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Basal Analog Study - Comparison of Lantus or Levemir With NPH Insulin From T1DM Diagnosis (BAS)

Primary Purpose

Diabetes Mellitus Type 1

Status
Unknown status
Phase
Phase 4
Locations
Sweden
Study Type
Interventional
Intervention
NPH insulin
Glargine
Detemir
Sponsored by
Karolinska Institutet
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Mellitus Type 1 focused on measuring Basal insulin, long acting insulin analogs, metabolic control, HbA1c, C-peptide, IGF-I, GH, IGFBP

Eligibility Criteria

7 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Diagnosis of diabetes and novel to insulin therapy
  • Age 7 - 17 years
  • Informed consent

Exclusion Criteria:

  • Moderate to severe ketoacidosis (pH<7.2 and/or standard bicarbonate <10 mmol/l)
  • Suspected non-type 1
  • IA2 and GAD65: all-antibody negative
  • Celiac disease or other chronic disease
  • Hypothyroidism, if not well controlled
  • Syndromes
  • Previous anorexia nervosa
  • Neuro-psychiatric disease
  • Malignancy

Sites / Locations

  • Division of Pediatrics, Karolinska University Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Active Comparator

Arm Label

Insulatard

Lantus

Levemir

Arm Description

Treatment twice daily with Insulatard plus Novorapid at meals. Doses adjusted according to bloodsugars

Treatment once daily with Levemir plus Novorapid at meals. Doses adjusted according to bloodsugars

Treatment twice daily with Levemir plus Novorapid at meals. Doses adjusted according to bloodsugars

Outcomes

Primary Outcome Measures

HbA1c
The study compare HbA1c one year after start of treatment at diagnosis of T1DM in patients treated with Lantus or Levemir with patients treated with Insulatard.

Secondary Outcome Measures

Stimulated C-peptide
Sustacal stimulated C-peptide after an overnight fast
IGF-I
Serum IGF-I concentrations

Full Information

First Posted
January 5, 2011
Last Updated
January 5, 2011
Sponsor
Karolinska Institutet
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1. Study Identification

Unique Protocol Identification Number
NCT01271517
Brief Title
Basal Analog Study - Comparison of Lantus or Levemir With NPH Insulin From T1DM Diagnosis
Acronym
BAS
Official Title
Effects of New Longacting Insulin Analogs on Metabolic Control, Endogenous Insulin Production, GH/IGF-I Axis and Quality of Life - Comparison of NPH, Glargine Och Detemir Insulin From the Debut of Type 1 Diabetes Mellitus in Adolescents
Study Type
Interventional

2. Study Status

Record Verification Date
January 2011
Overall Recruitment Status
Unknown status
Study Start Date
September 2005 (undefined)
Primary Completion Date
March 2011 (Anticipated)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Karolinska Institutet

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Hypothesis: Basal insulin analogs with continuous 24-hour delivery of insulin improve glycemic control during the first year of treatment of children/adolescents with type 1 diabetes mellitus (T1DM)by preserving endogenous insulin production and a close to normal balance of the GH-IGF-axis. This a randomized, open-label, parallel-group trial of 120 children, 7 - 17 years of age, newly diagnosed with T1DM. The investigators will investigate whether the use of long-acting basal insulin analogs Lantus (Glargine) or Levemir (Detemir) during the first year of treatment results in improved glycemic control (HbA1c) compared with Insulatard (NPH insulin) when given in a meal insulin therapy regimen with rapid acting Novorapid (insulin aspart). The investigators will explore possible mechanisms of action by determining remaining endogenous insulin production and changes in the GH-IGF-axis. The investigators will also assess changes in body composition and evaluate quality of life in each treatment arm.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus Type 1
Keywords
Basal insulin, long acting insulin analogs, metabolic control, HbA1c, C-peptide, IGF-I, GH, IGFBP

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
120 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Insulatard
Arm Type
Active Comparator
Arm Description
Treatment twice daily with Insulatard plus Novorapid at meals. Doses adjusted according to bloodsugars
Arm Title
Lantus
Arm Type
Active Comparator
Arm Description
Treatment once daily with Levemir plus Novorapid at meals. Doses adjusted according to bloodsugars
Arm Title
Levemir
Arm Type
Active Comparator
Arm Description
Treatment twice daily with Levemir plus Novorapid at meals. Doses adjusted according to bloodsugars
Intervention Type
Drug
Intervention Name(s)
NPH insulin
Intervention Description
Treatment twice daily with Insulatard plus Novorapid at meals. Doses adjusted according to bloodsugar
Intervention Type
Drug
Intervention Name(s)
Glargine
Intervention Description
Treatment once daily with Lantus plus Novorapid at meals. Doses adjusted according to bloodsugars
Intervention Type
Drug
Intervention Name(s)
Detemir
Intervention Description
Treatment twice daily with Levemir plus Novorapid at meals. Doses adjusted according to bloodsugars
Primary Outcome Measure Information:
Title
HbA1c
Description
The study compare HbA1c one year after start of treatment at diagnosis of T1DM in patients treated with Lantus or Levemir with patients treated with Insulatard.
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Stimulated C-peptide
Description
Sustacal stimulated C-peptide after an overnight fast
Time Frame
2 weeks and 3, 6 and 12 month
Title
IGF-I
Description
Serum IGF-I concentrations
Time Frame
diagnosis, 2 weeks, 3,6,9 and 12 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
7 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of diabetes and novel to insulin therapy Age 7 - 17 years Informed consent Exclusion Criteria: Moderate to severe ketoacidosis (pH<7.2 and/or standard bicarbonate <10 mmol/l) Suspected non-type 1 IA2 and GAD65: all-antibody negative Celiac disease or other chronic disease Hypothyroidism, if not well controlled Syndromes Previous anorexia nervosa Neuro-psychiatric disease Malignancy
Facility Information:
Facility Name
Division of Pediatrics, Karolinska University Hospital
City
Stockholm
ZIP/Postal Code
17176
Country
Sweden

12. IPD Sharing Statement

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Basal Analog Study - Comparison of Lantus or Levemir With NPH Insulin From T1DM Diagnosis

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