Insulin Pump Therapy in Adolescents With Newly Diagnosed Type 1 Diabetes (T1D)
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Purpose
Within 4 weeks after diagnosis of type 1 diabetes, 10 subjects (pubertal males, 12-17 years old) will be randomized to either receive multiple daily injection (MDI) using Lantus insulin, or continuous subcutaneous insulin infusion (CSII; pump therapy). The proposed protocol compares the changes in diabetes control between pump therapy and MDI treatment groups. More importantly, however, the study evaluates how these modes of therapy may affect the honeymoon period and glycemic control, specifically focusing on changes in insulin sensitivity (measured by the euglycemic-hyperinsulinemic clamp studies and adiponectin concentration changes) and beta cell function (measured by mixed meal tolerance testing). Demonstrating that pump therapy at the time of diagnosis of type 1 diabetes prolongs the honeymoon phase by improving insulin sensitivity and beta cell function may have important therapeutic implications that could influence the standard of care in pediatric diabetes.
| Condition | Intervention |
|---|---|
|
Diabetes Mellitus, Insulin-Dependent |
Device: Pump therapy (CSII) Drug: Multiple daily injections (MDI) using insulin glargine + rapid acting analog |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Pilot Study of the Effect of Continuous Subcutaneous Insulin Infusion in Adolescents With Newly-diagnosed Type 1 Diabetes on Insulin Resistance, Beta-cell Function and the Honeymoon Period. |
- Hemoglobin A1c (HbA1c or A1c) [ Time Frame: 24 months ] [ Designated as safety issue: No ]
- insulin sensitivity [ Time Frame: 24 months ] [ Designated as safety issue: No ]
- beta cell function [ Time Frame: 24 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 12 |
| Study Start Date: | December 2005 |
| Estimated Study Completion Date: | October 2014 |
| Estimated Primary Completion Date: | September 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Pump therapy (CSII)
Use of pump therapy
|
Device: Pump therapy (CSII)
CSII initiated within 1 month of dx
|
|
Active Comparator: Multiple daily injections (MDI)
Use of MDI (basal bolus therapy with glargine)
|
Drug: Multiple daily injections (MDI) using insulin glargine + rapid acting analog
MDI as control
|
Eligibility| Ages Eligible for Study: | 12 Years to 17 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female patient between the age of 12 and 17 years inclusive at time of entry into study (i.e., after their 12th but before their 18th birthday)
- Type 1 diabetes mellitus for no more than 10 days
- pubertal (Tanner stage 2 or above)
- The patient and parents or guardians should be able to do simple math calculations (necessary for pump management)
- Parent or legal guardian must give signed informed consent
Exclusion Criteria:
- No other chronic medical conditions (well-controlled thyroid disease is OK, and mild asthma is OK if the patient is not on chronic inhaled or oral daily corticosteroids)
- Exceptional psychological stress, more than expected for circumstances of having the new diagnosis of diabetes
- Inability or unwillingness to comply with requirements of the protocol
Contacts and Locations| United States, Florida | |
| Nemours Children's Clinic | |
| Jacksonville, Florida, United States, 32207 | |
| Principal Investigator: | Larry A Fox, MD | Nemours Chidlren's Clinic |
More Information
No publications provided
| Responsible Party: | Larry Fox, Pediatric Endocrinologist, Nemours Children's Clinic |
| ClinicalTrials.gov Identifier: | NCT00357890 History of Changes |
| Other Study ID Numbers: | 16-03890-002 |
| Study First Received: | July 26, 2006 |
| Last Updated: | October 26, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Nemours Children's Clinic:
|
type 1 diabetes diabetes new onset CSII |
insulin glargine insulin sensitivity beta cell function beta cell preservation |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 1 Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Autoimmune Diseases Immune System Diseases |
Glargine Insulin Insulin, Long-Acting Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 21, 2013