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Comparison of Glycaemic Fluctuation and Oxidative Stress Between Two Short-term Therapies for Type 2 Diabetes (COGFOST)

Primary Purpose

Diabetes Mellitus, Type 2

Status
Unknown status
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
insulin lispro
Insulin Glargine
Sponsored by
Third Affiliated Hospital, Sun Yat-Sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Mellitus, Type 2 focused on measuring glargine, continuous subcutaneous insulin injection, blood glucose control, blood glucose fluctuation, Oxidative Stress

Eligibility Criteria

25 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. investigator diagnosed type 2 diabetes( 1999 WHO diagnosis criteria).
  2. diagnosed as type 2 diabetes in the first time without drug therapy, or type 2 diabetes does not accept insulin in the near 3 month and duration is shorter than 10 years
  3. Fasting plasma glucose ( FPG ) ≥11.1mmol/L or glycated haemoglobin (HbA1c )≥9%.
  4. agree to participate the study and sign the informed consent.

Exclusion Criteria:

  1. obvious failure of heart, hepatic, kidney function.
  2. severe acute or chronic complications, associated diseases. or other diseases that should not use oral hypoglycemic drug.
  3. women in pregnancy or planning to get pregnancy.

Sites / Locations

  • Endocrinology department of the Third Affiliated Hospital of Sun Yet-san UniversityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

GROUP A

GROUP B

Arm Description

using continuous subcutaneous insulin injection with insulin lispro, Humalog, initiating with 0.5-0.8 IU/kg.

using glargine combined with oral drugs: insulin glargine, Lantus( initiating with 0.2 IU/kg) with metformin hydrochloride, Glucophage 500mg bid and gliclazide modified release tablets, Diamicron modified release(MR) tablets 60mg qd.

Outcomes

Primary Outcome Measures

mean amplitude of glycemic excursions( MAGE)
a Medtronic dynamic blood glucose meter was applied to the patient for 72 hours, and MAGE is calculated according to the data.

Secondary Outcome Measures

glycated hemoglobin A1c
changes of HbA1c before and after the intervention
glycated albumin
changes of glycated albumin before and after the intervention
fasting plasma glucose, postprandial plasma glucose (30min, 120min)
changes of fasting and postprandial plasma glucose before and after the intervention
Fasting C-peptide
changes of Fasting C-peptide before and after the intervention
Fasting insulin
changes of Fasting insulin before and after the intervention
Homa-β
changes of Homa-β before and after the intervention
insulin secretion-sensitivity index
changes of insulin secretion-sensitivity index before and after the intervention
disposition index
changes of disposition index before and after the intervention
standard deviation of glucose level
standard deviation of glucose level
area under curve (AUC) when the glucose level was higher than 7.8mmol/L
AUC when the glucose level was higher than 7.8mmol/L
area under curve (AUC) when the glucose level was lower than 3.9mmol/L
AUC when the glucose level was higher than 3.9mmol/L
thiobarbituric acid reactive substance
changes of thiobarbituric acid reactive substance before and after the intervention
the level of blood 8-hydroxy-2-deoxyguanosine(8-OHdG)
changes of the level of blood 8-OHdG substance before and after the intervention

Full Information

First Posted
August 10, 2015
Last Updated
August 19, 2015
Sponsor
Third Affiliated Hospital, Sun Yat-Sen University
Collaborators
Guangdong Provincial Department of Science and Technology
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1. Study Identification

Unique Protocol Identification Number
NCT02526810
Brief Title
Comparison of Glycaemic Fluctuation and Oxidative Stress Between Two Short-term Therapies for Type 2 Diabetes
Acronym
COGFOST
Official Title
Comparison of Glycaemic Fluctuation and Oxidative Stress Between Two Short-term Therapies for Type 2 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
August 2015
Overall Recruitment Status
Unknown status
Study Start Date
July 2015 (undefined)
Primary Completion Date
August 2016 (Anticipated)
Study Completion Date
September 2016 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Third Affiliated Hospital, Sun Yat-Sen University
Collaborators
Guangdong Provincial Department of Science and Technology

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to compare the blood glucose control, glycaemic fluctuation and oxidative stress for Type 2 Diabetes between two therapies, one is glargine combined with oral drugs and the other is continuous subcutaneous insulin injection.
Detailed Description
This study was a single-center, randomized, controled and prospective trial. Type 2 diabetic patients were randomized into 2 groups (Group A and Group B). Subjects in group A would be treated by using continuous subcutaneous insulin injection with insulin lispro, while subjects in group B would be treated by using glargine with oral drugs (metformin and gliclazide modified release tablets). After achieving the target glucose levels by two different approaches in 3-5 days, maintain the target glucose level for 3-5 days. Then a Medtronic dynamic blood glucose meter would be applied to the subjects for 72 hours. The clinical data, such as demographic information, present history, past history, personal history and so on were collected in the 1st day. In the 2nd day and the last day of the trial, the blood samples of the patient were collected for the Laboratory Measurements: Cr, uric acid, aminotransferase, lipid profiles, white blood cell count, N%, fasting plasma glucose, fasting C-peptide, insulin, HbA1c and standard meal test (0.5h-postprandial and 2h-postprandial blood glucose levels, C peptide and insulin, et al. The parameters of b-cell function and glycemia fluctuation were calculated and then analyzed by spss 13.0.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus, Type 2
Keywords
glargine, continuous subcutaneous insulin injection, blood glucose control, blood glucose fluctuation, Oxidative Stress

