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
調査の概要
詳細な説明
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).
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
-
-
Alberta
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Calgary、Alberta、カナダ、T3B 6A8
- Alberta Children's Hospital
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-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
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.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的：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.
他の名前：
|
|
アクティブコンパレータ：Standard TID insulin
Active Control Group: Usual TID Insulin Regimen (intermediate insulin- Humulin N or Novolin NPH)
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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.
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
|
ヘモグロビン A1C
時間枠：6ヶ月
|
6ヶ月
|
二次結果の測定
結果測定 |
時間枠 |
|---|---|
|
Number of episodes of hypoglycemia (severe and mild)
時間枠：6 months
|
6 months
|
|
Number of episodes of diabetic ketoacidosis (DKA)
時間枠：6 months
|
6 months
|
|
Body Mass Index (BMI) kg/m2
時間枠：6 months
|
6 months
|
|
Diabetes Quality of Life Questionaire-youth version
時間枠：6 months
|
6 months
|
協力者と研究者
スポンサー
捜査官
- 主任研究者：Josephine Ho, MD、University of Calgary
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- E-20635
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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