Insulin Infusion Diabetes Ulcer (IINDU)
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Purpose
Normoglycemia is important for the outcome of surgical and medical conditions. Insulin infusions have been studied to achieve normoglycemia during these circumstances and have proved to be useful. Insulin given by subcutaneous injections has longer duration compared to intravenous given insulin which makes it more difficult to control. The hypothesis behind the trial is the concept that insulin infusion is more effective in reaching normoglycemia in diabetic subjects during treatment for ulcer infections and/or planned cardio-vascular surgery.
- The study evaluates a target controlled insulin infusion or conventional therapy as antidiabetic treatment during ulcer infection and after cardio- vascular surgery.
- Secondary efficacy parameter will be hospital stay, laboratories for inflammation and oxidative stress.
| Condition | Intervention | Phase |
|---|---|---|
|
Diabetes Mellitus Insulin Resistance Hyperglycemia Surgery Ulcers Infection |
Procedure: Insulin infusion |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | The Effect of Insulin Infusion on Metabolic Control and Inflammation in Diabetic Patients During Cardio-vascular Intervention and/or Treatment for Acute Foot Ulcer Infection. |
- Plasma glucose levels [ Time Frame: 4 weeks ] [ Designated as safety issue: Yes ]
- Hospital stay [ Time Frame: 4 weeks ] [ Designated as safety issue: Yes ]
- HbA1c [ Time Frame: 4 weeks ] [ Designated as safety issue: Yes ]
- laboratories for inflammation and oxidative stress [ Time Frame: 4 weeks ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 40 |
| Study Start Date: | November 2011 |
| Estimated Study Completion Date: | November 2014 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Insulin infusion (aspart) |
Procedure: Insulin infusion
The infusion, a fast acting insulin analog in 1 Unit/ml of NaCl, starts prior the surgery the operation day for all patients and stops during the postoperative care in the control group (conventional therapy), the intervention group continues for three full days with insulin infusion. After the transition day (the fourth day) multiple doses of mixinsulin continues until the study ends 4 weeks after the randomization.
Other Name: Insulin aspart: NovoRapid
|
|
No Intervention: Standard care
Glucose control according to standard care at the ward, i.e., sliding scale insulin at the discretion of responsible physician.
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Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Patients are eligible for inclusion if the following criteria are fulfilled:
- Patients with diabetes type 1 or type 2.
- Older than 18 years.
- Patients scheduled for cardio- vascular surgery and/ or acute ulcer infection.
- Hyperglycaemia: Capillary P-glucose above 8 mmol/L.
- Informed consent obtained.
Exclusion Criteria:
Patients having any of the following at randomization will not be included in the study:
- Unconsciousness: not possible to wake up.
- Ketoacidosis: pH less or equal to 7.30.
- Hyperosmolar syndrome: S-Na more or equal to 150 mmol/L.
- Kidney failure: calculated GFR < 30 mL/min.
- Pregnancy.
- Mental condition making the subject unable to understand the concepts and risk of the study
Contacts and Locations| Sweden | |
| Department of Vascular Surgery, Karolinska University Hospital | |
| Stockholm, Sweden, SE-171 76 | |
| Study Director: | Kerstin Brismar, Professor | Karolinska Institutet |
| Principal Investigator: | Mats Bonnier, M.D | Karolinska Institutet |
More Information
Publications:
| Responsible Party: | Mats Bonnier, MD, Karolinska Institutet |
| ClinicalTrials.gov Identifier: | NCT00700154 History of Changes |
| Other Study ID Numbers: | IICVS_00 |
| Study First Received: | June 9, 2008 |
| Last Updated: | December 6, 2011 |
| Health Authority: | Sweden: Institutional Review Board |
Keywords provided by Karolinska Institutet:
|
Vascular Surgery Complications Hyperglycemia |
Insulin infusion Diabetic ulcers Infection |
Additional relevant MeSH terms:
|
Diabetes Mellitus Hyperglycemia Insulin Resistance Ulcer Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases |
Hyperinsulinism Pathologic Processes Insulin aspart Insulin Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 16, 2013