LANN-study: Lantus, Amaryl, Novorapid, Novomix Study
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Purpose
Many diabetics gain weight while on insulin therapy. In this study, we evaluate the efficacy of the combination of glimepiride and short-acting insulin on weight control and glucose control. In this study, 150 diabetics whose diabetic control is inadequate while on maximal oral treatment will be randomized to either the new combination treatment or twice daily injections with a mixture of short- and longacting insulin or once-daily injection with a basal insulin analog. The study will compare glucose control and weight gain during a year after randomisation between the three treatments.
| Condition | Intervention | Phase |
|---|---|---|
|
Diabetes Mellitus Type II |
Drug: Novomix 30 Drug: Novorapid and Amaryl Drug: Lantus |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | New Approach to Treat Type II Diabetes Failing on Maximal Oral Treatment |
- glycemic control based on HbA1c
- Body weight
- 8-point glucose day curve of three consecutive days
- 24-hour glycemic control measured by continuous glucose monitoring for three consecutive days
- recorded number of hypoglycemic events per month
- waist circumference
- dexa measurements of body composition
- plasma lipid levels
- basal and stimulated C-peptide levels
- adverse effects
| Estimated Enrollment: | 150 |
| Study Start Date: | May 2005 |
Diabetic patients failing on maximal oral treatment usually switch to twice daily administration of a mixture of short- and longacting insulin. Although this improves glycemic control, it is generally accompanied by a substantial gain in body weight. This may lead to an increase in body fat resulting in a worsening of insulin resistance, leading to an increase in insulin dose needed to maintain glycemic control.
The combination of glimepiride(amaryl) and short-acting insulin (novorapid) is thought to attain glycemic control with a smaller increase in body weight.
In this randomized controlled trial, 150 diabetics failing on maximal oral treatment will be randomized to preprandial use of Novorapid combined with Amaryl at 20.00 hours, twice daily Novomix 30, or once daily Lantus. Metformin will be continued.
In the year after randomisation, patients will be followed for glycemic control, body weight, body composition, recorded number of hypoglycemic events, plasma lipid levels, basal and stimulated C-peptide levels and adverse effects.
Eligibility| Ages Eligible for Study: | 30 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- failing maximal oral treatment, defined as mean fasting blood glucose over 8 mmol/l and HbA1C over 7.5% for three months or more
- BMI 25 - 35 kg/m2
- fasting plasma C-peptide level over 0.3 nmol/l
- stable metformin and sulfonylurea dose for at least three months
- stable weight for at least three months (change maximal 2 kg)
Exclusion Criteria:
- fasting glucose over 25 mmol/l
- use of alpha-glucosidase inhibitors or thiazolidinediones in the two months preceding the study
- renal or liver failure defined as serum creatinine over 150 micromol/l, liver enzymes over 1.5 upper normal limit
- heart failure
- pregnancy
- alcohol more than two units per day
- inflammatory or infectious diseases
- unstable chronic disease
- discontinuation of smoking within three months of randomisation date
- allergy for or intolerance of glimepiride or novorapid.
Contacts and Locations
More Information
Publications:
| ClinicalTrials.gov Identifier: | NCT00151697 History of Changes |
| Other Study ID Numbers: | LTC 297-161104 |
| Study First Received: | September 8, 2005 |
| Last Updated: | August 8, 2011 |
| Health Authority: | Netherlands: Dutch Health Care Inspectorate |
Keywords provided by Rijnstate Hospital:
|
diabetes failing oral treatment weight gain |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Glimepiride Insulin aspart Glargine |
Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions Immunosuppressive Agents Immunologic Factors Anti-Arrhythmia Agents Cardiovascular Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on June 17, 2013