OpT2mise Glucose Control in Type 2 Diabetes Mellitus (DM) With Insulin Pump Therapy
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Purpose
The purpose of this study is to evaluate the comparative effectiveness of insulin pump therapy versus multiple daily injections in insulin-taking type 2 Diabetes Mellitus who are sub optimally controlled with multiple daily injections (MDI).
| Condition | Intervention | Phase |
|---|---|---|
|
Diabetes Mellitus, Type 2 |
Device: Insulin Pump (Medtronic Minimed Paradigm® VEO) |
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: | OpT2mise Glucose Control in Type 2 DM With Insulin Pump Therapy |
- Between group difference in HbA1c when comparing CSII to MDI [ Time Frame: 6 months ] [ Designated as safety issue: No ]To evaluate change in glycemic control (HbA1c) after 6 months of insulin pump therapy in patients with type 2 DM, as compared to patients on MDI therapy over the same time period
- Change in glycemic variability [ Time Frame: 6 months ] [ Designated as safety issue: No ]Glycemic parameters calculated from blinded CGM data: Measure of the Average glucose/day; AUC in hypo- (≤70mg/dL) and in hyperglycemia (≥180 mg/dL; Time spent in hypo- (≤70mg/dL) and hyperglycemia (≥180 mg/dL); Mean Amplitude of Glycemic Excursions (MAGE) is the most common measure of the volatility of blood glucose levels; Standard deviation
- Safety [ Time Frame: 6 months treatment and 6 months follow-up ] [ Designated as safety issue: Yes ]Severe hypoglycemia incidence; Diabetic Ketoacidosis incidence and Diabetes related hospitalizations
- Change in postprandial glycemia [ Time Frame: 6 months ] [ Designated as safety issue: No ]Change in mean postprandial hyperglycemia 0 to 2 hours post meal, defined as ≥180 mg/dl and measured by SMBG
- Quality of Life and Treatment satisfaction [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Change in body weight or BMI, Lipids and blood pressure [ Time Frame: 6 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 400 |
| Study Start Date: | December 2010 |
| Estimated Study Completion Date: | September 2014 |
| Estimated Primary Completion Date: | January 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Insulin Pump Treatment
Patients will get an insulin pump
|
Device: Insulin Pump (Medtronic Minimed Paradigm® VEO)
The pump delivers insulin as specified by the patient
Other Name: Medtronic MiniMed Paradigm® VEO system (MMT-554/754
|
|
No Intervention: Insulin treatment with MDI
patients treated with Multiple Daily Injections (MDI); basal/bolus therapy with rapid- and long-acting analogs with at least 3 injections per day
|
Detailed Description:
The type of study is interventional post-market release. All the devices under investigation have CE mark, and are used within intended use.
This study has been designed to be prospective randomized controlled with a single-arm cross-over in the continuation phase.
Four hundred type 2 Multiple Daily Injections (MDI) treated patients will undergo a screening (run-in) phase of 8 weeks. The aim of the screening phase is to eliminate the study effect that might result in a decrease of HbA1c and to make sure that patients, who are failing current MDI therapy, are selected.
After this screening phase, eligible patients will be randomised to receive either Continuous Subcutaneous Insulin Infusion (CSII) treatment or continue MDI treatment. The first 6-months phase (2-arms parallel) will be followed by another 6-months continuation phase (single cross-over of the MDI arm alone switching to CSII).
