NCT01717911

Brief Summary

We have found that a 6-month course of insulin therapy after a short-term intensive insulin therapy could shorten the period of hyperglycemia to preserve ß-cell function and further improve long-term glycemic control in recently diagnosed type 2 diabetes with severe hyperglycemia (\>300 mg/dl, with HBA1C level around 9-11%) in our previous study. We thus hypothesized that a 6-month course of basal insulin therapy could also help to preserve ß-cell function in newly diagnosed type 2 diabetes with moderate hyperglycemia (200-300 mg/dl). This prospective study is outpatient-based to evaluate whether 6-month basal insulin therapy versus oral anti-diabetic treatment (Metformin and sitagliptin) soon after the diagnosis of type 2 diabetes with moderate hyperglycemia (200-300 mg/dl) is associated with better ß-cell function reservation. We skip a short-term intensive admission course of insulin therapy as our previous study in newly diagnosed type 2 diabetes with severe hyperglycemia.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
160

participants targeted

Target at P75+ for phase_4 type-2-diabetes

Timeline
Completed

Started Sep 2010

Longer than P75 for phase_4 type-2-diabetes

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

September 1, 2010

Completed
2.2 years until next milestone

First Submitted

Initial submission to the registry

October 28, 2012

Completed
3 days until next milestone

First Posted

Study publicly available on registry

October 31, 2012

Completed
1.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2013

Completed
5 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2018

Completed
Last Updated

October 31, 2012

Status Verified

July 1, 2010

Enrollment Period

3.3 years

First QC Date

October 28, 2012

Last Update Submit

October 28, 2012

Conditions

Keywords

Newly diagnosed type 2 diabetesInsulin, metformin, sitagliptinbeta-cell function, glycemic control

Outcome Measures

Primary Outcomes (1)

  • The primary outcome was the comparison of A1C change.

    The primary outcome was the comparison of A1C change.

    Dec. 2013

Secondary Outcomes (1)

  • Beta-cell function and insulin sensitivity and the proportion of subjects who reached the treatment target (A1C <7.0% or <6.5% at 6 months).

    Dec 2013

Study Arms (3)

Metformin

ACTIVE COMPARATOR

The titration of metformin was used 500 mg for an adjust unit in splitting dose with the same target to the maximum daily dose of 2550 mg (1000 mg twice daily and then 850 mg tid).

Drug: Metformin

Sitagliptin

EXPERIMENTAL

The subjects treated with sitagliptin started with 100 mg before breakfast once daily. The dosage was fixed as 100mg per day. Decreased by 50mg if fasting blood glucose was \<70mg /dl, discontinued the study if blood glucose was still \<70mg/dl under sitagliptin 50mg per day.

Drug: Sitagliptin

Insulin

EXPERIMENTAL

In the insulin therapy group (Insulin glargine), subjects were instructed in the techniques for insulin injection and home capillary glucose monitoring. Daily dose was administrated before breakfast.

Drug: Insulin

Interventions

In the insulin therapy group (Humulin-N), subjects were instructed in the techniques for insulin injection and home capillary glucose monitoring. Two third daily dose was administrated before breakfast and one third at bedtime. Insulin doses were titrated every 3 days to achieve target fasting plasma glucose values between 90 and 130 mg/dl.

Also known as: Humulin-N
Insulin

The titration of metformin was used 500 mg for an adjust unit in splitting dose with the same target to the maximum daily dose of 2550 mg (1000 mg twice daily and then 850 mg tid).

Also known as: Glucophage
Metformin

The subjects treated with sitagliptin started with 100 mg before breakfast once daily. The dosage was fixed as 100mg per day. Decreased by 50mg if fasting blood glucose was \<70mg /dl, discontinued the study if blood glucose was still \<70mg/dl under sitagliptin 50mg per day.

Also known as: Januvia
Sitagliptin

Eligibility Criteria

Age30 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Recently diagnosed type 2 diabetic patients.
  • Fasting plasma glucose between 200-300 mg/dl (A1C level between 7% and 10%).
  • Those who age between 30 and 80 years old and can inject insulin by themselves.

You may not qualify if:

  • Previous treated with anti-diabetic medication
  • Pregnant or nursing women.
  • Impaired liver function (ALT \> 120 U/L)
  • Impaired renal function (Serum creatinine \>1.5 mg/dL in male, \>1.4 mg/dL in female )
  • Recently suffered from MI or CVA.
  • Patients are acute intercurrent illness.
  • hour C-peptide level \< 1.8 ng/mL.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Taipei Veterans General Hospital

Taipei, Taiwan, 11217, Taiwan

RECRUITING

Related Publications (1)

  • Chen HS, Wu TE, Jap TS, Hsiao LC, Lee SH, Lin HD. Beneficial effects of insulin on glycemic control and beta-cell function in newly diagnosed type 2 diabetes with severe hyperglycemia after short-term intensive insulin therapy. Diabetes Care. 2008 Oct;31(10):1927-32. doi: 10.2337/dc08-0075. Epub 2008 Jun 12.

    PMID: 18556343BACKGROUND

MeSH Terms

Conditions

Diabetes Mellitus, Type 2Insulin Resistance

Interventions

InsulinInsulin, IsophaneMetforminSitagliptin Phosphate

Condition Hierarchy (Ancestors)

Diabetes MellitusGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesHyperinsulinism

Intervention Hierarchy (Ancestors)

ProinsulinInsulinsPancreatic HormonesPeptide HormonesHormonesHormones, Hormone Substitutes, and Hormone AntagonistsPeptidesAmino Acids, Peptides, and ProteinsInsulin, Long-ActingBiguanidesGuanidinesAmidinesOrganic ChemicalsTriazolesAzolesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsPyrazines

Study Officials

  • Harn-Shen Chen, MD, Phd

    Division of Endocrinology and Metabolism

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER GOV
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Division of Endocrinology and Metabolism

Study Record Dates

First Submitted

October 28, 2012

First Posted

October 31, 2012

Study Start

September 1, 2010

Primary Completion

December 1, 2013

Study Completion

December 1, 2018

Last Updated

October 31, 2012

Record last verified: 2010-07

Locations