Phase 4
Completed N=288
Effect of Insulin Glulisine Compared to Insulin Aspart and Insulin Lispro When Administered by Continuous Subcutaneous Insulin Infusion (CSII) on Specific Pump Parameters in Patient With Type 1 Diabetes Mellitus
Diabetes Mellitus, Type 1
Source: ClinicalTrials.gov NCT00607087 ↗
Enrolled (actual)
288
Serious AEs
7.2%
Results posted
Jul 2010
Primary outcomePrimary: Percentage of Patients With at Least One Unexplained Hyperglycemia and/ or Confirmed Infusion Set Occlusion — 68.4; 62.1; 61.3 percentage of patients — p=0.039
Summary
Primary objective: To demonstrate the superiority of insulin glulisine over insulin aspart and insulin lispro administered by external pump in term of unexplained hyperglycemia and/or infusion set occlusion.
Main Secondary objectives:
To compare insulin glulisine, insulin aspart and insulin lispro on:
* Unexplained hyperglycemia
* Infusion set occlusion
* Hypoglycemic episodes,7-point blood glucose profiles
* Episodes of significant ketosis and/or risk level for impending diabetic ketoacidosis
* Time to change the infusion set
* HbA1c (Glycosylated hemoglobin)
* Overall safety: incidence of adverse events
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Patients With at Least One Unexplained Hyperglycemia and/ or Confirmed Infusion Set Occlusion |
68.4; 62.1; 61.3 | 0.039 sig |
| SECONDARY Monthly Rate of Unexplained Hyperglycemia and/ or Confirmed Infusion Set Occlusion |
2.02; 1.32; 1.54 | <0.001 sig |
| SECONDARY Percentage of Patients With at Least One Unexplained Hyperglycemia |
61.3; 55.9; 56.3 | 0.080 |
| SECONDARY Monthly Rate of Unexplained Hyperglycemia |
1.61; 1.04; 1.23 | <0.001 sig |
| SECONDARY Percentage of Patients With at Least One Confirmed Infusion Set Occlusion |
32.8; 27.0; 27.0 | 0.079 |
| SECONDARY Monthly Rate of Confirmed Infusion Set Occlusion |
0.41; 0.28; 0.31 | 0.015 sig |
| SECONDARY Percentage of Patients With at Least One Episode of Significant Ketosis and/ or Risk Level for Impending Diabetic Ketoacidosis |
17.6; 10.9; 11.7 | 0.017 sig |
| SECONDARY Monthly Rate of Episode of Significant Ketosis and/ or Risk Level for Impending Diabetic Ketoacidosis |
0.14; 0.06; 0.06 | 0.009 sig |
| SECONDARY Rate of Symptomatic Hypoglycemia With a Plasma Glucose (PG) ≤ 70 mg/dL Per Patient-year |
73.88; 65.06; 62.74 | 0.008 sig |
| SECONDARY Rate of Severe Symptomatic Hypoglycemia Per Patient-year |
1.63; 1.39; 1.07 | 0.563 |
| SECONDARY Rate of Nocturnal Symptomatic Hypoglycemia With a Plasma Glucose (PG) ≤70 mg/dL Per Patient-year |
12.80; 9.66; 9.48 | <0.001 sig |
| SECONDARY Patients With at Least One Site Infection, Site Inflammation/Erythema, Pruritus or Isolated Pain at Injection Site |
110; 110; 107 | 1.000 |
| SECONDARY Time Interval Between Infusion Set Changes: All Changes |
69.1; 69.44; 69.98 | — |
| SECONDARY Time Interval Between Infusion Set Changes in Routine |
70.72; 71.00; 71.07 | — |
| SECONDARY Glycosylated Hemoglobin: HbA1c |
7.31; 7.33; 7.28; 7.32; 7.25; 7.33 | 0.078 |
| SECONDARY Total Daily Basal Insulin Infusion |
20.83; 20.93; 20.85; 20.86; 20.81; 21.11 | — |
| SECONDARY Total Daily Bolus Insulin Dose |
18.63; 18.49; 18.40; 18.58; 18.64; 19.19 | — |
Eligibility Criteria
Inclusion Criteria
- Type 1 diabetic subjects
- Treated with insulin for at least 2 years and by CSII for at least 6 months
- Using the same insulin (insulin glulisine, insulin aspart or insulin lispro) in CSII for at least 3 months with the same external pump compatible with the 3 short acting insulin analogues used in the study
- Using the same type of infusion set (catheter and cannula) for at least 3 months
- Performing at least 3 blood glucose controls per day
- HbA1c < 8.5%
- Body mass index (BMI) < 35 kg/m²
- Ability and willingness to perform blood glucose and ketone monitoring using the Sponsor-provided combined glucose and ketone meter and patient diary at home
Exclusion Criteria
- Diabetes other than Type 1
- Total daily dose of insulin greater than 90 U/day
- Using an insulin pump requiring pre-filled cartridges
- History of infection at infusion site requiring a drainage in the last 3 months
- History of severe episodes of ketosis requiring hospitalization in the last 6 months
- Active proliferative retinopathy, as defined by a photocoagulation or vitrectomy occurrence in the 6 months prior to visit 1, or any other unstable (rapidly progressing) retinopathy that may require photocoagulation or surgical treatment during the study. An ophthalmoscopic examination should have been performed in the 2 years prior to study entry
- Pregnancy (women of childbearing potential must have a negative pregnancy test at study entry and a medically approved contraception method) or breastfeeding
- Treatment with systemic corticosteroids or medication known to influence insulin sensitivity in the 3 months prior to visit 1
- Treatment with antidiabetic drug other than insulin in the 3 months prior to visit 1
- Likelihood of requiring treatments during the study which are not permitted
- Treatment with an investigational product in the 30 days prior to visit 1
- History of sensitivity to the study drugs or to drugs with a similar chemical structure
- Presence of any condition (medical, including clinically significant abnormal laboratory test, psychological, social or geographical) actual or anticipated that the Investigator feels would compromise the patient safety or limit his/her successful participation in the study
- Night shift workers
- Impaired renal function as shown by serum creatinine ≥1.5 mg/dL (133 μmol/L) or ≥1.4 mg/dL (124 μmol/L) in men and women, respectively
- Impaired hepatic function as shown by Alanine aminotransferase (ALT) and/or Aspart aminotransferase (AST) greater than three times the upper limit of normal range)
- Alcohol or drug abuse in the last year
- Mental condition rendering the patient unable to understand the nature, scope and possible consequences of the study
The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Data sourced from ClinicalTrials.gov (NCT00607087). 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. Informational only — not medical advice.