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Effects of Degludec/Liraglutide on Time in Range, Inflammation and Endothelial Function vs Insulin Basal Bolus in Diabetic Inpatients

Phase 4
Completed
Conditions
Diabetes Mellitus, Type 2
Interventions
Drug: Insulin Degludec / Liraglutide Injectable Product
Registration Number
NCT05360537
Lead Sponsor
University of Palermo
Brief Summary

The study aims to evaluate the effects of Insulin Degludec/Liraglutide on glycemic variability assessed by continuous glycemic monitoring with the function time in range, serum markers of inflammation, markers of endothelial dysfunction and a possible correlation with intra and extra-hospital mortality rates in a group of hospitalized diabetic patients compared to a control group of in-patient diabetic in treatment on insulin Basal-bolus.

Detailed Description

100 patients with type 2 diabetes mellitus were recruited at the Internal Medicine with Stroke care ward of the University hospital of Palermo "P. Giaccone" from April 2022 to April 2024. 50 patients were treated with Insulin Degludec/Liraglutide, 50 were undertaken treatment regime with Insulin Basal Bolus (control group).

The study was carried out in accordance with the principles of the Helsinki Declaration revised in 2001 and all patients gave their written consent to take part in this research.

Each patient treated was compared for age, sex and cardiovascular risk with control patients. The diagnosis of type 2 diabetes mellitus was based on the revised criteria of the American Diabetes Association (ADA), and using a clinical algorithm that considered the age of onset of the disease, the symptoms and weight present, the family history and the therapy practiced. Arterial hypertension was defined according to the 2017 ESC-ESH criteria. Dyslipidemia was defined based on total cholesterol levels\> 200 mg/dl, triglycerides\> 150 mg/dl and HDL levels \<40 mg/dl regardless of the patient's gender.

Among the cases enrolled, 135 (100%) had type 2 diabetes mellitus, 110 (80 %) had arterial hypertension and 74 (55%) hypercholesterolemia.

Clinical and anthropometric data were collected at the time of recruitment. Blood samples were taken from each patient (cases and controls) to determine serum glucose, HbA1c, CRP, Ferritin, IL-6. These withdrawals were then repeated three months and six months from the time of recruitment.

The glycemic variability was assessed by continuous glycemic monitoring with the analysis of Time in Range

The digital endothelial function was evaluated through the RHI-pat analysis using Endo-PAT2000.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
100
Inclusion Criteria
  • Diabetes mellitus type 2
  • Mild-moderate Hyperglycemia (180-400 mg/dl)
  • Acute events (Pneumonia, Acute cardiac Ischemia, Ictus, IVU)
Exclusion Criteria
  • Diabetes mellitus type 1
  • Diabetic ketoacidosis
  • Hyperosmolar coma
  • Severe hypoglycaemia
  • Acute Pancreatitis
  • Cancer
  • use of corticosteroids
  • pregnancy
  • Chronic kidney disease (< 30 ml/min) or hemodialysis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
patients treated with Insulin Degludec/LiraglutideInsulin Degludec / Liraglutide Injectable ProductDiabetes therapy with Insulin Degludec/Liraglutide and various combinations of metformin, repaglinide, sulfonylureas.
patients treated with Insulin regime Basal BolusInsulin GlargineDiabetes therapy with the combination of a single administration of glargine insulin and three administration of Aspart Insulin.
Primary Outcome Measures
NameTimeMethod
Change of Time in Range % at 7 days, at 1 and 6 months7 days, 1 months and 6 months

Evaluation of Time in Range % by continuous glycemic monitoring

Change of hypoglycemic events7 days, 1 months and 6 months

Change of hypoglycemic events (symptoms and serum glycemia \< 60 mg/dl)

Change from Baseline Reactive Hyperemia Index at 3 and 9 months7 days, 1 months and 6 months

Change of Endothelial function by the use of Endopat2000 with the evaluation of Reactive Hypereremia Index (normal value of RHI \> 1,27)

Secondary Outcome Measures
NameTimeMethod
Change from Baseline serum of C- Reactive-Protein (CRP)7 days, 1 months and 6 months

Variation from baseline serum levels of C- Reactive-Protein (CRP) (mg/dl)

Change from Baseline serum levels of Interleukin-6 (IL6)7 days, 1 months and 6 months

Variation from baseline serum levels of Interleukin-6 (IL6) (pg/ml)

Change from Baseline serum levels of ferritin7 days, 1 months and 6 months

Variation from baseline serum levels of ferritin (mcg/L)

Change of intra and extra-hospital mortality7 days, 1 months and 6 months

Change of intra and extra-hospital mortality

Trial Locations

Locations (1)

Internal Medicine Ward, University of Palermo

🇮🇹

Palermo, Italy

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