (DKA)
Délai: 6 months
|
6 months
|
Body Mass Index (BMI) kg/m2
Délai: 6 months
|
6 months
|
Diabetes Quality of Life Questionaire-youth version
Délai: 6 months
|
6 months
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Josephine Ho, MD, University of Calgary
Publications et liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- E-20635
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .
Essais cliniques sur Diabète de type 1
-
National Institute of Allergy and Infectious Diseases...PPD; Rho Federal Systems Division, Inc.; Immune Tolerance Network (ITN)ComplétéDiabète sucré de type 1 | DT1 | DT1 | Diabète sucré de type 1 d'apparition récenteÉtats-Unis, Australie
-
Eledon PharmaceuticalsRetiréDiabète sucré de type 1 fragileÉtats-Unis
-
Ain Shams UniversityInconnueDiabète sucré de type 1 avec hypoglycémie | diabète de type 1Egypte
-
Spiden AGDCB Research AGRecrutementDiabète sucré de type 1 | Diabète sucré de type 1 avec hypoglycémie | Diabète sucré de type 1 avec hyperglycémieSuisse
-
Medical College of WisconsinRecrutementDiabète de type 1 | Diabète sucré de type 1 | diabète de type 1États-Unis
-
Shanghai Changzheng HospitalRecrutementDiabète sucré de type 1 fragileChine
-
Instytut Diabetologii Sp. z o.o.National Center for Research and Development, Poland; Nalecz Institute of...InconnueDiabète sucré de type 1 avec hyperglycémie | Diabète sucré de type 1 avec hypoglycémiePologne
-
Capillary Biomedical, Inc.ComplétéDiabète sucré, type 1 | Diabète de type 1 | Diabète sucré de type 1 | Diabète sucré, dépendant de l'insuline, 1Australie
-
Poznan University of Medical SciencesInconnueDiabète sucré de type 1 | Rémission du diabète de type 1 | Complications chroniques du diabètePologne
-
Hadassah Medical OrganizationInconnuePatients diabétiques de type 1 non contrôlés