A Prospective Randomized Study of a Personalized Approach to the Inpatient Management of Hospitalized Oncology Patients With Hyperglycemia
Overview
- Phase
- Early Phase 1
- Intervention
- Insulin
- Conditions
- Hyperglycemia
- Sponsor
- H. Lee Moffitt Cancer Center and Research Institute
- Enrollment
- 9
- Locations
- 1
- Primary Endpoint
- Proportion of blood glucose values within normal range
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
The purpose of this study is to compare the outcomes between hospitalized cancer patients with high blood sugar receiving the current standard of care of administering insulin, and hospitalized cancer patients receiving a new, individualized method of insulin administration.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Provision of signed and dated informed consent form
- •Stated willingness to comply with all study procedures and availability for the duration of the study
- •Provide race and ethnicity information
- •Male or female, aged 18 years or greater
- •Diagnosed with cancer
- •Hospitalized at MCC in the medical, hematologic, or bone marrow transplant units
- •Having in-hospital hyperglycemia with or without a pre-existing diagnosis of DM, with 2 measurements of BG \> 180 mg/dL and/or 1 measurement of BG \> 350mg/dL within the first 72 hours of admission, detected by bedside point-of-care testing and/or basic metabolic panel laboratory data.
- •Participants enrolled in other clinical trials are admissible to this trial.
Exclusion Criteria
- •An individual who meets any of the following criteria will be excluded from participation in this study:
- •Participants \< 18 years of age
- •Participants at the end of life and/or with limited life expectancies (\< 6 months)
- •Participants without cancer diagnoses
- •Surgical patients and patients admitted directly to the intensive care unit, other than those in the Bone Marrow Transplant Unit, who are included
- •Participants treated and discharged in outpatient settings (ie, direct referral center, infusion center, or clinical research unit) or those admitted for observation only (hospitalized less than 24 hours)
- •Participants on total parenteral nutrition
- •Participants on insulin pumps
- •Participants admitted with diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome
- •Pregnant Participants based on medical history
Arms & Interventions
Basal-Prandial-Correctional Insulin Regimen
Participants hospitalized in the medical, hematologic, or bone marrow transplant units will begin with basal long-acting insulin glargine with correctional and prandial rapid-acting insulin that is personalized and precise, to achieve target blood glucose levels with daily assessments during hospitalization. Adjustments will be made in real time to reach the target range.
Intervention: Insulin
Standard of Care Insulin Regimen
Participants hospitalized in the medical, hematologic, or bone marrow transplant units' blood sugar levels will be managed with sliding scale insulin or a combination of long- and short-acting insulin as per standard of care.
Intervention: Insulin
Outcomes
Primary Outcomes
Proportion of blood glucose values within normal range
Time Frame: During hospital admission, up to 30 days
Proportion of blood glucose values in the 70 mg/dL to 180 mg/dL (normal) range
Secondary Outcomes
- Duration of normal blood glucose level(During hospital admission, up to 30 days)
- Proportion of high blood glucose levels(During hospital admission, up to 30 days)
- Proportion of low blood glucose levels(During hospital admission, up to 30 days)