Effect of Repaglinide Versus Metformin Treatment in Non-Obese Patients With Type-2-Diabetes

NCT ID: NCT00118963

Last Updated: 2008-12-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

102 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-01-31

Study Completion Date

2006-02-28

Brief Summary

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Aim:

The United Kingdom Prospective Diabetes Study (UKPDS) showed a reduction in cardiovascular events in obese patients with type-2-diabetes treated with metformin compared with other hypoglycaemic treatments with no difference in glycemic control between treatments. Non-obese patients with type-2-diabetes are usually treated with insulin-secretagogues or insulin when diet fails. Since non-obese patients with type-2-diabetes also carry a high risk of cardiovascular events, the use of metformin for this sub-group of patients might be more beneficial. Moreover, when insulin-treatment is initiated ongoing oral hypoglycaemic agents (OHA) are often continued, but in non-obese patients with type-2 diabetes little evidence exist for choosing the optimal class of OHA to be combined with insulin. The aim of the project is therefore to investigate the effect of metformin vs. an insulin-secretagogue (repaglinide) in combination with insulin on glycemic control and non-glycemic cardiovascular risk-factors in non-obese patients with type-2-diabetes, uncontrolled on diet alone.

Methodology:

Single-center, double-blind, double-dummy, randomized, parallel study involving 100 non-obese (BMI 27 kg/m2 or lower) patients with type-2-diabetes investigating the effect of treatment with metformin vs. repaglinide each in combination with biphasic insulin (Insulin-aspart 30/70, BIAsp30) for a period of 12 months.

Detailed Description

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After four months run-in with repaglinide plus metformin combination-therapy, patients with HemoglobinA1c ≥6.5% will be randomized (baseline=0 month) to repaglinide 2 mg thrice-daily or metformin 1g twice-daily, both in combination with BIAsp30 (30% insulin-aspart; 70% protaminated insulin-aspart) (6U once-daily, pre-dinner) for 12 months.

Conditions

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Diabetes Mellitus, Type 2

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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3

BIAsp30 plus Metformin plus Placebo-Repaglinide. Double-Masked and randomized. Duration: 12 months.

Group Type ACTIVE_COMPARATOR

Metformin

Intervention Type DRUG

Tablets of 500 mg; 1000 mg two times daily.

Insulin BIAsp30 (Novolog 70/30)

Intervention Type DRUG

Subcutaneous injection. Starting dose 6 units. Titration according to glycaemic targets during the entire intervention period.

Placebo-Repaglinide

Intervention Type DRUG

Tablet corresponding to 1 mg; two tablets three times daily.

2

BIAsp30 plus Repaglinide plus Placebo-Metformin. Double-masked and randomized. Duration: 12 months.

Group Type ACTIVE_COMPARATOR

Insulin BIAsp30 (Novolog 70/30)

Intervention Type DRUG

Subcutaneous injection. Starting dose 6 units. Titration according to glycaemic targets during the entire intervention period.

Repaglinide

Intervention Type DRUG

Tablets of 1 mg; Dosage: 2 mg three times daily.

Placebo-Metformin

Intervention Type DRUG

Tablets corresponding to 500 mg; two tablets two times daily.

1

Run-in period of four months duration with Repaglinide 6 mg daily plus Metformin 2000 mg daily. No masking of interventions.

Group Type OTHER

Metformin

Intervention Type DRUG

Tablets of 500 mg; 1000 mg two times daily.

Repaglinide

Intervention Type DRUG

Tablets of 1 mg; Dosage: 2 mg three times daily.

Interventions

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Metformin

Tablets of 500 mg; 1000 mg two times daily.

Intervention Type DRUG

Insulin BIAsp30 (Novolog 70/30)

Subcutaneous injection. Starting dose 6 units. Titration according to glycaemic targets during the entire intervention period.

Intervention Type DRUG

Repaglinide

Tablets of 1 mg; Dosage: 2 mg three times daily.

Intervention Type DRUG

Placebo-Metformin

Tablets corresponding to 500 mg; two tablets two times daily.

Intervention Type DRUG

Placebo-Repaglinide

Tablet corresponding to 1 mg; two tablets three times daily.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Non-obese patients (BMI \< 27 kg/m2)
* Type 2 diabetes
* Age 40 years or older
* HbA1c = 6.5% or higher at baseline.

Exclusion Criteria

* No known contraindications for either of the study-drugs (known allergy to the study-drugs; heart-, liver- or kidney-failure)
* Pregnancy
* Other serious physical or mental illnesses with a life-shortening prognosis.
* Drug or alcohol abuse.
* Weight-loss of more than 5 kg during the last 6 month prior to enrollment.
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Steno Diabetes Center Copenhagen

OTHER

Sponsor Role lead

Principal Investigators

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Allan A Vaag, M.D. Chief Physician

Role: STUDY_CHAIR

Steno Diabetes Center Copenhagen

Locations

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Steno Diabetes Center

Gentofte Municipality, , Denmark

Site Status

Countries

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Denmark

References

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Lund SS, Tarnow L, Frandsen M, Nielsen BB, Hansen BV, Pedersen O, Parving HH, Vaag AA. Combining insulin with metformin or an insulin secretagogue in non-obese patients with type 2 diabetes: 12 month, randomised, double blind trial. BMJ. 2009 Nov 9;339:b4324. doi: 10.1136/bmj.b4324.

Reference Type DERIVED
PMID: 19900993 (View on PubMed)

Other Identifiers

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Reform

Identifier Type: -

Identifier Source: org_study_id