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
GROUP A
Arm Type
Active Comparator
Arm Description
using continuous subcutaneous insulin injection with insulin lispro, Humalog, initiating with 0.5-0.8 IU/kg.
Arm Title
GROUP B
Arm Type
Experimental
Arm Description
using glargine combined with oral drugs: insulin glargine, Lantus( initiating with 0.2 IU/kg) with metformin hydrochloride, Glucophage 500mg bid and gliclazide modified release tablets, Diamicron modified release(MR) tablets 60mg qd.
Intervention Type
Drug
Intervention Name(s)
insulin lispro
Other Intervention Name(s)
Humalog
Intervention Description
continuous subcutaneous insulin injection( insulin lispro, Humalog) to reduce blood glucose in a certain level
Intervention Type
Drug
Intervention Name(s)
Insulin Glargine
Other Intervention Name(s)
Lantus
Intervention Description
long-acting insulin injection with metformin hydrochloride, Glucophage and gliclazide modified release tablets, Diamicron MR to reduce blood glucose in a certain level
Primary Outcome Measure Information:
Title
mean amplitude of glycemic excursions( MAGE)
Description
a Medtronic dynamic blood glucose meter was applied to the patient for 72 hours, and MAGE is calculated according to the data.
Time Frame
3-5 days after patients achieving the target glucose levels, From date of randomization, assessed up to 10 days
Secondary Outcome Measure Information:
Title
glycated hemoglobin A1c
Description
changes of HbA1c before and after the intervention
Time Frame
From date of randomization until the end of study, assessed up to 15 days
Title
glycated albumin
Description
changes of glycated albumin before and after the intervention
Time Frame
From date of randomization until the end of study, assessed up to 15 days
Title
fasting plasma glucose, postprandial plasma glucose (30min, 120min)
Description
changes of fasting and postprandial plasma glucose before and after the intervention
Time Frame
From date of randomization until the end of study, assessed up to 15 days
Title
Fasting C-peptide
Description
changes of Fasting C-peptide before and after the intervention
Time Frame
From date of randomization until the end of study, assessed up to 15 days
Title
Fasting insulin
Description
changes of Fasting insulin before and after the intervention
Time Frame
From date of randomization until the end of study, assessed up to 15 days
Title
Homa-β
Description
changes of Homa-β before and after the intervention
Time Frame
From date of randomization until the end of study, assessed up to 15 days
Title
insulin secretion-sensitivity index
Description
changes of insulin secretion-sensitivity index before and after the intervention
Time Frame
From date of randomization until the end of study, assessed up to 15 days
Title
disposition index
Description
changes of disposition index before and after the intervention
Time Frame
From date of randomization until the end of study, assessed up to 15 days
Title
standard deviation of glucose level
Description
standard deviation of glucose level
Time Frame
during three days' CGMS
Title
area under curve (AUC) when the glucose level was higher than 7.8mmol/L
Description
AUC when the glucose level was higher than 7.8mmol/L
Time Frame
during three days' CGMS
Title
area under curve (AUC) when the glucose level was lower than 3.9mmol/L
Description
AUC when the glucose level was higher than 3.9mmol/L
Time Frame
during three days' CGMS
Title
thiobarbituric acid reactive substance
Description
changes of thiobarbituric acid reactive substance before and after the intervention
Time Frame
From date of randomization until the end of study, assessed up to 15 days
Title
the level of blood 8-hydroxy-2-deoxyguanosine(8-OHdG)
Description
changes of the level of blood 8-OHdG substance before and after the intervention
Time Frame
From date of randomization until the end of study, assessed up to 15 days
Other Pre-specified Outcome Measures:
Title
the incidence of hypoglycemia
Description
the incidence of hypoglycemia, defined as blood glucose lower than 3.9mmol/L
Time Frame
From date of randomization until the end of study, assessed up to 15 days
Title
the incidence of severe hypoglycemia
Description
defined as hypoglycemia which need other people's help or blood glucose lower than 2.8mmol/L
Time Frame
From date of randomization until the end of study, assessed up to 15 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: investigator diagnosed type 2 diabetes( 1999 WHO diagnosis criteria). diagnosed as type 2 diabetes in the first time without drug therapy, or type 2 diabetes does not accept insulin in the near 3 month and duration is shorter than 10 years Fasting plasma glucose ( FPG ) ≥11.1mmol/L or glycated haemoglobin (HbA1c )≥9%. agree to participate the study and sign the informed consent. Exclusion Criteria: obvious failure of heart, hepatic, kidney function. severe acute or chronic complications, associated diseases. or other diseases that should not use oral hypoglycemic drug. women in pregnancy or planning to get pregnancy.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Zeng Longyi, professor
Phone
0086-020-85252160
Email
zssynfmk@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Lin Shuo, doctor
Phone
0086-020-85253408
Email
littltpig@yeah.net
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zeng Longyi, professor
Organizational Affiliation
Endocrinology department of the Third Affiliated Hospital of Sun Yet-san University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Endocrinology department of the Third Affiliated Hospital of Sun Yet-san University
City
Guangzhou City
State/Province
Guangdong
ZIP/Postal Code
510630
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zeng Longyi, Professor
Phone
0086-020-85252160
Email
zssynfmk@163.com
First Name & Middle Initial & Last Name & Degree
Lin Shuo, Doctor
Phone
0086-020-85253408
Email
littltpig@yeah.net
First Name & Middle Initial & Last Name & Degree
Zeng Longyi, Professor
First Name & Middle Initial & Last Name & Degree
lin Shuo, Doctor