Eligibility| Ages Eligible for Study: | 30 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria at screening:
- Diagnosed with type 2 DM, as per Investigator discretion
- HbA1c (DCCT-standard) must be ≥ 8.0% and ≤12% as evidenced by central lab value taken at screening
- Insulin resistance defined as required daily dose between 0.5-1.8 U/Kg or a maximum of 220 units of insulin per day
- Aged 30 to 75 years old (inclusive)
- On MDI regimen (basal/bolus regimen with long-acting insulin and rapid acting analogs) defined as ≥ 3 injections per day for at least 3 months prior signing the informed consent
- Ability to comply with technology, according to Investigator's judgment
- Patients must be willing to undergo all study procedures
- Female patients of child-bearing potential must be using adequate contraception means as assessed by Investigator
at randomisation:
- Diagnosed with type 2 DM, as per Investigator discretion
- HbA1c (DCCT-standard) must be ≥ 8.0% and ≤12% as evidenced by central lab value
- Insulin resistance defined as required daily dose between 0.7-1.8 U/Kg or a maximum of 220 units of insulin per day
- On MDI (basal/bolus regimen with long-acting insulin and rapid acting analogs) defined as ≥ 3 injections per day
- Ability to comply with technology, according to Investigator's judgment
- ≥ 2.5 SMBG per day on average, as reported in Carelink clinical during the run-in phase.
- Patients must be willing to undergo all study procedures
- Female patients of child-bearing potential must be using adequate contraception means as assessed by Investigator
Exclusion Criteria :
- Subject has a history (≥ 2 events) of hypoglycemic seizure or hypoglycemic coma within the last 6 months
- Subject is pregnant as assessed by a pregnancy test with central laboratory, or plans to become pregnant during the course of the study
- Participation in another interventional clinical study, on-going or completed less than 3 months prior to signature of Patient Informed Consent.
- Subject has proliferative retinopathy or sight threatening maculopathy
Subject has
- an acute coronary syndrome (myocardial infarction or unstable angina) within 12 months OR
- coronary artery revascularization by bypass surgery or stenting within 3 months OR
- a transient ischemic attack (TIA) or cerebrovascular accident (CVA) within 3 months OR
- hospitalization for heart failure within 3 months or current New York Functional Class III or IV OR
- current 2nd or 3rd degree heart block OR
- symptomatic ventricular rhythm disturbances OR
- thromboembolic disease within the last 3 months OR
- 2nd degree Mobitz type II or 3rd degree heart block
- Subject with renal impairment expressed as estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) formula < 30 ml/min as demonstrated by the screening central laboratory value at the time of enrollment
- Subject has taken oral or injectable steroids within the last 30 days
- Systolic blood pressure on screening visit is > 180 mmHg
- Diastolic blood pressure on screening visit is > 110 mmHg
- Any other disease (eg active cancer under treatment) or condition including abnormalities found on the screening tests, that in the opinion of the Investigator, may preclude him/her from participating in the study
- Taking any medication prescribed for weight loss
- Alcohol or drug abuse, other than nicotine, at the investigator's discretion
- Use of a GLP-1 agonist or pramlintide (Symlin)
Contacts and Locations| Contact: Sarah Runzis | (+41-21) 802-7028 | sarah.runzis@medtronic.com |
Hide Study Locations| United States, Georgia | |
| Atlanta Diabetes Associates | Recruiting |
| Atlanta, Georgia, United States, 30318 | |
| Principal Investigator: Bruce Bode, Dr. | |
| United States, New York | |
| Albany Medical College | Recruiting |
