Study on the Efficacy of Slow Release Insulin in Cystic Fibrosis Patients With Glucide Intolerance and Clinical Decay
NCT ID: NCT00687466
Last Updated: 2009-08-04
Study Results
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Basic Information
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UNKNOWN
PHASE3
70 participants
INTERVENTIONAL
2005-08-31
2009-10-31
Brief Summary
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Detailed Description
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In this randomized controlled clinical trial we evaluate whether the anticipated use of glargine in CF patients with glucose intolerance may prevent the worsening of nutritional status and pulmonary function.
Eligible patients who will accept to participate to this study will be randomly allocated in the group who will or will not receive glargine as additional supportive therapy. Patients will in any case continue the CF therapy prescribed by their treating physicians and their usual diet. All the patients will be evaluated every three months to assess their nutritional, pulmonary and glycometabolic status. The follow-up will continue until the 18th month after the study entry.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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1
Insulin yes
Insulin
Insulin Glargine will be administered subcutaneously at the dosage of 0.1 U/Kg/die for three months. In case no hypoglycemic episodes occur during this period, the dosage will be increased to 0.15 U/Kg/die in occasion of the first control (T1) and will be scheduled for other three months. If even during this latter period no cases no hypoglycemic episodes occur, at the second control (T2) the dosage will be increased to the maximum of 0.2/U/Kg/die. It is generally accepted that the final dosage of glargine can be tailored to each patient, but it should be maintained between 0.1 and 0.2 U/Kg/die.
Glargine should be administered once daily in the morning and always at the same hour.
2
Insulin no
No interventions assigned to this group
Interventions
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Insulin
Insulin Glargine will be administered subcutaneously at the dosage of 0.1 U/Kg/die for three months. In case no hypoglycemic episodes occur during this period, the dosage will be increased to 0.15 U/Kg/die in occasion of the first control (T1) and will be scheduled for other three months. If even during this latter period no cases no hypoglycemic episodes occur, at the second control (T2) the dosage will be increased to the maximum of 0.2/U/Kg/die. It is generally accepted that the final dosage of glargine can be tailored to each patient, but it should be maintained between 0.1 and 0.2 U/Kg/die.
Glargine should be administered once daily in the morning and always at the same hour.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Age ≥ 10 years
* Glucide intolerance: 2 pathologic OGTT ( at 120' glucose value: \>140 mg% and \<200 mg%) at 2-6 months' interval between each other
* At least one of the following conditions:
* BMI (body mass index) \< 10th centile for age and sex (according to Rolland Cachera 1991)
* Loss of one BMI centile class for age and sex in the last year (according to Rolland Cachera 1991)
* FEV1 ≤ 80% of predicted
* FEV1 decrease ≥ 10% in the last year
Exclusion Criteria
10 Years
70 Years
ALL
No
Sponsors
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Fondazione per la ricerca sulla Fibrosi Cistica
OTHER
Responsible Party
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Pediatric Department,CF Center Genova, G.Gaslini Institute, Genova, Italy
Principal Investigators
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Laura Minicucci, MD
Role: PRINCIPAL_INVESTIGATOR
G.Gaslini Institute Pediatric Department CF Center
Locations
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Pediatric Department, General Hospital,CF Center
Cerignola (Foggia), , Italy
Ospedale Maggiore Policlinico, Adult CF Center
Milan, , Italy
Pediatric Department, Federico II University, Pediatric CF Center
Napoli, , Italy
Pediatric Department G.De Cristina Hospital CF Center
Palermo, , Italy
Bambino Gesù Hospital CF Center
Roma, , Italy
Policlinico Umberto I. CF Center
Roma, , Italy
Countries
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References
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Moran A, Hardin D, Rodman D, Allen HF, Beall RJ, Borowitz D, Brunzell C, Campbell PW 3rd, Chesrown SE, Duchow C, Fink RJ, Fitzsimmons SC, Hamilton N, Hirsch I, Howenstine MS, Klein DJ, Madhun Z, Pencharz PB, Quittner AL, Robbins MK, Schindler T, Schissel K, Schwarzenberg SJ, Stallings VA, Zipf WB, et al. Diagnosis, screening and management of cystic fibrosis related diabetes mellitus: a consensus conference report. Diabetes Res Clin Pract. 1999 Aug;45(1):61-73. doi: 10.1016/s0168-8227(99)00058-3. No abstract available.
