MedPath

Lantus Versus Levemir Treat-To-Target

Phase 4
Completed
Conditions
Diabetes Mellitus, Type 2
Interventions
Registration Number
NCT00405418
Lead Sponsor
Sanofi
Brief Summary

Primary objective:

To demonstrate the non-inferiority of insulin glargine in comparison to insulin detemir in term of percentage of patients who reach the target of HbA1c \< 7% at the end of the treatment period and do not experience symptomatic hypoglycemia, confirmed by plasma glucose (PG) ≤ 56 mg/dL (3.1 mmol/L)

Secondary objectives:

* To compare between the 2 treatment groups, the percentage of patients who reach the target of HbA1c \< 7% and \< 6.5% at the end of the treatment period

* To compare the changes in HbA1c and fasting plasma glucose (FPG)

* To compare the evolution of blood glucose profiles

* To compare the day to day FPG variability, the insulin doses

* To determine in each treatment group the biochemical and patient-related determinants of failure to reach HbA1c targets

* To compare the overall incidence and rate of symptomatic hypoglycemia and nocturnal symptomatic hypoglycemia confirmed by PG ≤ 56 mg/dL (3.1 mmol/L)

* To compare over the treatment period, the overall incidence and rate of symptomatic hypoglycemia and symptomatic nocturnal hypoglycemia (with PG ≤ 70 mg/dL \[3.9 mmol/L\]), of symptomatic day-time hypoglycemia (with PG ≤ 70 mg/dL and with PG ≤ 56 mg/dL), of severe hypoglycemia, of asymptomatic hypoglycemia with PG ≤ 56 mg/dL

* To compare the overall safety: incidence of adverse events (including serious hypoglycemia and local tolerance at injection site), change in body weight, in waist circumference and in waist / hip ratio

* To assess the quality of life and treatment satisfaction

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
973
Inclusion Criteria
  • Type 2 diabetes for at least 1 year
  • Insulin naïve
  • Treated with stable doses of oral antidiabetics for at least 3 months prior to study start, including at least metformin (at least 1g/day)
  • 7% ≤ HbA1c ≤ 10.5 %
  • Body mass index (BMI) < 40 kg/m²
  • Ability and willingness to perform blood glucose monitoring using a blood glucose meter and to use a patient diary
Exclusion Criteria
  • Type 1 diabetes
  • Current or previous use of insulin (except for previous treatment of gestational diabetes or brief treatment with insulin for less than 1 week)
  • Treatment with glucagon-like peptide (GLP)-1 receptor agonists or with dipeptidyl peptidase (DPP)-IV inhibitors
  • Active proliferative diabetic retinopathy, as defined by the application of photocoagulation or surgery, in the 6 months before study entry or any other unstable (rapidly progressing) retinopathy that may require photocoagulation or surgery during the study (an optic fundus 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 contraceptive method)
  • Breast-feeding
  • History of hypersensitivity to the study drugs or to drugs with a similar chemical structure
  • Treatment with systemic corticosteroids in the 3 months prior to study entry
  • Treatment with any investigational product in the 2 months prior to study entry
  • Likelihood of requiring treatment during the study period with drugs not permitted by the clinical study protocol
  • Clinically relevant cardiovascular, hepatic, neurological, endocrine, or other major disease making implementation of the protocol or interpretation of the study results difficult
  • Impaired hepatic function as shown by Alamine aminotransferase (ALT) and/or Aspartate aminotransferase (AST) greater than three times the upper limit of normal range at study entry
  • Impaired renal function as shown by serum creatinine ≥ 1.5 mg/dL (≥ 133 μmol/L) in men and ≥ 1.4 mg/dL (124 μmol/L) in women at study entry
  • History of drug or alcohol abuse in the last year

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1Insulin glargineInsulin Glargine
2Insulin DetemirInsulin Detemir
Primary Outcome Measures
NameTimeMethod
HbA1c recordedAt baseline, week 12 and week 24
Self-monitored fasting BG in both treatment arms and pre-dinner BG in detemir armOn the 4 consecutive days before each visit
Self-monitored BG values from 8-point 24-hour profile recorded on 2 consecutive daysWithin the week prior to baseline, week 12 and week 24
Episodes of hypoglycemia (symptomatic, total and categorized as day-time/nocturnal, severe or asymptomatic)All across the study
Self-monitored BG values whenever patient experiences symptoms possibly related to hypoglycemia.All across the study
Secondary Outcome Measures
NameTimeMethod
Doses of insulin glargine or insulin detemirDaily
Laboratory fasting plasma glucoseAt baseline, week 12 and week 24
Insulinemia and fasting C-peptide levelAt baseline
Lipid profileat baseline and week 24
Patient reported outcomes (quality of life and treatment satisfaction)at baseline, week 4, week 12 and at the last visit
Safety data: occurrence of adverse events and weightassessed at each visit
Waist and hip circumferencesmeasured at baseline, week 12 and week 24
Systolic and diastolic blood pressuremeasured at study entry, baseline, week 12 and week 24
Physical examinationperformed at study entry and at last visit.

Trial Locations

Locations (1)

Sanofi-Aventis

🇬🇧

Guildford, United Kingdom

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