Treatment of Mild-to-moderate Hypoglycemia in Adults With Type 1 Diabetes: a Validation Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 29
- 试验地点
- 1
- 主要终点
- Change in glucose levels 15 minutes after hypoglycemic treatment
研究概览
简要总结
According to guidelines, when a mild-to-moderate hypoglycemia occurs (capillary blood glucose < 4.0 mmol/L), 15-20g of rapidly absorbed carbohydrates should be ingested. Patients should re-test and re-ingest 15-20g carbohydrates every 15 minutes until they recover from hypoglycemia. These recommendations were principally based on two studies conducted in the 80s before the introduction of intensive insulin therapy secondary to the DCCT trial and with insulin formulations with largely different pharmacokinetic profiles from current insulin analogs. Recent studies suggest that with current insulin analogs and intensive therapeutic approach, 15g of carbohydrates may be insufficient to rapidly correct an important proportion of hypoglycemic episodes. It is thus important to determine if the recommended hypoglycemia treatment remains the recommendation.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Males and females ≥ 18 years of old.
- •Clinical diagnosis of type 1 diabetes for at least one year.
- •Treatment with multiple daily insulin injections or insulin pump therapy and using insulin analogs (rapid, ultra-rapid and basal).
- •HbA1c ≤ 10%.
排除标准
- •Clinically significant microvascular complications: nephropathy (estimated glomerular filtration rate below 40 ml/min), neuropathy (especially diagnosed gastroparesis) or severe proliferative retinopathy as judged by the investigator.
- •Recent (< 3 months) acute macrovascular event e.g. acute coronary syndrome or cardiac surgery.
- •Known significant cardiac rhythm abnormality based on investigator judgment.
- •Abnormal blood panel and/or anemia (Hb < 100g/L).
- •Ongoing pregnancy or breastfeeding.
- •Severe hypoglycemic episode within 1 month of screening.
- •Known uncorrected hypokalemia (potassium < 3.5 mmol/L; available within the past 3 months).
结局指标
主要结局
Change in glucose levels 15 minutes after hypoglycemic treatment
时间窗: 15 minutes after hypoglycemic treatment
Change in glucose levels 15 minutes after hypoglycemic treatment (16g vs. 32g of carbohydrates) when glucose levels at the time of treatment are below 3.0 mmol/L or between 3.0 and 3.5 mmol/L.
次要结局
- Change in glucose levels 20 minutes after hypoglycemic treatment(20 minutes after hypoglycemic treatment)
- Change in glucose levels 30 minutes after hypoglycemic treatment(30 minutes after hypoglycemic treatment)
- Change in glucose levels 60 minutes after hypoglycemic treatment(60 minutes after hypoglycemic treatment)
- Number of patients for whom hypoglycemia was corrected 20 minutes after hypoglycemic treatment(20 minutes after hypoglycemic treatment)
- Number of hypoglycemic events corrected 15 minutes after hypoglycemic treatment(15 minutes after hypoglycemic treatment)
- Number of hypoglycemic events corrected 20 minutes after hypoglycemic treatment(20 minutes after hypoglycemic treatment)
- Glucose levels 60 minutes after meal consumption(60 minutes after meal consumption)
- Glucose levels 90 minutes after meal consumption(90 minutes after meal consumption)
- Number of patients for whom hypoglycemia was corrected 35 minutes after hypoglycemic treatment(35 minutes after hypoglycemic treatment)
- Number of hypoglycemic events corrected 35 minutes after hypoglycemic treatment(35 minutes after hypoglycemic treatment)
- Change in glucose levels 45 minutes after hypoglycemic treatment(45 minutes after hypoglycemic treatment)
- Number of patients for whom hypoglycemia was corrected 10 minutes after hypoglycemic treatment(10 minutes after hypoglycemic treatment)
- Number of patients for whom hypoglycemia was corrected 25 minutes after hypoglycemic treatment(25 minutes after hypoglycemic treatment)
- Number of patients for whom hypoglycemia symptoms disappeared 15 minutes after hypoglycemic treatment(15 minutes after hypoglycemic treatment)
- Number of patients for whom hypoglycemia symptoms disappeared 35 minutes after hypoglycemic treatment(35 minutes after hypoglycemic treatment)
- Number of patients requiring a second treatment 40 minutes after the first hypoglycemic treatment(40 minutes after the first hypoglycemic treatment)
- Number of participants with glucose levels above 8.0 mmol/L 1 hour after hypoglycemia correction(60 minutes after hypoglycemia correction)
- Number of participants with glucose levels above 10.0 mmol/L 1 hour after hypoglycemia correction(60 minutes after hypoglycemia correction)
- Number of patients for whom hypoglycemia symptoms disappeared 10 minutes after hypoglycemic treatment(10 minutes after hypoglycemic treatment)
- Number of patients for whom hypoglycemia symptoms disappeared 25 minutes after hypoglycemic treatment(25 minutes after hypoglycemic treatment)
- Number of patients requiring a second treatment 15 minutes after the first hypoglycemic treatment(15 minutes after the first hypoglycemic treatment)
- Number of patients for whom hypoglycemia was corrected 15 minutes after hypoglycemic treatment(15 minutes after hypoglycemic treatment)
- Number of patients for whom hypoglycemia was corrected 30 minutes after hypoglycemic treatment(30 minutes after hypoglycemic treatment)
- Number of hypoglycemic events corrected 10 minutes after hypoglycemic treatment(10 minutes after hypoglycemic treatment)
- Number of hypoglycemic events corrected 25 minutes after hypoglycemic treatment(25 minutes after hypoglycemic treatment)
- Number of hypoglycemic events corrected 30 minutes after hypoglycemic treatment(30 minutes after hypoglycemic treatment)
- Number of patients for whom hypoglycemia symptoms disappeared 20 minutes after hypoglycemic treatment(20 minutes after hypoglycemic treatment)
- Number of patients for whom hypoglycemia symptoms disappeared 30 minutes after hypoglycemic treatment(30 minutes after hypoglycemic treatment)
研究者
Rémi Rabasa-Lhoret
Full professor
Institut de Recherches Cliniques de Montreal
