Effect of Insulin Glulisine Compared to Insulin Aspart and Insulin Lispro When Administered by Continuous Subcutaneous Insulin Infusion (CSII) on Specific Pump Parameters in Patient With Type 1 Diabetes Mellitus

NCT ID: NCT00607087

Last Updated: 2010-08-31

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

289 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-01-31

Study Completion Date

2009-06-30

Brief Summary

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Primary objective: To demonstrate the superiority of insulin glulisine over insulin aspart and insulin lispro administered by external pump in term of unexplained hyperglycemia and/or infusion set occlusion.

Main Secondary objectives:

To compare insulin glulisine, insulin aspart and insulin lispro on:

* Unexplained hyperglycemia
* Infusion set occlusion
* Hypoglycemic episodes,7-point blood glucose profiles
* Episodes of significant ketosis and/or risk level for impending diabetic ketoacidosis
* Time to change the infusion set
* HbA1c (Glycosylated hemoglobin)
* Overall safety: incidence of adverse events

Detailed Description

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The maximal duration of the study participation for patients was 41 weeks and one day, split in:

* a 2-week screening period,
* a 39-week treatment period: 3 treatment periods of 13 weeks with a crossover alternative regimen, including a dose adjustment period of 1 week at the beginning of each period (sequence1: insulin glulisine, then insulin aspart, then insulin lispro; sequence2: insulin aspart, then insulin lispro, then insulin glulisine; sequence 3: insulin lispro, then insulin glulisine, then insulin aspart)
* and a follow-up period of 24 hours.

Conditions

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Diabetes Mellitus, Type 1

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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sequence 1

sequence 1: insulin glulisine / insulin aspart / insulin lispro.

Group Type EXPERIMENTAL

Insulin glulisine

Intervention Type DRUG

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Insulin lispro

Intervention Type DRUG

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Insulin aspart

Intervention Type DRUG

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Sequence 2

Sequence 2: insulin aspart / insulin lispro / insulin glulisine

Group Type EXPERIMENTAL

Insulin glulisine

Intervention Type DRUG

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Insulin lispro

Intervention Type DRUG

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Insulin aspart

Intervention Type DRUG

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Sequence 3

Sequence 3: insulin lispro / insulin glulisine / insulin aspart

Group Type EXPERIMENTAL

Insulin glulisine

Intervention Type DRUG

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Insulin lispro

Intervention Type DRUG

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Insulin aspart

Intervention Type DRUG

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Interventions

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Insulin glulisine

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Intervention Type DRUG

Insulin lispro

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Intervention Type DRUG

Insulin aspart

100 U/ml, administration by Continuous Subcutaneous Insulin Infusion with external pump

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Type 1 diabetic subjects
* Treated with insulin for at least 2 years and by CSII for at least 6 months
* Using the same insulin (insulin glulisine, insulin aspart or insulin lispro) in CSII for at least 3 months with the same external pump compatible with the 3 short acting insulin analogues used in the study
* Using the same type of infusion set (catheter and cannula) for at least 3 months
* Performing at least 3 blood glucose controls per day
* HbA1c \< 8.5%
* Body mass index (BMI) \< 35 kg/m²
* Ability and willingness to perform blood glucose and ketone monitoring using the Sponsor-provided combined glucose and ketone meter and patient diary at home

Exclusion Criteria

* Diabetes other than Type 1
* Total daily dose of insulin greater than 90 U/day
* Using an insulin pump requiring pre-filled cartridges
* History of infection at infusion site requiring a drainage in the last 3 months
* History of severe episodes of ketosis requiring hospitalization in the last 6 months
* Active proliferative retinopathy, as defined by a photocoagulation or vitrectomy occurrence in the 6 months prior to visit 1, or any other unstable (rapidly progressing) retinopathy that may require photocoagulation or surgical treatment during the study. An ophthalmoscopic examination should have been performed in the 2 years prior to study entry
* Pregnancy (women of childbearing potential must have a negative pregnancy test at study entry and a medically approved contraception method) or breastfeeding
* Treatment with systemic corticosteroids or medication known to influence insulin sensitivity in the 3 months prior to visit 1
* Treatment with antidiabetic drug other than insulin in the 3 months prior to visit 1
* Likelihood of requiring treatments during the study which are not permitted
* Treatment with an investigational product in the 30 days prior to visit 1
* History of sensitivity to the study drugs or to drugs with a similar chemical structure
* Presence of any condition (medical, including clinically significant abnormal laboratory test, psychological, social or geographical) actual or anticipated that the Investigator feels would compromise the patient safety or limit his/her successful participation in the study
* Night shift workers
* Impaired renal function as shown by serum creatinine ≥1.5 mg/dL (133 μmol/L) or ≥1.4 mg/dL (124 μmol/L) in men and women, respectively
* Impaired hepatic function as shown by Alanine aminotransferase (ALT) and/or Aspart aminotransferase (AST) greater than three times the upper limit of normal range)
* Alcohol or drug abuse in the last year
* Mental condition rendering the patient unable to understand the nature, scope and possible consequences of the study

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sanofi

INDUSTRY

Sponsor Role lead

Responsible Party

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sanofi-aventis

Principal Investigators

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Medical Affairs

Role: STUDY_DIRECTOR

Sanofi

Locations

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Sanofi-Aventis Administrative Office

Bridgewater, New Jersey, United States

Site Status

Sanofi-Aventis Administrative Office

Macquarie Park, , Australia

Site Status

Sanofi-Aventis Administrative Office

Vienna, , Austria

Site Status

Sanofi-Aventis Administrative Office

Paris, , France

Site Status

Sanofi-Aventis Administrative Office

Budapest, , Hungary

Site Status

Sanofi-Aventis Administrative Office

Netanya, , Israel

Site Status

Sanofi-Aventis Administrative Office

Milan, , Italy

Site Status

Sanofi-Aventis Administrative Office

PE Gouda, , Netherlands

Site Status

Sanofi-Aventis Administrative Office

Seoul, , South Korea

Site Status

Sanofi-Aventis Administrative Office

Barcelona, , Spain

Site Status

Sanofi-Aventis Administrative Office

Bromma, , Sweden

Site Status

Sanofi-Aventis Administrative Office

Guildford Surrey, , United Kingdom

Site Status

Countries

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United States Australia Austria France Hungary Israel Italy Netherlands South Korea Spain Sweden United Kingdom

References

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van Bon AC, Bode BW, Sert-Langeron C, DeVries JH, Charpentier G. Insulin glulisine compared to insulin aspart and to insulin lispro administered by continuous subcutaneous insulin infusion in patients with type 1 diabetes: a randomized controlled trial. Diabetes Technol Ther. 2011 Jun;13(6):607-14. doi: 10.1089/dia.2010.0224. Epub 2011 Apr 2.

Reference Type DERIVED
PMID: 21457066 (View on PubMed)

Other Identifiers

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2007-003579-38

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

APIDR_C_02083

Identifier Type: -

Identifier Source: org_study_id