Basal Analog Study - Comparison of Lantus or Levemir With NPH Insulin From T1DM Diagnosis (BAS)
Recruitment status was Active, not recruiting
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Purpose
Hypothesis: Basal insulin analogs with continuous 24-hour delivery of insulin improve glycemic control during the first year of treatment of children/adolescents with type 1 diabetes mellitus (T1DM)by preserving endogenous insulin production and a close to normal balance of the GH-IGF-axis.
This a randomized, open-label, parallel-group trial of 120 children, 7 - 17 years of age, newly diagnosed with T1DM. The investigators will investigate whether the use of long-acting basal insulin analogs Lantus (Glargine) or Levemir (Detemir) during the first year of treatment results in improved glycemic control (HbA1c) compared with Insulatard (NPH insulin) when given in a meal insulin therapy regimen with rapid acting Novorapid (insulin aspart). The investigators will explore possible mechanisms of action by determining remaining endogenous insulin production and changes in the GH-IGF-axis. The investigators will also assess changes in body composition and evaluate quality of life in each treatment arm.
| Condition | Intervention | Phase |
|---|---|---|
|
Diabetes Mellitus Type 1 |
Drug: NPH insulin Drug: Glargine Drug: Detemir |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Effects of New Longacting Insulin Analogs on Metabolic Control, Endogenous Insulin Production, GH/IGF-I Axis and Quality of Life - Comparison of NPH, Glargine Och Detemir Insulin From the Debut of Type 1 Diabetes Mellitus in Adolescents |
- HbA1c [ Time Frame: 1 year ] [ Designated as safety issue: No ]The study compare HbA1c one year after start of treatment at diagnosis of T1DM in patients treated with Lantus or Levemir with patients treated with Insulatard.
- Stimulated C-peptide [ Time Frame: 2 weeks and 3, 6 and 12 month ] [ Designated as safety issue: No ]Sustacal stimulated C-peptide after an overnight fast
- IGF-I [ Time Frame: diagnosis, 2 weeks, 3,6,9 and 12 month ] [ Designated as safety issue: No ]Serum IGF-I concentrations
| Enrollment: | 120 |
| Study Start Date: | September 2005 |
| Estimated Primary Completion Date: | March 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Insulatard
Treatment twice daily with Insulatard plus Novorapid at meals. Doses adjusted according to bloodsugars
|
Drug: NPH insulin
Treatment twice daily with Insulatard plus Novorapid at meals. Doses adjusted according to bloodsugar
|
|
Active Comparator: Lantus
Treatment once daily with Levemir plus Novorapid at meals. Doses adjusted according to bloodsugars
|
Drug: Glargine
Treatment once daily with Lantus plus Novorapid at meals. Doses adjusted according to bloodsugars
|
|
Active Comparator: Levemir
Treatment twice daily with Levemir plus Novorapid at meals. Doses adjusted according to bloodsugars
|
Drug: Detemir
Treatment twice daily with Levemir plus Novorapid at meals. Doses adjusted according to bloodsugars
|
Eligibility| Ages Eligible for Study: | 7 Years to 17 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosis of diabetes and novel to insulin therapy
- Age 7 - 17 years
- Informed consent
Exclusion Criteria:
- Moderate to severe ketoacidosis (pH<7.2 and/or standard bicarbonate <10 mmol/l)
- Suspected non-type 1
- IA2 and GAD65: all-antibody negative
- Celiac disease or other chronic disease
- Hypothyroidism, if not well controlled
- Syndromes
- Previous anorexia nervosa
- Neuro-psychiatric disease
- Malignancy
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Peter Bang, MD, PhD, Associated Professor, Karolinska Institutet |
| ClinicalTrials.gov Identifier: | NCT01271517 History of Changes |
| Other Study ID Numbers: | Eudract-number 2005-001726-80 |
| Study First Received: | January 5, 2011 |
| Last Updated: | January 5, 2011 |
| Health Authority: | Sweden: Medical Products Agency |
Keywords provided by Karolinska Institutet:
|
Basal insulin long acting insulin analogs metabolic control HbA1c |
C-peptide IGF-I GH IGFBP |
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, NPH Insulin, Long-Acting Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013