Abdominal Adipose Tissue Distribution in Type 2 Diabetic Patients Treated During 6 Months With Pioglitazone or Insulin
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Purpose
In type 2 diabetic patients with poor glycemic control despite maximum "classic" oral treatment, bed time insulin therapy may lead to a parallel increase in abdominal visceral and subcutaneous fat, whereas pioglitazone treatment should lead to a stability (or even a decrease ) in visceral and an increase in subcutaneous abdominal fat. As visceral fat mass is correlated with insulin-resistance and cardio-vascular risk, the evolution of visceral abdominal fat in type 2 diabetic patients is of great importance.
Main objective:
To compare visceral and subcutaneous abdominal fat compartment after a six-month bed time insulin or pioglitazone treatment in type 2 diabetic patients with poor glycemic control despite a maximal oral treatment with metformin and sulfonylureas.
The study hypothesis is that quantity of visceral and subcutaneous abdominal adipose tissue should differently evolute comparing a 6 month treatment with pioglitazone® (30 or 45mg/j) or NPH " bed-time " insulin (0.2u/kg/
| Condition | Intervention |
|---|---|
|
Type 2 Diabetes |
Drug: UMULINE NPH Drug: pioglitazone |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Evolution of Abdominal Adipose Tissue Distribution in Type 2 Diabetic Patients Treated During 6 Months With Pioglitazone or Insulin, in Association With Metformin or Sulfonylurea. |
- Abdominal adipose tissue (on scan) variation at 6 month [ Time Frame: 6 months ]
- Cellularity of subcutaneous adipose variation tissue at 6 month [ Time Frame: 6 months ]
- HbA1c, lipid level, adiponectin, CRP variation at 6 month [ Time Frame: 6 months ]
- inflammation gene expression in sub-cutaneous fat [ Time Frame: 6 months ]
| Enrollment: | 28 |
| Study Start Date: | May 2005 |
| Study Completion Date: | May 2007 |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
UMULINE NPH at bed time
|
Drug: UMULINE NPH
UMULINE NPH at bed time with a increasing dose up to get a fasting glycemia under 1.1 g/l
Other Name: UMULINE NPH
|
|
Experimental: 2
pioglitazone 30 mg
|
Drug: pioglitazone
30mg daily. After 2 months, if HbA1c has not decreased at least of 1%, the dosage should be increased to 45 mg daily
Other Name: pioglitazone
|
Detailed Description:
In type 2 diabetic patients with poor glycemic control despite maximum "classic" oral treatment, bed time insulin therapy may lead to a parallel increase in abdominal visceral and subcutaneous fat, whereas pioglitazone treatment should lead to a stability (or even a decrease ) in visceral and an increase in subcutaneous abdominal fat. As visceral fat mass is correlated with insulin-resistance and cardio-vascular risk, the evolution of visceral abdominal fat in type 2 diabetic patients is of great importance.
The study hypothesis is that quantity of visceral and subcutaneous abdominal adipose tissue should differently evolute comparing a 6 month treatment with pioglitazone® (30 or 45mg/j) or NPH " bed-time " insulin (0.2u/kg/
Eligibility| Ages Eligible for Study: | 35 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Type 2 diabetes
- BMI= 26kg/m2
- Maximal treatment with metformin and sulfonylurea
- HbA1c between 7.5 and 9.5%
Exclusion Criteria:
- Anterior treatment with glitazones
- Anterior treatment with insulin
- Known heart failure
- Hepatopathy
- Renal filtration less than 60ml/min, Hb<10g/dl
- Corticoids treatment
Contacts and Locations| France | |
| Sce de Diabétologie, hôpital de la Pitié-salpêtrière, 83bld de l'hôpital | |
| Paris, France, 75013 | |
| Principal Investigator: | Agnès Hartemann-Heurtier, MDPHD | Assistance Publique des Hôpitaux de Paris Hôpital Pitié Salpêtrière France |
More Information
No publications provided by Assistance Publique - Hôpitaux de Paris
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| ClinicalTrials.gov Identifier: | NCT00159211 History of Changes |
| Other Study ID Numbers: | P031006 |
| Study First Received: | September 7, 2005 |
| Last Updated: | November 6, 2007 |
| Health Authority: | France: Institutional Ethical Committee |
Keywords provided by Assistance Publique - Hôpitaux de Paris:
|
type 2 diabetes |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases |
Pioglitazone Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 18, 2013