Comparing the Metabolic Control of Once to Twice-daily Insulin Detemir Injections
Comparing the Metabolic Control of Once to Twice-daily Insulin Detemir Injections in Children and Adolescence With Type 1 Diabetes Mellitus.
An open-label, treat to target, intervention study in order to compare the metabolic control of once to twice-daily insulin Detemir injections in children and adolescence with type 1 diabetes mellitus.
All eligible patients will be assigned to receive insulin Detemir once daily before breakfast. Short acting insulin analog, Novorapid, will be used for mealtime insulin. The starting dose of insulin Detemir will be individually determined.Based on self-measured fasting blood glucose levels, insulin doses will be titrated throughout the trial, aiming at pre-breakfast and premeal concentrations of 90-180 mg/dl for subjects aged 6-12 years and 80-130 mg/dl for subjects aged 13-18 years.Patients that after 4 weeks titration phase will not achieve the target blood glucose and up titration of insulin Detemir cannot be done, due to hypoglycemic episodes would be switched to treatment consist of twice daily insulin Detemir. If the target blood glucose are not achieved at the end of the 4 weeks titration phase, but further up titration is possible and patient does not suffer from hypoglycemic episodes, the titration period would be extended and patient would not be switched to treatment with 2 injections of insulin Detemir.When achieving blood glucose targets patient will continue until study end on the maintenance phase.
研究概览
详细说明
An open label,treat to target, prospective, intervention study in order to compare the metabolic control of once to twice-daily insulin detemir injections in children and adolescence with type 1 diabetes mellitus.
Study objectives:
- To assess the efficacy and safety of insulin detemir therapy (once or twice daily) using a treat to target titration protocol for initiating and maintaining therapy in children and adolescents with type 1 diabetes.
- To evaluate the percentage of patients That will achieve a reduction of 0.5% of HbA1c from baseline to end of study evaluation.
- To evaluate Incidence of sever, nocturnal, symptomatic and asymptomatic hypoglycemia and glucose excursions of both hyper and hypoglycemia as measured by the area under the curve determined by the CGMS technique.
Treatment plan:
Patients will be assigned to receive insulin detemir once daily before breakfast. Short acting insulin analog , Novorapid, will be used for mealtime insulin. The starting dose of insulin detemir will be individually determined. Based on self-measured fasting blood glucose levels, insulin doses will be titrated throughout the trial, aiming at pre breakfast and premeal concentrations of 90-180 mg/dl for subjects aged 6-12 years and 80-130 mg/dl for subjects aged 13-18 years.
Patients that after 4 weeks titration phase will not achieve the target blood glucose and up titration of insulin Detemir cannot be done, due to hypoglycemic episodes, would be switched to treatment consist of twice daily insulin Detemir.
If the target blood glucose are not achieved at the end of the 4 weeks titration phase, but further up titration is possible and patient does not suffer from hypoglycemic episodes, the titration period would be extended and patient would not be switched to treatment with 2 injections of insulin Detemir.
研究类型
注册 (预期的)
阶段
- 第四阶段
联系人和位置
学习地点
-
-
-
Petach-Tikva、以色列
- Schneider Children's Medical Center
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Informed consent obtained before any trial related activity
- Children with type 1 diabetes who have been treated with insulin for at least 12 months prior to the study.
- Age > 6 years and < 18 years
- HbA1c > 7.7%
- Ability and willingness to accept the study conditions and to inject insulin detemir
Exclusion Criteria:
- Impaired renal function or current renal dialysis.
- Acute or chronic metabolic acidosis, including diabetic ketoacidosis.
- Known hypoglycemia unawareness.
- Known or suspected allergy to trial products.
- Clinical evidence of active liver disease or impaired hepatic function
- Participation in another study (with study drug) within the last 3 months prior to this trial.
- Significant concomitant disease likely to interfere with glucose metabolism
- Proven eating disorders
- Malignancy within the last 5 years
- History of repeated severe hypoglycemia within the last year.
- Known diabetes retinopathy
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:非随机化
- 介入模型:单组作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
---|---|
实验性的:1
once a day
|
Levemir once a day
|
实验性的:2
twice a day
|
Levemir twice a day
|
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
---|---|
HbA1C
大体时间:at screening visit, at the middle of the study, at the end of the study and prior to sweetching to twice daily treatment
|
at screening visit, at the middle of the study, at the end of the study and prior to sweetching to twice daily treatment
|
SBGM
大体时间:4-8 times a day
|
4-8 times a day
|
CGMS
大体时间:72 hours prior to switching to twice daily treatment and at the end of study
|
72 hours prior to switching to twice daily treatment and at the end of study
|
Total daily basal and bolus insulin
大体时间:will be calculated every visit
|
will be calculated every visit
|
次要结果测量
结果测量 |
大体时间 |
---|---|
documentation of hypoglycemic and hyperglycemic episodes
大体时间:diary will be collected every visit
|
diary will be collected every visit
|
合作者和调查者
调查人员
- 首席研究员:Moshe Phillip, Professor、Schneider Children Medical Center
出版物和有用的链接
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
1 型糖尿病的临床试验
Levemir (insulin detemir)的临床试验
-
University of Texas Southwestern Medical CenterNovo Nordisk A/S撤销
-
Novo Nordisk A/S完全的2型糖尿病 | 糖尿病 | 糖尿病,1 型印度尼西亚
-
Novo Nordisk A/S完全的
-
Novo Nordisk A/S完全的