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Long Acting Insulin Glargine Titration Web Tool (LTHome) vs Enhanced Usual Therapy of Glargine Titration (INNOVATE)

1. september 2015 oppdatert av: Ronnie Aronson, LMC Diabetes & Endocrinology Ltd.

A 12 Week, Parallel, Open-label, Randomized, Multi-center Study Evaluating Use, Safety and Effectiveness of a Web Based Tool vs. Enhanced Usual Therapy of Glargine Titration in T2DM Patients With a 4 Week Safety Extension

Evaluating patients with type 2 diabetes either starting once daily basal insulin or requiring increased basal titrations in order to compare the LTHome web based tool with the usual standard of practice for insulin glargine dosing adjustment.

Studieoversikt

Detaljert beskrivelse

INNOVATE is a 12 week, parallel, open-label, randomized, multi-center study evaluating use, safety and effectiveness of a web based tool (LTHome) vs. enhanced usual therapy (EUT) of glargine titration in T2DM patients.

The primary objective of this study is to compare the effectiveness LTHome versus EUT of glargine titration in people with T2DM patients on basal insulin not meeting local targets or patients requiring basal initiation. Success will be measured by the percentage of subjects reaching Canadian Diabetes Association (CDA) guideline targets.

The efficacy objective is to demonstrate that the percentage (%) of subjects to reach FPG target by titration of insulin glargine using the LTHome tool with dose adjustment advice is not inferior to the % of subjects to reach FPG target using Enhanced Usual Therapy glargine titration during study participation (LTHome vs. EUT treatments).

The secondary objectives of this study are to assess safety, effectiveness, satisfaction and adherence of LTHome use versus Enhanced Usual Therapy glargine titration.

Studietype

Intervensjonell

Registrering (Faktiske)

139

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • Ontario
      • Toronto, Ontario, Canada, M4G 3E8
        • LMC Diabetes & Endocrinology

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år til 75 år (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Patient with type 2 diabetes mellitus (T2DM) between 18 and 75 years old (inclusively) with BMI ≤ 45 kg/m2.
  • Signed written informed consent
  • Patients scheduled to: initiate basal insulin treatment or increase their dose of current basal insulin therapy, independently of study participation, because of :

    • inadequate blood glucose control

  • If on basal therapy at screening, must be using a stable dose of insulin glargine x 1 week prior to randomization
  • Patients with poor blood glucose control defined by:

    • HbA1c level between > 7% at screening AND
    • mean FPG > 7 mmol/l as determined by most recent self-measured blood glucose in 3 of 7 days prior to randomization
  • Patients proficient in computer literacy
  • Patient is able and willing to monitor glucose with a home glucose monitor, and consistently record his/her blood glucose and insulin doses in a patient diary/web tool.

Exclusion Criteria:

  • Any technical/administrative reason that makes it impossible to include the patient in the study, including closing enrollment due to full enrollment
  • Patient who has previously participated in any clinical trial investigating the LTHome algorithm
  • Patient who withdraws consent during screening (starting from signed informed consent form)
  • Use of systemic steroids in the last 90 days
  • Conditions/situations:

    • Patients with short life expectancy (less than 1 year)
    • Type 1 diabetes mellitus
    • Patients with conditions/concomitant diseases making them non-evaluable for the primary efficacy endpoint
    • Clinically significant cardiac disease, retinopathy, hepatic, renal dysfunction or relevant other major diseases as determined by Principal Investigator or designee.
    • Unstable oral antihyperglycemic drugs and/or Glucagon-Like Peptide Receptor (GLP-1R) Agonists therapy during the 4 week period prior to screening
    • Impossibility to meet specific protocol requirements (e.g. ability to perform blood glucose measurements, manage their own insulin glargine administration or deemed unlikely to safely manage insulin dosage on guidance by their HCP)
    • Patient is a primary relative of the Investigator or any Sub-Investigator, research assistant, pharmacist, study coordinator, or other staff or is directly involved in the conduct of the protocol
    • Patients with hypoglycemia unawareness, severe hypoglycemic episode in the last 90 days or hospitalization (for any reason) in the last 30 days
    • Cognitive disorder, dementia or any neurologic disorder, that would affect patient's ability to participate in the study, or patients who have no legal capacity or are under guardianship
  • Pregnant or breastfeeding women, or women of child-bearing potential not protected by highly effective method(s) of birth control (as defined in the informed consent form and/or in a local protocol addendum) and who are unwilling or unable to be tested for pregnancy.
  • Patients who are using, or need to start using, mealtime (Bolus) insulin during the timeframe of the study.
  • Night shift workers

