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Comparison of Insulin Detemir and Insulin Aspart in 2 Separate Injections Twice Daily to Extemporaneous Mixing Injection Regimen Twice Daily - The Paediatric Mixing Trial

Phase 4
Completed
Conditions
Diabetes
Diabetes Mellitus, Type 1
Interventions
Registration Number
NCT00542620
Lead Sponsor
Novo Nordisk A/S
Brief Summary

This trial is conducted in Europe. The aim of the trial is to compare two methods of injection in basal-bolus insulin regimen in children with type 1 diabetes with insulin detemir associated with insulin aspart given twice daily in either separate or mixed injections and to investigate if there is any clinical impact in choosing one regimen over another.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
25
Inclusion Criteria
  • Parents' Informed Consent (IC) obtained before any trial-related activities
  • Obtained child's assent (when possible)
  • Type 1 diabetes
  • Treatment with insulin detemir and insulin aspart either in extemporaneous mixed or separate injections
  • HbA1c (glycosylated haemoglobin A1c) lesser than or equal to 8.6%
Exclusion Criteria
  • History of alcoholism, drug abuse, or psychiatric disease or personality disorders likely to invalidate voluntary consent or to prevent good compliance with the trial protocol
  • Mental incapacity, unwillingness or language barrier precluding adequate understanding or co-operation
  • Anticipated change or new use in concomitant medication known to interfere with glucose metabolism, such as systemic corticotherapy more than 5 mg/day (prednisone)
  • Any other condition that the Investigator (trial physician) feels would interfere with trial participation or evaluation of results

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Mixed injectioninsulin detemir-
Separate injectioninsulin detemir-
Mixed injectioninsulin aspart-
Separate injectioninsulin aspart-
Primary Outcome Measures
NameTimeMethod
Glycosylated Haemoglobin A1c (HbA1c)Week 0 and Week 8

Measured for the ITT (Intention-to-Treat) set

Secondary Outcome Measures
NameTimeMethod
Pharmacokinetics: Cmax of Free InsulinWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2 hours (hrs), T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Tmax of Free InsulinWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Area Under the Concentration vs. Time Curve From Time Zero to the Time of the Last Measured Level of Free InsulinWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Area Under the Concentration vs. Time Curve From Time Zero to Infinity of Free InsulinWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Terminal Phase Elimination Half-life (T½) - Parameter of Free InsulinWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Cmax of Insulin DetemirWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Terminal Phase Elimination Half-life (T½) - Parameter of Insulin AspartWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Weight Z ScoreWeek 0 and Week 8

Z score of weight. To estimate the growth of children, standardised mean weight values were calculated for each month of age and for each sex

Body Mass Index (BMI) Z ScoreWeek 0 and Week 8

Z score of BMI index. To estimate the growth of children, standardised mean BMI values were calculated for each month of age and for each sex

Incidence of Hypoglycaemic Episodes - All EpisodesWeeks 0-8

Number of hypoglycaemic episodes from Week 0 to Week 8, defined as self-measurement plasma glucose less than 56 mg/dL (3.1 mmol/L). Classified as major, minor or symptoms only. Major if unable to treat her/himself (given the age of the study population, the definition of major hypoglycemia was to be adapted through the investigator's judgment). Minor if able to treat her/himself and plasma glucose below 3.1 mmol/L (56 mg/dL). Symptoms only if able to treat her/himself and no plasma glucose measurement or plasma glucose higher than or equal to 3.1 mmol/L.

Incidence of Hypoglycaemic Episodes - Glycaemia Below 0.56 g/LWeeks 0-8

Number of minor hypoglycaemic episodes from Week 0 to Week 8, defined as self-measurement plasma glucose below 3.1 mmol/L (56 mg/dL) and the child is able to treat her/himself.

Incidence of Hypoglycaemic Episodes - Glycaemia Above or Equal to 0.56 g/LWeeks 0-8

Number of "symptoms only" hypoglycaemic episodes from Week 0 to Week 8, defined as self-measurement plasma glucose higher than or equal to 3.1 mmol/L (56 mg/dL) or no plasma glucose measurement and the child is able to treat her/himself.

Percentage of Children Assessing Insulin Therapy Injection Pain as "Sad Face"Week 0 and Week 8

Via a paper diary, the children perceived insulin therapy injection pain by using a four-grade facial visual analogue scale (VAS): very sad face, sad face, happy face or very happy face.

Percentage of Children Assessing Insulin Therapy Injection Pain as "Happy Face"Week 0 and week 8

Via a paper diary, the children perceived insulin therapy injection pain by using a four-grade facial visual analogue scale (VAS): very sad face, sad face, happy face or very happy face.

Percentage of Children Assessing Insulin Therapy Injection Pain as "Very Happy Face"Week 0 and Week 8

Via a paper diary, the children perceived insulin therapy injection pain by using a four-grade facial visual analogue scale (VAS): very sad face, sad face, happy face or very happy face.

Self-measured Plasma Glucose Profile (Before Breakfast)Week 0 and Week 8
FructosamineWeek 0 and Week 8
Pharmacokinetics: Tmax of Insulin DetemirWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Area Under the Concentration vs. Time Curve From Time Zero to the Time of the Last Measured Level of Insulin DetemirWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Area Under the Concentration vs. Time Curve From Time Zero to Infinity of Insulin DetemirWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Terminal Phase Elimination Half-life (T½) - Parameter of Insulin DetemirWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Self-measured Plasma Glucose Profile (After Breakfast)Week 0 and Week 8
Pharmacokinetics: Cmax of Insulin AspartWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Tmax of Insulin AspartWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Area Under the Concentration vs. Time Curve From Time Zero to the Time of the Last Measured Level of Insulin AspartWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Pharmacokinetics: Area Under the Concentration vs. Time Curve From Time Zero to Infinity of Insulin AspartWeek 0 and Week 8

The observed peak drug concentration at time (T): T0, T0.5hour (hr), T1hr, T1.5hr, T2hrs, T2.5hrs, T3hrs, T3.5hrs, T4hrs

Self-measured Plasma Glucose Profile (Before Dinner)Week 0 and Week 8
Self-measured Plasma Glucose Profile (After Dinner)Week 0 and Week 8
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