Efficacy of Continuous Subcutaneous Insulin Infusion Versus Basal-bolus Multiple Daily Injections Regimen in Type 2 Diabetes

NCT ID: NCT00942318

Last Updated: 2013-12-11

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

52 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-03-31

Study Completion Date

2013-02-28

Brief Summary

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A lot of insulin-treated type 2 diabetic patients do not reach adequate glycemic control despite intensive basal-bolus insulin regimen. In such cases, continuous subcutaneous insulin infusion (CSII), using an external pump, could be a solution to improve diabetes control.

The aim of this study is to compare, over a one-year period, the efficacy of CSII (with aspart insulin) and basal-bolus multiple daily injections (MDI) treatment (with detemir x 2/d and aspart before meals) in type 2 diabetic patients, already treated by basal-bolus regimen for at least 6 months, who didn't reach adequate target for glycemic at baseline (HbA1c\>7 -10%).

Detailed Description

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Visit 1: patient information and eligibility criteria assessment Visit 2: Inform consent signature and randomisation (group CSII or MDI). Patients randomised in the CSII group are instructed to use pump between V2 and V3.

Visit 3: 5-day's hospitalisation. Start of CSII or MDI treatments. Stop of all oral diabetic medications except for metformin, which is followed up until the end of the study. Teaching program on diabetes management (diet, physical activity and self-adjustment of insulin doses). HbA1c, clinical and biological parameters. Questionnaires.

Follow-up visits 4-7 (1, 3, 6, 9 months): HbA1c. Treatment adjustment. Adverse events collection.

Final visit (12 months): HbA1c, clinical and biological parameters. Questionnaires. Adverse events collection.

Conditions

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Type 2 Diabetes Mellitus

Keywords

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Type 2 Diabetes Mellitus Continuous subcutaneous insulin infusion Insulin external pump Multiple daily injections Basal-bolus regimen Education

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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PPE

PPE : CSII +/- Metformin.

Group Type EXPERIMENTAL

Detemir insulin, Aspart insulin, Metformin

Intervention Type DRUG

Insulin doses adapted by patients according to self monitoring blood glucose results.

injections

INJ: basal/bolus MDI +/- Metformin

Group Type ACTIVE_COMPARATOR

Detemir insulin, Aspart insulin, Metformin

Intervention Type DRUG

Insulin doses adapted by patients according to self monitoring blood glucose results.

Interventions

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Detemir insulin, Aspart insulin, Metformin

Insulin doses adapted by patients according to self monitoring blood glucose results.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Type 2 diabetes mellitus
* Age \> 18 years
* Patients treated for at least 6 months by Multiple daily insulin injections associating long acting insulin (at least 1 long acting insulin analog injection -Glargine or Detemir- or at least 2 NPH insulin injections) plus mealtimes rapid acting insulin injections (Human or analogs) +/- oral hypoglycemic agents.
* 7,5% ≤ HbA1c ≤ 10%
* Patients able to perform self-monitoring blood glucose (SMBG) measurement and insulin injections.
* SMBG \> 3/day

Exclusion Criteria

* Diabetic retinopathy contraindicating glycemic control intensification
* Situation or pathology not allowing therapeutic education program (blindness, deafness, low language fluency…)
* Situation or pathology not allowing insulin therapy self-management and / or portable insulin pump use (rheumatologic pathology, low visual acuity, …)
* Recent (\<3 month) serious pathology
* Planned treatment or therapy able to induce long-term glycemic control worsening
* Long lasting (\> 2 month) planned treatment with glucocorticoids, octreotide, lanreotide or danazol
* Pregnancy wish or ongoing pregnancy
* Known Haemoglobinopathy.
* Creatinin clearance \<30ml/min (MDRD formula).
* Organ transplant.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Toulouse

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Vincent Melki, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Toulouse

Locations

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University Hospital Toulouse

Toulouse, , France

Site Status

Countries

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France

Other Identifiers

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AOL 2008

Identifier Type: -

Identifier Source: secondary_id

0816202

Identifier Type: -

Identifier Source: org_study_id