Comparison of Standard vs Higher Starting Dose of Insulin Glargine in Chinese Patients With Type 2 Diabetes (Glargine Starting Dose)

NCT02836704 | Completed Phase 4

• 2 other identifiers: LANTUL07191U1111-1172-2903
• Study Type: interventional
• Target: 892
• Locations: 1 country
• Sites: 1

Brief Summary

Primary Objective:

• To test the hypothesis that higher initial dose of basal insulin (0.3 U/kg) is non inferior to standard initial dose (0.2 U/kg) based on the percentage of patients with at least one episode of hypoglycemia (≤3.9 mmol/L or severe) during the 16 weeks of treatment in overweight and obese type 2 diabetic patients uncontrolled with oral anti-diabetes drugs (OADs). Secondary Objective:
• To evaluate the percentage of patients achieving glycated hemoglobin (HbA1c) \<7%.
• To evaluate the percentage and accumulated percentage of patients achieving fasting plasma glucose (FPG) target (\<5.6, \<6.1, and \<7.0 mmol/L).
• To assess the changes in HbA1c, FPG, and postprandial glucose (PPG).
• To evaluate the insulin doses change.
• To evaluate the weight change.
• To evaluate overall hypoglycemia, nocturnal hypoglycemia and severe hypoglycemia occurrence.
• To descriptively evaluate the safety profile.
• To assess patient and physician satisfaction and adherence (drop-out rate and the percentage of patients who can follow the treatment and insulin titration).
• Subgroup analysis on efficacy (control rate, control rate without confirmed hypoglycemia, and changes in HbA1c, FPG and PPG) and safety data according to:
• Age
• Duration of diabetes
• Baseline treatment (OAD)
• Baseline HbA1c, FPG and PP

Conditions

Diabetes Mellitus, Type 2

Outcome Measures

Primary Outcomes (1)

• Percentage of patients with at least one episode of hypoglycemia

  16 weeks

Secondary Outcomes (11)

• Percentage of patients achieving HbA1c <7%

  16 weeks

• Percentage of patients achieving Fasting Plasma Glucose target (<5.6, <6.1, and <7.0 mmol/L)

  16 weeks

• Accumulated percentage of patients achieving Fasting Plasma Glucose target (<5.6, <6.1, and <7.0 mmol/L)

  16 weeks

• Change from baseline in HbA1c

  Baseline, 16 weeks

• Change from baseline in Fasting Plasma Glucose

  Baseline, 16 weeks

Study Arms (2)

Standard initial dose of insulin glargine

ACTIVE COMPARATOR

Dose 1 of insulin glargine will be administered subcutaneously once a day at the same time every day. Previous non-sulfonylurea OADs (eg, metformin, acarbose) are background treatment and will be continued at the same dosage and dosing frequency as before.

Drug: INSULIN GLARGINE; Drug: metformin; Drug: acarbose

Higher initial dose of insulin glargine

EXPERIMENTAL

Dose 2 of insulin glargine will be administered subcutaneously once a day at the same time every day. Previous non-sulfonylurea OADs (eg, metformin, acarbose) are background treatment and will be continued at the same dosage and dosing frequency as before.

Drug: INSULIN GLARGINE; Drug: metformin; Drug: acarbose

Interventions

INSULIN GLARGINE DRUG

Pharmaceutical form: solution Route of administration: subcutaneous injection

Also known as: HOE901

Higher initial dose of insulin glargine; Standard initial dose of insulin glargine

metformin DRUG

Pharmaceutical form: table or capsule Route of administration: oral administration

Higher initial dose of insulin glargine; Standard initial dose of insulin glargine

acarbose DRUG

Pharmaceutical form: table or capsule Route of administration: oral administration

Higher initial dose of insulin glargine; Standard initial dose of insulin glargine

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥ 18 and ≤ 70 years.
• Type 2 diabetes patients with diabetes diagnosis at least 2 years.
• Continuous treatment with stable doses of 2-3 OADs, for more than three months prior to randomization, among which metformin ≥1.5 g/day or at maximum tolerated dose
• HbA1c \>7.5% and ≤11%.
• FPG \>9 mmol/L.
• BMI ≥25 and ≤40 kg/m\^2.
• Ability and willingness to perform self-monitoring of blood glucose using the Sponsor-provided glucose meter and to complete the patient diary.
• Willingness and ability to comply with the study protocol.
• Signed informed consent obtained prior any study procedure.