| Albany, New York, United States, 12208 | |
| Principal Investigator: Elizabeth Nardacci, NP | |
| SUNY Upstate Medical University | Recruiting |
| Syracuse, New York, United States, 13210 | |
| Principal Investigator: Rutgh Weinstock, MD | |
| Austria | |
| City hopital Vienna-Hieting | Recruiting |
| Vienna, Austria, 1130 | |
| Principal Investigator: Rudolf Prager, MD | |
| Canada, Alberta | |
| Clinical Professor Department of Medicine University of Calgary | Recruiting |
| Calgary, Alberta, Canada, T3B 0M3 | |
| Principal Investigator: Stuart Ross, Dr. | |
| Canada, British Columbia | |
| Endocrinologist, 202-301 Columbia Street East | Recruiting |
| New Westminster, British Columbia, Canada, V3L 3W5 | |
| Principal Investigator: Anne Priestman, Dr. | |
| 416-1033 Davie St | Recruiting |
| Vancouver, British Columbia, Canada, V6E 1M7 | |
| Principal Investigator: Hugh Tildesley, Dr. | |
| Canada, Newfoundland and Labrador | |
| Health Science Centre | Recruiting |
| St. John's, Newfoundland and Labrador, Canada, A1B 3V6 | |
| Principal Investigator: Carol Joyce, Dr. | |
| Canada, Ontario | |
| LMC Endocrinology Centre | Recruiting |
| Oakville, Ontario, Canada, L6H 3P1 | |
| Contact: Ronnie Aronsson, MD | |
| Principal Investigator: Ronnie Aronsson, MD | |
| Canadian Centre for Research on Diabetes | Recruiting |
| Smiths' Falls, Ontario, Canada, K7A 4W8 | |
| Principal Investigator: Robin Conway, MD | |
| Toronto General Hsopital | Recruiting |
| Toronto, Ontario, Canada, M5G 2C4 | |
| Contact: Bruce Perkins, MD | |
| Principal Investigator: Bruce A Perkins, MD | |
| Canada, Quebec | |
| McGill University, McGill Nutrition and Food Science Centre | Recruiting |
| Montreal, Quebec, Canada, H3A 1A1 | |
| Principal Investigator: Jean-Francois Yale, Dr. | |
| Czech Republic | |
| Institute of Neurology and Geriatrics | Active, not recruiting |
| Moravski Beroun, Czech Republic, 79305 | |
| France | |
| CHU Côte de Nacre | Recruiting |
| Caen, France, 14033 | |
| Contact: Yves Reznik | |
| Principal Investigator: Yves Reznik, MD | |
| CHU - Ste Marguerite | Terminated |
| Marseille, France, 13274 | |
| Hopital Lapeyronie | Terminated |
| Montpellier, France, 34295 | |
| CHU de Nancy | Recruiting |
| Nancy, France, 54500 | |
| Principal Investigator: Bruno Guercy, Prof | |
| CHU Strasbourg | Recruiting |
| Strasbourg, France, 67091 | |
| Principal Investigator: Francois Moreau, Dr. | |
| CHU Toulouse Rangueil | Recruiting |
| Toulouse, France, 31059 | |
| Principal Investigator: Helene Hanaire, Prof. | |
| Germany | |
| Fachklinik Bad Heilbrunn | Recruiting |
| Bad Heilbrunn, Germany, 83670 | |
| Principal Investigator: Andreas Liebl, Dr. | |
| Zentrum für Diabetes und Gefäßerkrankungen | Recruiting |
| Münster, Germany, 48145 | |
| Principal Investigator: Ludger Rose, Dr. | |
| Hungary | |
| Péterfy Hospital and Emergency Center Diabetes Outpatient Clinic | Recruiting |
| Budapest, Hungary, 1076 | |
| Principal Investigator: Győző Kocsis, Dr. | |
| Israel | |
| Soroka University Medical Center | Recruiting |
| Beer-Sheva, Israel, 84105 | |
| Principal Investigator: Ilana Harman-Boehm, MD | |
| Diabetic Clinic | Recruiting |
| Jerusalem, Israel, 93106 | |
| Principal Investigator: Muriel Metzger, MD | |
| Chaim Sheba Medical center Endocrinology unit | Recruiting |
| Tel Hashomer - Ramat Gan, Israel, 5262 | |
| Principal Investigator: Ohad Cohen, Prof. | |
| Assaf- Harofeh Medical Center | Recruiting |
| Zerifin, Israel, 70300 | |
| Principal Investigator: Andreas Buchs, MD | |
| Italy | |
| Università degli Studi di Bari - Policlinico Universitario | Recruiting |
| Bari, Italy, 70124 | |
| Principal Investigator: Francesco Giorgino, Prof | |
| Universita di Perugia - Ospedale S.M. Della Misericordia | Recruiting |
| Perugia, Italy, 06132 | |
| Principal Investigator: Geremia Bolli, Prof. | |
