Study To Evaluate Beta Cell Function and Glycemic Outcome by Intensive Insulin Therapy

NCT ID: NCT00474838

Last Updated: 2013-09-26

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

112 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-04-30

Study Completion Date

2012-12-31

Brief Summary

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This randomized controlled prospective study aims to evaluate the efficacy of intensive insulin therapy for long term glycemic control and improvement or preservation of beta cell function in newly diagnosed type 2 diabetes patients.

Detailed Description

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Type 2 diabetes is associated with beta cell dysfunction and insulin action at diagnosis of diabetes. Although the relative importance of these two alterations is controversial, growing evidence is swinging to the concept that there is no hyperglycemia without β-cell dysfunction. Also there is agreement that deterioration of glucose tolerance over time is associated with a progressive decrease of beta cell function.

Beside the role of genetic factor, the continuous decline in β-cell function is affected by glucotoxicity generated by hyperglycemia and lipotoxicity due to high fatty acid. A vicious cycle of hyperglycemia per se further impairs and may destroy β-cell. Recently, many reports have shown that early intensive glycemic control plays a role in the prevention of progressive ß-cell function and worsening of diabetes.

Some studies have shown that early intensive insulin therapy(IIT) to achieve near normoglycemia in new onset type 2 diabetes gives short term and long term improvement in glycemic control after discontinuation of insulin. It is suggested that long term glycemic control is associated with improvement of β-cell function.

In the unpublished previous pilot study, the investigators found that early intensive insulin therapy using multiple daily injection (MDI) or daily twice injection in newly diagnosed type 2 diabetes can significantly improve the beta cell function and facilitate further long term glycemic control. To establish the effectiveness of intensive insulin therapy for long term glycemic control and improvement of β-cell function, the investigators will perform a randomized controlled prospective study in newly diagnosed type 2 diabetes in Korea.

Conditions

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Type 2 Diabetes Mellitus Pancreatic Beta Cell Function Glucotoxicity

Keywords

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type 2 diabetes mellitus intensive insulin therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Oral AntiDiabetic Drug

glimepiride and metformin and/or once daily glargine

Group Type ACTIVE_COMPARATOR

Oral AntiDiabetic Drug (glimepiride and metformin)

Intervention Type DRUG

glimepiride and metformin combined therapy

intensive insulin group

insulin glargine insulin glulisine

Group Type EXPERIMENTAL

intensive insulin group

Intervention Type DRUG

Once daily long acting insulin and preprandial rapid acting insulin injection

Interventions

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intensive insulin group

Once daily long acting insulin and preprandial rapid acting insulin injection

Intervention Type DRUG

Oral AntiDiabetic Drug (glimepiride and metformin)

glimepiride and metformin combined therapy

Intervention Type DRUG

Other Intervention Names

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glimepiride(amaryl) metformin(diabex)

Eligibility Criteria

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Inclusion Criteria

* Newly diagnosed drug naïve type 2 diabetic patient with typical diabetic symptom (polydipsia, polyuria, unexplained weight loss) within recent 1 year
* Initial HbA1c : 8.0 % ≤ HbA1c \< 12.0%

Exclusion Criteria

* Known contraindication to insulin glargine, insulin glulisine, metformin, glimepiride
* Patients with proliferative diabetic retinopathy
* Severe liver disease or AST, ALT ≥ 2.5 x ULN
* History of lactic acidosis
* Unstable or severe angina
* Congestive heart failure
* Chronic disease treated with continuous corticosteroid therapy
* Diagnosis of cancer
* Positive urine pregnancy test or plan to become pregnant during the clinical trial
Minimum Eligible Age

25 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Korea University Guro Hospital

OTHER

Sponsor Role collaborator

Hanyang University

OTHER

Sponsor Role collaborator

Inha University Hospital

OTHER

Sponsor Role collaborator

Ajou University

OTHER

Sponsor Role collaborator

Sanofi

INDUSTRY

Sponsor Role collaborator

East West Neo Medical Center

OTHER

Sponsor Role collaborator

The Catholic University of Korea

OTHER

Sponsor Role collaborator

Jeju National University Hospital

OTHER

Sponsor Role collaborator

Kyunghee University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Jeong-taek Woo

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jeong-taek Woo, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Kyunghee University Medical Center

Locations

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Hanyang University Medical Center

Guri-si, Gyeonggi-do, South Korea

Site Status

The Catholic University of Korea Bucheon St.Mary's Hospital

Bucheon-si, , South Korea

Site Status

Inha University Hospital

Incheon, , South Korea

Site Status

Jeju National University Hospital

Jeju-do, , South Korea

Site Status

Kyunghee University Medical Center

Seoul, , South Korea

Site Status

Korea University Guro Hospital

Seoul, , South Korea

Site Status

Kyung Hee University East Weast Neo Medicalcenter

Seoul, , South Korea

Site Status

Ajou University Medical Center

Suwon, , South Korea

Site Status

Countries

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South Korea

Other Identifiers

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KIIT-KMC-0701

Identifier Type: -

Identifier Source: org_study_id