Continuous Glucose Monitoring Evaluation of Exenatide Twice Daily Versus Insulin Glargine
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Purpose
The primary purpose of this study is to compare the effect on 24-hour blood glucose patterns, HbA1c, and weight management when adding insulin glargine, or exenatide, or a combination of insulin glargine and exenatide to metformin.
| Condition | Intervention |
|---|---|
|
Type 2 Diabetes |
Drug: Exenatide Drug: Insulin Glargine |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Evaluation of Insulin Glargine and Exenatide: A Randomized Clinical Trial With Continuous Glucose Monitoring and Ambulatory Glucose Profile Analysis |
- Continuous Glucose Monitoring [ Time Frame: 40 weeks ] [ Designated as safety issue: No ]
Employ CGM with AGP analysis to characterize the diurnal patterns produced by oral medications (metformin) used in the treatment of type 2 diabetes.
Employ CGM to measure the effect of exenatide, insulin glargine and exenatide plus insulin glargine in terms of underlying physiological defects and alter medications in a manner that improves- i. Glucose exposure (area under the diurnal median curve) ii. Glucose variability (inter-quartile range) iii. Glucose stability (hourly change in the median curve iv. Incidence of hypoglycemia (degree, duration, frequency)
- Continuous Glucose Monitoring and Lab Tests [ Time Frame: 40 weeks ] [ Designated as safety issue: No ]
Measure the changes in HbA1C attributable to exenatide, insulin glargine and their combination Measure the changes in weight attributable to exenatide, insulin glargine and their combinations.
Employ CGM with AGP analysis to determine if there is an incremental benefit for subjects who do not reach target to add exenatide to insulin glargine or insulin glargine to exenatide in patients taking metformin.
| Estimated Enrollment: | 60 |
| Study Start Date: | April 2010 |
| Estimated Study Completion Date: | May 2013 |
| Estimated Primary Completion Date: | May 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Exenatide
5 mcg BID for 1 month increasing to 10 mcg BID for the remainder of the study
|
Drug: Exenatide
refer to Arm detail
|
|
Active Comparator: Insulin Glargine
.1 unit per kg to start, titrated based on Continuous Glucose Monitoring results
|
Drug: Insulin Glargine
refer to Arm detail
|
| Active Comparator: Exenatide + Insulin Glargine |
Drug: Exenatide
refer to Arm detail
Drug: Insulin Glargine
refer to Arm detail
|
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female subjects ≥18 and ≤75 years of age
- Clinical diagnosis of type 2 diabetes
- Diabetes duration ≥ 1 year
- HbA1c ≥7.0%
- Currently treated with metformin (HbA1c ≤9%) or metformin/sulfonylurea (SU) (HbA1c ≤8%)or SU alone (HbA1c ≤8%)
Exclusion Criteria:
- Previously treated with insulin or incretin-based therapy
- Treated with a thiazolidinedione within past 6 weeks
- Taken oral or injected prednisone or cortisone medications in the previous 30 days
- Any pancreatic disease or at high risk of pancreatitis (history of alcohol abuse, active gallbladder disease)
- Serum creatinine >1.4mg/dL (women) or >1.5 mg/dL (men)
- eGFR <30 ml/min (using MDRD equation
- ALT>2xULN
- Presence of any severe medical or psychological condition or chronic conditions/infections that in the opinion of the Investigator would compromise he subject's safety or successful participation in the study
- Currently pregnant or planning pregnancy during the study period
- Unable to follow the study protocol
- Unable to speak, read and write in English
- Uncontrolled hyperglycemia with HbA1c > 9% on metformin or >8% on SU or metformin/SU combination or ketonuria requiring immediate insulin therapy
- At the investigator's discretion for other medical or psychological reasons
Contacts and Locations| United States, Minnesota | |
| International Diabetes Center | |
| Minneapolis, Minnesota, United States, 55416 | |
| Principal Investigator: | Richard M Bergenstal, MD | International Diabetes Center at Park Nicollet |
| Principal Investigator: | Roger S Mazze, PhD | International Diabetes Center at Park Nicollet |
| Principal Investigator: | Elinor S Strock, APRN | International Diabetes Center at Park Nicollet |
More Information
Publications:
| Responsible Party: | Park Nicollet Institute |
| ClinicalTrials.gov Identifier: | NCT01089569 History of Changes |
| Other Study ID Numbers: | 03951-10-C |
| Study First Received: | March 17, 2010 |
| Last Updated: | April 11, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Park Nicollet Institute:
|
diabetes continuous glucose monitoring exenatide insulin glargine |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Exenatide |
Glargine Insulin Insulin, Long-Acting Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013