You may not qualify if:

• Known hypersensitivity/intolerance to insulin glargine or any of its excipients.
• History of hypoglycemia unawareness.
• Unexplained hypoglycemia in the past 6 months.
• Pregnancy or planned pregnancy or current lactation (women of childbearing potential must have a negative pregnancy test at study entry and a medically approved contraception method).
• Acute diabetic complications (diabetic ketoacidosis, lactic acidosis, hyperosmolar nonketotic diabetic coma).
• History of stroke, myocardial infarction, angina pectoris, coronary artery bypass graft, or percutaneous transluminal coronary angioplasty within the previous 12 months.
• Active proliferative retinopathy, as defined by a photocoagulation or vitrectomy occurrence in the 6 months prior to study entry, or any other unstable (rapidly progressing) retinopathy that may require photocoagulation or surgical treatment during the study, documented by retina examination or disease history record, in the 2 years prior to study entry.
• Impaired renal function defined as, but not limited to, serum creatinine levels ≥1.5 mg/dL (132 μmol/L) for males and ≥1.4 mg/dL (123 μmol/L) for females or presence of macroproteinuria (\>2 g/day).
• Active liver disease (alanine transaminase \[ALT\] greater than two times the upper limit of the reference range, as defined by the local laboratory).
• The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Sponsors & Collaborators

• Sanofi: lead

Study Sites (1)

Unknown Facility

China, China

Location

Related Publications (2)

• Wan H, Wen B, Wang X, Wang J, Zhang Y, Ning T, Duan B, Li Y, Feng W, Zhang X, Cui N, Ji L. Effect of Baseline Characteristics on Hypoglycaemia Risk with Insulin Glargine 100 U/mL: Post Hoc Analysis of the BEYOND 7 Study. Diabetes Ther. 2021 Sep;12(9):2359-2369. doi: 10.1007/s13300-021-01112-z. Epub 2021 Jul 21.

  PMID: 34286454 DERIVED

• Ji L, Gao Z, Shi B, Bian R, Yin F, Pang W, Gao H, Cui N. Safety and Efficacy of High Versus Standard Starting Doses of Insulin Glargine in Overweight and Obese Chinese Individuals with Type 2 Diabetes Mellitus Inadequately Controlled on Oral Antidiabetic Medications (Beyond VII): Study Protocol for a Randomized Controlled Trial. Adv Ther. 2018 Jun;35(6):864-874. doi: 10.1007/s12325-018-0717-x. Epub 2018 Jun 5.

  PMID: 29873004 DERIVED

MeSH Terms

Conditions

Diabetes Mellitus, Type 2

Interventions

Insulin Glargine; Metformin; Acarbose

Condition Hierarchy (Ancestors)

Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Intervention Hierarchy (Ancestors)

Insulin, Long-Acting; Insulins; Pancreatic Hormones; Peptide Hormones; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Peptides; Amino Acids, Peptides, and Proteins; Biguanides; Guanidines; Amidines; Organic Chemicals; Trisaccharides; Oligosaccharides; Polysaccharides; Carbohydrates

Study Officials

• Clinical Sciences & Operations

  Sanofi

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 7, 2016
• First Posted: July 19, 2016
• Study Start: September 9, 2016
• Primary Completion: April 26, 2018
• Study Completion: April 26, 2018
• Last Updated: April 25, 2022

Record last verified: 2022-04

Data Sharing

• IPD Sharing: Will share

Locations

CN (1)