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Phase 4 N=1,116 Randomized Treatment

Hyperglycemia and Cardiovascular Outcomes With Type 2 Diabetes

Diabetes Mellitus, Type 2 · Acute Myocardial Infarction

Enrolled (actual)
1,116
Serious AEs
Results posted
Aug 2009
Primary outcome: Primary: Number of Participants Who Experienced a Primary Combined Outcome — 174; 181 participants — p=0.866

Study Design & Population

Study type
Interventional
Phase
Phase 4
Interventions
Insulin lispro (Drug); Human insulin isophane suspension (NPH) (Drug); Insulin glargine (Drug); Human insulin isophane suspension (Drug); Human insulin 30/70 (Drug)
Age
Adult, Older Adult · 30+ yrs
Sex
All
Sponsor
Eli Lilly and Company
Primary completion
Oct 2007

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Participants Who Experienced a Primary Combined Outcome
174; 181 0.866
SECONDARY
Number of Participants Who Experienced Death From Any Cause or Any One of the Primary Outcomes
178; 189 0.715
SECONDARY
Number of Participants Who Experienced Any One of the Primary Outcomes Adjusted for Indicators of Metabolic Control
174; 181 0.914
SECONDARY
Number of Participants Who Experienced Primary Outcomes Adjusted for Metabolic Control and Major Cardiovascular (CV) Risk Factors
174; 181 0.706
SECONDARY
Number of Participants Who Experienced Death From Any Cause
51; 51 0.982
SECONDARY
Number of Participants Who Experienced Cardiovascular (CV) Death
44; 42 0.816
SECONDARY
Number of Participants Who Experienced Myocardial Infarction (MI)
63; 63 0.948
SECONDARY
Number of Participants Who Experienced Stroke
20; 17 0.581
SECONDARY
Number of Participants Who Experienced Hospitalization for Acute Coronary Syndromes (HACS)
58; 54 0.647
SECONDARY
Number of Participants Who Experienced Coronary Revascularization Procedures
84; 94 0.525
SECONDARY
Number of Participants Who Experienced Amputation for Peripheral Vascular Disease Planned After Randomization
9; 8 0.800
SECONDARY
Number of Participants Who Experienced Congestive Heart Failure
33; 37 0.662
SECONDARY
Number of Participants Who Experienced Revascularization Procedure for Peripheral Vascular Disease Planned After Randomization
11; 12 0.863
SECONDARY
Number of Participants Who Experienced Coronary Angiography Planned After Randomization
75; 86 0.471
SECONDARY
Number of Participants With Self-Reported Hypoglycemia During Month 1
124; 119 0.7168
SECONDARY
Number of Episodes of Self-Reported Hypoglycemia Reported by Participants With Self-Reported Hypoglycemia During Month 1
353; 302
SECONDARY
Number of Participants With Self-Reported Hypoglycemia During Month 3
160; 139 0.0860
SECONDARY
Number of Episodes of Self-Reported Hypoglycemia Reported by Participants With Self-Reported Hypoglycemia During Month 3
567; 524
SECONDARY
Number of Participants With Self-Reported Hypoglycemia During Month 6
163; 145 0.1424
SECONDARY
Number of Episodes of Self-Reported Hypoglycemia Reported by Participants With Self-Reported Hypoglycemia During Month 6
770; 576
SECONDARY
Number of Participants With Self-Reported Hypoglycemia During Month 9
155; 138 0.1957
SECONDARY
Number of Episodes of Self-Reported Hypoglycemia Reported by Participants With Self-Reported Hypoglycemia During Month 9
747; 569
SECONDARY
Number of Participants With Self-Reported Hypoglycemia During Month 12
146; 130 0.2434
SECONDARY
Number of Episodes of Self-Reported Hypoglycemia Reported by Participants With Self-Reported Hypoglycemia During Month 12
710; 486
SECONDARY
Number of Participants With Self-Reported Hypoglycemia During Month 18
143; 129 0.2617
SECONDARY
Number of Episodes of Self-Reported Hypoglycemia Reported by Participants With Self-Reported Hypoglycemia During Month 18
945; 669

Summary

The primary objective was to demonstrate a difference between two insulin strategies, one targeting postprandial (PP) hyperglycemia and the other targeting fasting and interprandial hyperglycemia, on time until the first combined adjudicated cardiovascular (CV) event (primary outcome defined as CV death, nonfatal myocardial infarction [MI], nonfatal stroke, coronary revascularization, or hospitalized acute coronary syndrome).

Eligibility Criteria

Inclusion Criteria

  • Are at least 30 years old
  • Have had type 2 diabetes for at least 3 months prior to Visit 1
  • Were admitted to the Coronary Care Unit (CCU) within 18 days prior to Visit 1 for an acute MI
  • Are capable and willing to do specified study procedures
  • Have given informed consent to participate in the study in accordance with local regulations

Exclusion Criteria

  • Were on one of the following therapies prior to admission to the CCU for the recent MI: a)diet therapy only and have glycosylated hemoglobin (HbA1c) <1.15 times the upper limit of normal or b) an intensive basal/bolus insulin regimen
  • Are using any oral antihyperglycemic medication at the time of Visit 2 and are unwilling to stop the use of such medication for the duration of the study
  • Have substantial myocardial damage, which would significantly outweigh the potential benefit of the treatment strategies for diabetes
  • Have the most severe form of congestive heart failure
  • Have liver disease so severe that it precludes the patient from following and completing the protocol
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00191282). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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