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- Registre américain des essais cliniques
- Essai clinique NCT00922402
Heart & Diabetes - Feasibility Study
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
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.
Type d'étude
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
-
-
-
Catania, Italie
- Garibaldi Nesima Hospital
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Pavia, Italie
- Policlinico S. Matteo
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-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
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
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Non randomisé
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
---|---|
Expérimental: 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. |
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Délai |
---|---|
Average time to glycemic target (90-130 mg/dL)
Délai: Within two days after enrollment
|
Within two days after enrollment
|
Mesures de résultats secondaires
Mesure des résultats |
Délai |
---|---|
Number of patient-days without deviations from the protocol
Délai: Within two days after enrollment
|
Within two days after enrollment
|
Average glycemia in the first 6 hours
Délai: Within six hours after enrollment
|
Within six hours after enrollment
|
Slope of decremental curve of glycemia in the first 6 hours
Délai: Within six hours after enrollment
|
Within six hours after enrollment
|
Median number of glycemia controls/patient in the first 12 hours
Délai: Within twelve hours after enrollment
|
Within twelve hours after enrollment
|
Percentage of patients in glycemic range during the first 6 hours of infusion
Délai: Within six hours after enrollment
|
Within six hours after enrollment
|
Number of hypoglycemia episodes in the first 5 days
Délai: 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
Délai: Within five days after enrollment
|
Within five days after enrollment
|
HbA1c at 3 months and variation with respect to baseline
Délai: Within three months after enrollment
|
Within three months after enrollment
|
Number of hypoglycemia episodes in the follow-up
Délai: Within three months after enrollment
|
Within three months after enrollment
|
Evaluation of the number of finger-stick measurement and CGM readings
Délai: Within five days after enrollment
|
Within five days after enrollment
|
Evaluation of the correlation between finger-stick measurement and CGM readings
Délai: 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
Délai: Within five days after enrollment
|
Within five days after enrollment
|
Number of times that finger-stick overruled CGM readings or alarms not to do any therapy adjustment
Délai: WIthin five days after enrollment
|
WIthin five days after enrollment
|
Evaluation of healthcare resource consumption
Délai: Within three months after enrollment
|
Within three months after enrollment
|
Evaluation of organizational impact
Délai: Within three months after enrollment
|
Within three months after enrollment
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chaise d'étude: Riccardo Vigneri, MD, Garibaldi-Nesima Hospital - Catania - Italy
- Chaise d'étude: Maddalena Lettino, MD, Policlinico S. Matteo - Pavia - Italy
- Chaise d'étude: Michele Gulizia, MD, Garibaldi-Nesima Hospital - Catania - Italy
- Chaise d'étude: Luigi Magnani, MD, Policlinico S. Matteo - Pavia - Italy
- Chaise d'étude: Luigi Tavazzi, MD, Ospedale Villa Maria Cecilia - Gruppo Villa Maria - Cotignola (Ravenna) - Italy
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
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- Heart & Diabetes
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 .
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