Comparison of the Efficacy and Safety of GLARGEN® Versus NPH Insulin in Diabetic Tunisian Patients.

NCT ID: NCT06999551

Last Updated: 2025-05-31

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

NOT_YET_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-01

Study Completion Date

2025-12-31

Brief Summary

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This study will have a single arm: the patient on NPH will continue his treatment for 4 weeks, at the end of the NPH treatment, the patient will receive his CGM device for three days for glycemic holter, a switch to insulin glargine is started for a period of 12 weeks with a dose adjustment and a control of the glycemic balance by CGM for three days at the end of the study.

The NPH insulin vial is a 10 ml vial dosed at 100 IU/mL, The Glargen vial is in the form of a solution for injection, a 3 ml vial dosed at 100 IU/mL

Detailed Description

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Follow-up visits will include :

* V0: - 4 weeks: Screening visit (before the start of treatment): patients will be selected at this initial visit, if they meet all the inclusion criteria and none of the non-inclusion criteria, the patient will receive the glucometer. The patient presents himself to do his initial assessment (including HbA1c) and sign the consent, to do his therapeutic education and to receive the nutrition booklet
* V1: -3 weeks: the patient will be contacted by the ARC (phone call) to communicate the results of the glycemic cycle already performed and for titration of his NPH, continue with the new dose until the monitoring stops
* V2: inclusion visit: D0: 4 weeks later, the patient will receive his CGM. A glycemic cycle will be done and communicated to the ARC.
* V3: Visit of 4 weeks + 07 days: the day the patient presents himself to put the CGM device back on (stop monitoring) and collect data (glycemic holter under NPH) and switch to insulin glargine.
* V4 + V5: respectively at 2 and 3 weeks after switching to insulin glargine, the CRA contacts the patient by phone to record the results of the glycemic cycle and thus adapt the dose of insulin glargine upwards or downwards as needed (titration). The patient will do a glycemic cycle and communicate it to their ARC. Continue with the new dose until the next V6 titration
* V6: at 6 weeks after switching to insulin glargine, the patient will attend the consultation (face-to-face) to communicate the results of the corresponding glycemic cycle and thus adapt the dose of insulin glargine upwards or downwards as needed (titration). Continue with the new dose until monitoring is stopped
* V7: 12 weeks after starting glargine, the patient presents again for placement of the CGM device (start of monitoring). The patient will also do a glycemic cycle at the same time and communicate it to his ARC. A laboratory assessment (including glycated hemoglobin) will be requested.
* V8: 12 weeks + 7 days stop CGM monitoring (collection of holter results under glargine) and end of the study.

Conditions

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Diabetes Mellitus

Keywords

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diabetes mellitus NPH Insulin glargin continuous glucose monitoring efficacy safety

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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patient receiving NPH insulin

evaluating safety and efficacy after switching the patient receiving NPH into glargin insulin.

Group Type EXPERIMENTAL

switch NPH to glargin

Intervention Type DRUG

Switch of patients with type 2 diabetes mellitus from NPH insulin to insulin glargine

Interventions

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switch NPH to glargin

Switch of patients with type 2 diabetes mellitus from NPH insulin to insulin glargine

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age≥ 18 and \<70
* Type 2 diabetic patients, with a duration of NPH between 5 and 10 years.
* Patients treated with a double dose of NPH insulin with a stable dose of insulin and a stable dose of ADO (oral antidiabetic drugs) for at least 2 months prior to the start of the study.
* An HbA1c level between 7% and 10%
* Ability to use a continuous glucose monitoring (CGM) system and cycle blood glucose with the meter.
* Written informed consent obtained prior to participation in the study.

Exclusion Criteria

* Pregnant and breastfeeding women
* Patients with active proliferative and/or complicated diabetic retinopathy, treated by photocoagulation or surgically, within 6 months prior to study entry or any other rapidly progressing unstable retinopathy that may require photocoagulation or surgery during the study (plan to perform fundus prior to inclusion).
* History of insulin glargine hypersensitivity
* Treatment with systemic, neuroleptic, immunosuppressive and antiretroviral corticosteroids within 3 months prior to study entry and during the study and other treatments, which may significantly affect blood glucose.
* Severe renal impairment at baseline defined by a \< 30ml/min.
* Patients on sulfonylurea drugs or glinides or on more than three oral antidiabetic drugs (ODAs)
* Patients on rapid insulin.
* Patients Enrolled in Other Clinical Studies
* Patients who refuse to sign consent.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Les Laboratoires des Médicaments Stériles

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nabila Rekik, Professor

Role: PRINCIPAL_INVESTIGATOR

STEDIAM

Locations

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Hedi Chaker Hospital

Sfax, , Tunisia

Site Status

Countries

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Tunisia

Central Contacts

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Nabila Rekik, Professor

Role: CONTACT

Phone: 98609300

Email: [email protected]

Ibtissem Ben naceuf, Professor

Role: CONTACT

Phone: 22544 395

Email: [email protected]

Facility Contacts

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Nabila Rekik, Professor

Role: primary

References

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Cohen MP, Shea E, Chen S, Shearman CW. Glycated albumin increases oxidative stress, activates NF-kappa B and extracellular signal-regulated kinase (ERK), and stimulates ERK-dependent transforming growth factor-beta 1 production in macrophage RAW cells. J Lab Clin Med. 2003 Apr;141(4):242-9. doi: 10.1067/mlc.2003.27.

Reference Type RESULT
PMID: 12677169 (View on PubMed)

Danielsson P, Truedsson L, Eriksson KF, Norgren L. Inflammatory markers and IL-6 polymorphism in peripheral arterial disease with and without diabetes mellitus. Vasc Med. 2005 Aug;10(3):191-8. doi: 10.1191/1358863x05vm617oa.

Reference Type RESULT
PMID: 16235772 (View on PubMed)

Hirsch IB, Brownlee M. Should minimal blood glucose variability become the gold standard of glycemic control? J Diabetes Complications. 2005 May-Jun;19(3):178-81. doi: 10.1016/j.jdiacomp.2004.10.001.

Reference Type RESULT
PMID: 15866065 (View on PubMed)

Other Identifiers

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GRANT2025

Identifier Type: -

Identifier Source: org_study_id