12. IPD Sharing Statement

Citations:
PubMed Identifier
20335585
Citation
Yang W, Lu J, Weng J, Jia W, Ji L, Xiao J, Shan Z, Liu J, Tian H, Ji Q, Zhu D, Ge J, Lin L, Chen L, Guo X, Zhao Z, Li Q, Zhou Z, Shan G, He J; China National Diabetes and Metabolic Disorders Study Group. Prevalence of diabetes among men and women in China. N Engl J Med. 2010 Mar 25;362(12):1090-101. doi: 10.1056/NEJMoa0908292.
Results Reference
background
PubMed Identifier
18502299
Citation
Weng J, Li Y, Xu W, Shi L, Zhang Q, Zhu D, Hu Y, Zhou Z, Yan X, Tian H, Ran X, Luo Z, Xian J, Yan L, Li F, Zeng L, Chen Y, Yang L, Yan S, Liu J, Li M, Fu Z, Cheng H. Effect of intensive insulin therapy on beta-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes: a multicentre randomised parallel-group trial. Lancet. 2008 May 24;371(9626):1753-60. doi: 10.1016/S0140-6736(08)60762-X.
Results Reference
background
PubMed Identifier
21898754
Citation
Mu PW, Chen YM, Lu HY, Wen XQ, Zhang YH, Xie RY, Shu J, Wang MM, Zeng LY. Effects of a combination of oral anti-diabetes drugs with basal insulin therapy on beta-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes. Diabetes Metab Res Rev. 2012 Mar;28(3):236-40. doi: 10.1002/dmrr.1292.
Results Reference
background
PubMed Identifier
21877913
Citation
Zeng L, Lu H, Deng H, Mu P, Li X, Wang M. Noninferiority effects on glycemic control and beta-cell function improvement in newly diagnosed type 2 diabetes patients: basal insulin monotherapy versus continuous subcutaneous insulin infusion treatment. Diabetes Technol Ther. 2012 Jan;14(1):35-42. doi: 10.1089/dia.2011.0123. Epub 2011 Aug 30. Erratum In: Diabetes Technol Ther. 2014 Mar;16(3):193.
Results Reference
background
PubMed Identifier
11522721
Citation
Brun E, Zoppini G, Zamboni C, Bonora E, Muggeo M. Glucose instability is associated with a high level of circulating p-selectin. Diabetes Care. 2001 Sep;24(9):1685. doi: 10.2337/diacare.24.9.1685. No abstract available.
Results Reference
background
PubMed Identifier
10857967
Citation
Muggeo M, Zoppini G, Bonora E, Brun E, Bonadonna RC, Moghetti P, Verlato G. Fasting plasma glucose variability predicts 10-year survival of type 2 diabetic patients: the Verona Diabetes Study. Diabetes Care. 2000 Jan;23(1):45-50. doi: 10.2337/diacare.23.1.45.
Results Reference
background
PubMed Identifier
24998009
Citation
Reznik Y, Cohen O, Aronson R, Conget I, Runzis S, Castaneda J, Lee SW; OpT2mise Study Group. Insulin pump treatment compared with multiple daily injections for treatment of type 2 diabetes (OpT2mise): a randomised open-label controlled trial. Lancet. 2014 Oct 4;384(9950):1265-72. doi: 10.1016/S0140-6736(14)61037-0. Epub 2014 Jul 2.
Results Reference
background
PubMed Identifier
10645822
Citation
Hanson RL, Pratley RE, Bogardus C, Narayan KM, Roumain JM, Imperatore G, Fagot-Campagna A, Pettitt DJ, Bennett PH, Knowler WC. Evaluation of simple indices of insulin sensitivity and insulin secretion for use in epidemiologic studies. Am J Epidemiol. 2000 Jan 15;151(2):190-8. doi: 10.1093/oxfordjournals.aje.a010187.
Results Reference
background

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Comparison of Glycaemic Fluctuation and Oxidative Stress Between Two Short-term Therapies for Type 2 Diabetes

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