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Prospective Influence of Bedtime Insulin Glargine on Mobilization and Function of Endothelial Progenitor Cells

Phase 4
Conditions
Type 2 Diabetes
Interventions
Drug: Insulin Glargin
Registration Number
NCT00523393
Lead Sponsor
Heidelberg University
Brief Summary

In this trial, it will be studied whether early addition of the long acting insulin analogue Glargine is capable of increasing the number and differentiation of endothelial progenitor cells (EPC) in patients with type 2 diabetes, which can be seen as a marker of vascular regenerative potential and cardiovascular risk. In addition, the effect of Glargine on microvascular function will be studied. This will be done using laser Doppler measurements of the skin; in addition, MRI of the heart will be performed which is capable of quantifying the perfusion reserve of the myocardium and additional functional aspects of ventricular function. A beneficial effect of early addition of bedtime Glargine on EPC and vascular as well as myocardial function in this study might argue for a change in the therapeutic approach in type 2 diabetes and possibly improve the cardiovascular outcome in patients affected.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
75
Inclusion Criteria
  • Type 2 Diabetes
  • Oral antidiabetic therapy
  • Age 35 - 70
  • 6,5%< HbA1c ≤ 9%
  • Ability of subject to understand character and individual consequences of clinical trial
  • Written informed consent must be available before enrollment in the trial
  • For women with childbearing potential, adequate contraception (Pearl Index < 1%, e.g. birth control pill) and negative blood pregnancy test
  • 6,5%< HbA1c ≤ 9%
  • Ability of subject to understand character and individual consequences of clinical trial
  • Written informed consent must be available before enrollment in the trial
  • For women with childbearing potential, adequate contraception (Pearl Index < 1%, e.g. birth control pill) and negative blood pregnancy test
Exclusion Criteria
  • MODY
  • Malignant disease
  • Hematopoietic disorders
  • Impairment of renal function (Serum creatinine > 1,5mg/dl)
  • autoimmune disease
  • treatment with immunosuppressive drugs
  • Psychiatric disease
  • Myocardial ischemia during previous 6 month
  • Acute coronary syndrome
  • pAVK IIb, III, IV (Fontaine-Ratschow)
  • Erythropoietin treatment
  • Glitazone treatment during two weeks before inclusion
  • Insulin treatment during two weeks before inclusion
  • Pregnancy and lactation
  • History of hypersensitivity to the investigational product or to any drug with similar chemical structure or to any excipient present in the pharmaceutical form of the investigational product
  • Participation in other clinical trials and observation period of competing trials, respectively
  • No subject will be allowed to enroll in this trial more than once.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
2Insulin Glargin-
3Human Insulin-
Primary Outcome Measures
NameTimeMethod
Change of number of circulating EPC 4 weeks after start of therapy compared to baseline as detected by FACS analysis4 weaks of treatment
Secondary Outcome Measures
NameTimeMethod
Change of number of circulating EPC 4 as detected by in vitro outgrowth4 weeks, 4 months
Skin microvascular function (as measured by laser Doppler perfusion upon heat stimulation)4 months
Myocardial function and myocardial perfusion reserve as measured by MRI4 months
Intima-Media-Thickness4 months
Long-term Glucose control (HbA1c)4 weeks, 4 months
Short-term Glucose control (fasting glucose)4 weeks, 4 months
Markers of inflammation and vascular risk in diabetes4 weeks, 4 months

Trial Locations

Locations (1)

University Clinics Heidelberg, Dept. Medicine1

🇩🇪

Heidelberg, Germany

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