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A Study Comparing Insulin Intensification Therapies in Patients With Type 2 Diabetes Mellitus

Phase 4
Completed
Conditions
Diabetes Mellitus, Type 2
Interventions
Registration Number
NCT01175811
Lead Sponsor
Eli Lilly and Company
Brief Summary

The purpose of the study is to compare the effects on overall glycaemic control of two insulin intensification therapies.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
402
Inclusion Criteria
  • Present with type 2 diabetes mellitus
  • Have been receiving twice-daily premixed insulin therapy with or without metformin and/or alpha-glucosidase inhibitors, for at least six months prior to study entry
  • Have Haemoglobin A1c (HbA1c) >7.0% and <12.0%
Exclusion Criteria
  • Within the last 3 months prior to entry into the study, are taking any non-permitted glucose-lowering agents, or are taking any non-permitted oral antihyperglycaemic medications
  • Are pregnant or intend to become pregnant during the course of the study, or are sexually active women of childbearing potential not actively practicing birth control by a method determined by the investigator to be medically acceptable.
  • Are women who are breastfeeding.
  • Have an irregular sleep/wake cycle (for example, participants who sleep during the day and work during the night).
  • Do not regularly consume three meals per day.
  • Have a body mass index >35 kilogram per square meter (kg/m^2).
  • Have had more than one episode of severe hypoglycaemia within 24 weeks prior to entry into the study.
  • Have cardiac disease with a functional status that is Class III or IV
  • Have a history of renal or liver disease
  • Have used less than or equal to 20 Units per day (U/day) of insulin during the past 90 days for more than 14 days (accumulated).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Premixed InsulinInsulin Lispro PremixTwice daily (before breakfast and lunch) insulin lispro mix 50 (50% insulin lispro, 50% insulin lispro protamine suspension \[LM50\]) and once daily (before dinner) insulin lispro mix 25 (25% insulin lispro, 75% insulin lispro protamine suspension \[LM25\])
Basal-BolusInsulin LisproOnce daily (bedtime) insulin glargine and three pre-meal insulin lispro
Basal-BolusInsulin GlargineOnce daily (bedtime) insulin glargine and three pre-meal insulin lispro
Primary Outcome Measures
NameTimeMethod
Change in Haemoglobin A1c (HbA1c) From Baseline to 24 Week EndpointBaseline, 24 weeks

Least Squares (LS) means are calculated using mixed model repeating measures (MMRM) with the change from baseline in HbA1c at all post baseline measurement as dependent variables, treatment, country, visit and treatment by visit interaction as fixed effects, baseline HbA1c value as a covariate and participant as a random effect.

Secondary Outcome Measures
NameTimeMethod
Daily Dose of Insulin: Total, Basal, and Prandial24 weeks
The 7-point Self-monitored Blood Glucose (SMBG) Profiles at Baseline, 12 Weeks and 24 Weeks.Baseline, 12 weeks, and 24 weeks

7-point Self-monitored Blood Glucose (SMBG) Profiles are measures of blood glucose taken 7 times a day at the morning pre-meal, morning 2-hours post-meal, midday pre-meal, midday 2-hours post-meal, evening pre-meal, evening 2-hours post-meal, and 0300 hour \[3 am\]. Each participant took measures on 3 non-consecutive days and the average was calculated for each of the 7 time points. The mean of the 7-point averages was calculated for all the participants at baseline, Weeks 12 and 24.

Percentage of Participants Experiencing a Severe Hypoglycemic Episodebaseline through 24 weeks

Severe hypoglycemic episode is defined as any event requiring the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. The percentage of participants experiencing a severe hypoglycemic episode is defined as the 100 multiplied by the number of participants experiencing a severe hypoglycemic episode divided by the number of participants exposed to study drug.

Change in HbA1c From Baseline to 12 Week EndpointBaseline, 12 weeks

Least Squares (LS) means are calculated using mixed model repeating measures (MMRM) with the change from baseline in HbA1c at all post baseline measurement as dependent variables, treatment, country, visit and treatment by visit interaction as fixed effects, baseline HbA1c value as a covariate and participant as a random effect.

The Percentage of Participants Who Achieved Haemoglobin A1c (HbA1c) Less Than or Equal to 6.5% and Less Than or Equal to 7% at 12 Weeks and 24 Weeks12 weeks, 24 weeks

The Percentage of participants achieving a haemoglobin A1c (HbA1c) less than or equal (\<=) to 6.5% or 7% is defined as 100 multiplied by the number of participants with a HbA1c of the cut-off value (6% or 7%) divided by the number of participants exposed to study drug. Participants with missing HbA1c values at endpoint were treated as not achieving the HbA1c goal.

Daily Dose of Insulin Per Kilogram of Body Weight: Total, Basal and Prandial24 weeks
Percentage of Participants With Hypoglycemic Episodes (Incidence)baseline through 24 weeks

Incidence of hypoglycemic episodes is defined as 100 multiplied by the number of participants experiencing a hypoglycemic episode divided by the number of participants exposed to study drug. Hypoglycemic episodes are defined as an event which is associated with reported signs and symptoms of hypoglycemia, and/or a documented blood glucose (BG) concentration of \<= 70 mg/dL (3.9 mmol/L).

Change in Body Mass Index (BMI) From Baseline to 12 and 24 WeeksBaseline, 12 weeks, and 24 weeks

Body mass index is an estimate of body fat based on body weight divided by height squared. Least Squares (LS) means are calculated using mixed model repeating measures (MMRM) using change from baseline in BMI at all post baseline measurement as dependent variables, treatment, country, visit and treatment by visit interaction as fixed effects, baseline BMI value as a covariate and participants as a random effect.

The Rate of Hypoglycemic Episodesbaseline through 24 weeks

The rate of hypoglycemic episodes is defined as the mean number of hypoglycemic episodes per 30 days per participant. Hypoglycemic episodes are defined as an event which is associated with reported signs and symptoms of hypoglycemia, and/or a documented blood glucose (BG) concentration of \<= 70 mg/dL (3.9 mmol/L).

Trial Locations

Locations (1)

For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.

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Yong Kung City, Taiwan

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