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: LTHome web tool
The long-acting insulin glargine titration web tool (LTHome) will provide insulin glargine titration suggestions based on user inputted blood glucose readings.
The LTHome study arm will receive insulin glargine titration instructions from the LTHome web-based tool
Individual diabetes education, detailed instructions on the use of the blood glucose monitor and unlimited availability of blood glucose monitoring supplies.
Aktiv komparator: Enhanced Usual Therapy (EUT)
The Enhanced Usual Therapy arm will receive insulin glargine titration instructions that are the usual therapy provided by the physician/HCP, in addition to diabetes education.
Individual diabetes education, detailed instructions on the use of the blood glucose monitor and unlimited availability of blood glucose monitoring supplies.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Percentage of subjects reaching fasting plasma glucose (FPG) target
Tidsramme: 12 weeks

The primary outcome is defined as all of the following

  • At least 4 out of 7 FPG readings done within a 10 day period are within the target range of 5-7.2 mmol/L
  • Mean glucose for three consecutive prior FPG values is between 5-7.2 mmol/L
  • There is no severe hypoglycemia during the 7-10 day period (Severe hypoglycemia is defined as third party intervention in management of the hypoglycemia).
12 weeks

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Uønskede hendelser
Tidsramme: 12 uker
12 uker
Number of days to first reach fasting plasma glucose target
Tidsramme: 12 weeks
The number of days in the study until the first day the target is reached.
12 weeks
Number of days in target range after reaching fasting plasma glucose target
Tidsramme: 12 weeks
The number of days after reaching target where the FPG was between 5.0 and 7.2 mmol/L (inclusive)
12 weeks
Fasting plasma glucose
Tidsramme: 12 weeks
Fasting plasma glucose values over the entire study period will be summarized by mean and standard deviation
12 weeks
Hemoglobin A1c (HbA1c)
Tidsramme: 12 weeks
The change in HbA1c will be evaluated as an expression of overall glycemic control in the two treatment arms and compared.
12 weeks
Rate of documented hypoglycemia in subjects that reach target
Tidsramme: 12 weeks
12 weeks
Rate of documented hypoglycemia in subjects that do not reach target
Tidsramme: 12 weeks
12 weeks
Proportion of all patients with hypoglycemia
Tidsramme: 12 weeks
A summary of any hypoglycemia, severe hypoglycemia, nocturnal hypoglycemia, day-time hypoglycemia, symptomatic hypoglycemia, probable symptomatic hypoglycemia, and asymptomatic hypoglycemia will be summarized
12 weeks
Frequency of contact with physician/HCP
Tidsramme: 12 weeks
The number of times subjects contacted their physician/HCP during the study
12 weeks
Diabetes Treatment Satisfaction Questionnaire (DTSQ)
Tidsramme: 12 weeks
A questionnaire to assess subject's overall satisfaction with their diabetes treatment
12 weeks
Hypoglycemia Fear Survey (HFS)
Tidsramme: 12 weeks
A questionnaire to assess the subject's behaviours to avoid hypoglycemia and to measure the subjects' worries about hypoglycemia and its consequences
12 weeks
WHO-5 Well-Being Index
Tidsramme: 12 weeks
A questionnaire to measure emotional well-being to screening for likely depression in subjects with diabetes
12 weeks
Diabetes Distress Scale
Tidsramme: 12 weeks
A questionnaire to assess diabetes-related emotional distress
12 weeks
LTHome Patient Satisfaction Survey
Tidsramme: 12 weeks
LTHome arm only; a questionnaire to measure satisfaction of the use of the LTHome
12 weeks
Number of days subjects self-monitored their fasting plasma glucose
Tidsramme: 12 weeks
12 weeks
Number of dose recommendations prior to reaching target - LTHome only
Tidsramme: 12 weeks
12 weeks
Number of dose recommendations after target is reached - LTHome only
Tidsramme: 12 weeks
12 weeks
Number of days insulin glargine was taken - LTHome only
Tidsramme: 12 weeks
12 weeks
Reasons for disregarding LTHome advice - LTHome only
Tidsramme: 12 weeks
A summary of the reasons that subjects gave for not taking the insulin glargine dose recommendation given by the LTHome web tool when the recommendation was not followed
12 weeks
Serious adverse events
Tidsramme: 12 weeks
12 weeks

Andre resultatmål

Resultatmål
Tidsramme
Body weight (kg)
Tidsramme: 12 weeks
12 weeks
List of concomitant medications initiated after randomization
Tidsramme: 12 weeks
12 weeks

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Samarbeidspartnere

Etterforskere

  • Hovedetterforsker: Ronnie Aronson, MD, LMC Diabetes & Endocrinology Ltd.

Publikasjoner og nyttige lenker

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Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. desember 2013

Primær fullføring (Faktiske)

1. mars 2015

Studiet fullført (Faktiske)

1. mars 2015

Datoer for studieregistrering

Først innsendt

21. august 2015

Først innsendt som oppfylte QC-kriteriene

1. september 2015

Først lagt ut (Anslag)

4. september 2015

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

4. september 2015

Siste oppdatering sendt inn som oppfylte QC-kriteriene

1. september 2015

Sist bekreftet

1. september 2015

Mer informasjon

Begreper knyttet til denne studien

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