| University La Sapienza - Policlinico | Recruiting |
| Roma, Italy, 00161 | |
| Principal Investigator: Sebastiano Filetti, Prof. | |
| Macedonia, The Former Yugoslav Republic of | |
| University Clinic of Endocrinology | Recruiting |
| Skopje, Macedonia, The Former Yugoslav Republic of, 1000 | |
| Principal Investigator: Goran Petrovski, Prof. | |
| Netherlands | |
| IJsselland Ziekenhuis Poli Interne geneeskunde | Recruiting |
| Capelle a/d IJssel, Netherlands, 2906 | |
| Principal Investigator: RA Alwani, Dr. | |
| Maxima Medisch Centrum | Recruiting |
| Eindhoven, Netherlands, 5600 | |
| Principal Investigator: Louis Lieverse, Dr. | |
| Bethesda Diabetes Research Center | Recruiting |
| Hoogeveen, Netherlands, 7900 | |
| Principal Investigator: Adriaan Kooy, Dr | |
| Serbia | |
| Clinic for Endocrinology, Diabetes and Metabolic Diseases | Recruiting |
| Belgrade, Serbia, 11 000 | |
| Principal Investigator: Nebojsa Lalic, Prof. | |
| South Africa | |
| Centre for Diabetes and Endocrinology | Recruiting |
| Johannesburg, South Africa, 2198 | |
| Principal Investigator: Larry Distiller, Prof. | |
| Dr.Garcjan Podgorski | Recruiting |
| Port Elizabeth, South Africa, 6001 | |
| Contact: Garcjan Podgorski, Dr. | |
| Principal Investigator: Gracjan Podgorski, Dr. | |
| Spain | |
| ICMDM Hospital Clínic i Universitari | Recruiting |
| Barcelona, Spain, 08036 | |
| Contact: Ignacio Conget, Dr | |
| Principal Investigator: Ignacio Conget, MD | |
| Principal Investigator: | Ohad Cohen, MD | Chaim Sheba Medical Center, Tel Hashomer, Israel |
| Principal Investigator: | Ignacio Conget, MD | ICMDM Hospital Clínic i, Barcelona, Spain |
| Principal Investigator: | Yves Reznic, MD | CHU Côte de Nacre, France |
| Principal Investigator: | Ronnie Aronson, MD | FRCPC, FACE LMC Endocrinology Centres, Canada |
More Information
No publications provided
| Responsible Party: | Medtronic |
| ClinicalTrials.gov Identifier: | NCT01182493 History of Changes |
| Other Study ID Numbers: | EUR05 / CEP234 |
| Study First Received: | August 11, 2010 |
| Last Updated: | April 12, 2013 |
| Health Authority: | Austria: Agency for Health and Food Safety Austria: Ethikkommission Canada: Ethics Review Committee Canada: Health Canada Czech Republic: Ethics Committee France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis) France: Comité consultatif sur le traitement de l'information en matière de recherche dans le domaine de la santé France: Direction Générale de la Santé France: Institutional Ethical Committee France: Agence Nationale de Sécurité du Médicament et des produits de santé France: The Commission nationale de l’informatique et des libertés Germany: Ethics Commission Germany: Federal Institute for Drugs and Medical Devices Hungary: Institutional Ethics Committee Hungary: National Institute for Quality and Organizational Development in Healthcare and Medicines Hungary: Research Ethics Medical Committee Hungary: Scientific and Medical Research Council Ethics Committee Israel: Ethics Commission Israel: Israeli Health Ministry Pharmaceutical Administration Israel: Ministry of Health Italy: Ethics Committee Italy: National Institute of Health Macedonia: Ethics Committee Macedonia: Ministry of Health Netherlands: Independent Ethics Committee Netherlands: Dutch Health Care Inspectorate Netherlands: Medical Ethics Review Committee (METC) Serbia: Ethics Committee South Africa: Human Research Ethics Committee South Africa: National Health Research Ethics Council Spain: Ethics Committee Spain: Ministry of Health United States: Institutional Review Board |
Keywords provided by Medtronic:
|
Diabetes Mellitus MDI pump therapy |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases |
Insulin Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on June 18, 2013