Mackie AD, Thornton SJ, Edenborough FP. Cystic fibrosis-related diabetes. Diabet Med. 2003 Jun;20(6):425-36. doi: 10.1046/j.1464-5491.2003.00924.x.
Solomon MP, Wilson DC, Corey M, Kalnins D, Zielenski J, Tsui LC, Pencharz P, Durie P, Sweezey NB. Glucose intolerance in children with cystic fibrosis. J Pediatr. 2003 Feb;142(2):128-32. doi: 10.1067/mpd.2003.5.
Lanng S, Thorsteinsson B, Nerup J, Koch C. Influence of the development of diabetes mellitus on clinical status in patients with cystic fibrosis. Eur J Pediatr. 1992 Sep;151(9):684-7. doi: 10.1007/BF01957574.
Milla CE, Warwick WJ, Moran A. Trends in pulmonary function in patients with cystic fibrosis correlate with the degree of glucose intolerance at baseline. Am J Respir Crit Care Med. 2000 Sep;162(3 Pt 1):891-5. doi: 10.1164/ajrccm.162.3.9904075.
Dobson L, Hattersley AT, Tiley S, Elworthy S, Oades PJ, Sheldon CD. Clinical improvement in cystic fibrosis with early insulin treatment. Arch Dis Child. 2002 Nov;87(5):430-1. doi: 10.1136/adc.87.5.430. No abstract available.
Rafii M, Chapman K, Stewart C, Kelly E, Hanna A, Wilson DC, Tullis E, Pencharz PB. Changes in response to insulin and the effects of varying glucose tolerance on whole-body protein metabolism in patients with cystic fibrosis. Am J Clin Nutr. 2005 Feb;81(2):421-6. doi: 10.1093/ajcn.81.2.421.
Rolon MA, Benali K, Munck A, Navarro J, Clement A, Tubiana-Rufi N, Czernichow P, Polak M. Cystic fibrosis-related diabetes mellitus: clinical impact of prediabetes and effects of insulin therapy. Acta Paediatr. 2001 Aug;90(8):860-7.
Nousia-Arvanitakis S, Galli-Tsinopoulou A, Karamouzis M. Insulin improves clinical status of patients with cystic-fibrosis-related diabetes mellitus. Acta Paediatr. 2001 May;90(5):515-9.
Dobson L, Sheldon CD, Hattersley AT. Conventional measures underestimate glycaemia in cystic fibrosis patients. Diabet Med. 2004 Jul;21(7):691-6. doi: 10.1111/j.1464-5491.2004.01219.x.
Lombardo F, De Luca F, Rosano M, Sferlazzas C, Lucanto C, Arrigo T, Messina MF, Crisafulli G, Wasniewska M, Valenzise M, Cucinotta D. Natural history of glucose tolerance, beta-cell function and peripheral insulin sensitivity in cystic fibrosis patients with fasting euglycemia. Eur J Endocrinol. 2003 Jul;149(1):53-9. doi: 10.1530/eje.0.1490053.
Bizzarri C, Lucidi V, Ciampalini P, Bella S, Russo B, Cappa M. Clinical effects of early treatment with insulin glargine in patients with cystic fibrosis and impaired glucose tolerance. J Endocrinol Invest. 2006 Mar;29(3):RC1-4. doi: 10.1007/BF03345538.
Bismuth E, Laborde K, Taupin P, Velho G, Ribault V, Jennane F, Grasset E, Sermet I, de Blic J, Lenoir G, Robert JJ. Glucose tolerance and insulin secretion, morbidity, and death in patients with cystic fibrosis. J Pediatr. 2008 Apr;152(4):540-5, 545.e1. doi: 10.1016/j.jpeds.2007.09.025. Epub 2007 Nov 26.
Other Identifiers
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eudraCT number 2005-002135-27
Identifier Type: -
Identifier Source: secondary_id
IGG-FC-G-01
Identifier Type: -
Identifier Source: secondary_id
FFC #21/2006
Identifier Type: -
Identifier Source: org_study_id
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