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Treatment Trial Evaluating Long Acting Insulin in Type 1 Diabetes
This study has been completed.
First Received: January 11, 2006   No Changes Posted
Sponsored by: Mayo Clinic
Information provided by: Mayo Clinic
ClinicalTrials.gov Identifier: NCT00276393
  Purpose

Patients with type 1 diabetes trained in multiple daily insulin injection were treated with two diffferent kinds of long acting insulin preparations. The two insulin preparations were glargine and ultralente insulin.

Patients were randomized to receive one of the two insulin preparations for the first 4 months followed by the second preparation for a further four months. Short acting insulin used was the same during both periods. We found that glargine insulin was better than ultralente insulin in our study.


Condition Intervention Phase
Type 1 Diabetes
Drug: Basal insulin
Phase IV

Study Type: Interventional
Study Design: Treatment, Randomized, Single Blind, Active Control, Crossover Assignment, Bio-equivalence Study
Official Title: Randomized Trial Comparing Insulin Glargine to Ultra-Lente Insulin in Type I Diabetes

Resource links provided by NLM:


Further study details as provided by Mayo Clinic:

Primary Outcome Measures:
  • HbA1c
  • Hypoglycemic events
  • Nocturnal hypoglycemia
  • Mean glucose
  • Mean fasting glucose

Secondary Outcome Measures:
  • Days of titration of basal insulin
  • Fear of hypoglycemia
  • Continuos glucose monitoring

Estimated Enrollment: 22
Study Start Date: July 2002
Estimated Study Completion Date: December 2003
Detailed Description:

Multiple daily insulin injection (MDI) programs are commonly accompanied by considerable glycemic variation and hypoglycemia. In order to determine whether use of insulin glargine as a basal insulin would result in comparable HbA1c with less glycemic variation and hypoglycemia than ultralente insulin, 22 individuals with type

1 diabetes, experienced with MDI, and a HbA1c of <7.8 % were randomized, to receive either glargine or ultralente as the basal insulin for 4-months. Aspart insulin was used as the prandial. Physicians providing insulin dose adjustment advice were masked to the type of basal insulin. Treatment with glargine resulted in lower mean HbA1c, less nocturnal variability , and less hypoglycemia primarily due to less daytime hypoglycemia (p=0.002). On the other hand, serious hypoglycemia and average glucose concentration measured with continuous glucose monitoring system (CGMS) did not differ. We conclude that, while use of either ultralente or glargine as a basal insulin can result in excellent glycemic control, treatment with glargine is associated with slightly but significantly lower HbA1C, with less nocturnal glycemic variability and less hypoglycemia.

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Type 1 diabetes, HbA1c < 7.8%, who have had prior instruction in a complex insulin program, and presently using a MDI insulin program with basal insulin preparations of Glargine or Ultralente and Humalog as the short acting insulin, should be free of hepatorenal abnormalities and hypoglycemia unawareness; non-pregnant, and should be able to perform frequent self monitoring of blood glucose (SMBG) and accept the use of continuous glucose monitoring system (CGMS). They should also possess the skill and understanding of insulin dose adjustments and supplementation.

  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00276393

Locations
United States, Minnesota
Mayo Clinic
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
Mayo Clinic
Investigators
Principal Investigator: Yogish C. Kudva, M.B.B.S Mayo Clinic
  More Information

Publications:
Study ID Numbers: 70-02, 1A4372
Study First Received: January 11, 2006
Last Updated: January 11, 2006
ClinicalTrials.gov Identifier: NCT00276393     History of Changes
Health Authority: United States: Institutional Review Board

Study placed in the following topic categories:
Metabolic Diseases
Autoimmune Diseases
Diabetes Mellitus
Endocrine System Diseases
Diabetes Mellitus Type 1
Insulin
Insulin, Long-Acting
Hypoglycemic Agents
Diabetes Mellitus, Type 1
Glargine
Endocrinopathy
Glucose Metabolism Disorders
Metabolic Disorder

Additional relevant MeSH terms:
Hypoglycemic Agents
Autoimmune Diseases
Metabolic Diseases
Immune System Diseases
Diabetes Mellitus, Type 1
Physiological Effects of Drugs
Diabetes Mellitus
Endocrine System Diseases
Glucose Metabolism Disorders
Pharmacologic Actions
Insulin

ClinicalTrials.gov processed this record on September 11, 2009