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Comparison of Different Insulin Dosing Algorithms Using Hepatic Directed Vesicle-Insulin Lispro and Insulin Degludec

Primary Purpose

Diabetes Mellitus, Type 1

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
HDV-Insulin Lispro and Insulin Degludec (-40%)
HDV-Insulin Lispro and Insulin Degludec (-10%)
Sponsored by
Diasome Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Mellitus, Type 1

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female of age 18 to 65 years, inclusive.
  2. If female of child-bearing potential, must agree for the duration of the study. to use adequate contraceptive measures, such as, intra-uterine device [IUD], oral or injectable contraceptives, or barrier method plus spermicide.
  3. Has at Screening been diagnosed as T1DM for at least 12 months.
  4. Has at Screening C-peptide ≤0.8 ng/mL (single retest allowed).
  5. Has at Screening been on treatment with rapid analog insulin for the previous six (6) months.
  6. Has at Screening willingness to use continuous glucose monitoring (CGM) technology throughout study.
  7. Is, for the duration of the study, willing to use insulin lispro as the only analog bolus insulin and insulin degludec as the only basal insulin.
  8. Has at Screening a BMI ≥18.0 kg/m2 and ≤33.0 kg/m2.
  9. Has at Screening HbA1c ≥6.5% and ≤8.5%.

Exclusion Criteria:

  1. Has known or suspected allergy to any component of any of the study drugs in this trial.
  2. Is, at Screening, pregnant or breast-feeding, or intends to become pregnant at any time during the duration of the study.
  3. Has, at Screening, as judged by the Site Investigator, a history or current evidence of any of the following complications of diabetes: proliferative retinopathy or maculopathy, severe neuropathy (in particular, autonomic neuropathy), symptomatic gastroparesis.
  4. Is, at Screening, judged by the Site Investigator to have a current addiction to alcohol or substances of abuse.
  5. Is, at Screening, using one or more drugs that may interfere with the interpretation of trial results or are known to cause clinically relevant interference with insulin action, glucose utilization, or recovery from hypoglycemia (e.g., beta blockers, systemic corticosteroids at pharmacologic doses, cancer chemotherapies.).
  6. Has at Screening any of the following findings, unless approved by both the Site Investigator and the Medical Monitor:

    • Uncontrolled hypertension, defined as diastolic blood pressure ≥ 100 mmHg and/or systolic blood pressure ≥ 160 mmHg after 5 minutes in the sitting position;
    • History of or findings on EKG of cardiac arrhythmia or conduction defect;
    • Clinically significant abnormalities on Screening laboratory studies
  7. Has, within one (1) month prior to Screening, used either oral anti-diabetic medication or non-insulin anti-diabetic injection therapies (e.g. SGLT-2 inhibitors, pramlintide, GLP-1 agonists, etc.).
  8. Has, within one (1) month prior to Screening, received any investigational drug.
  9. Has, within two (2) months prior to Screening, used an insulin pump delivery system.
  10. Has, within three (3) months prior to Screening, smoked tobacco or used any smokeless tobacco or nicotine delivery system (inhaled, oral or buccal).
  11. Has at Screening, as judged by the Site Investigator, any condition (intrinsic or extrinsic) that could reasonably be expected to interfere with trial participation, confound evaluation of the data, or pose additional risk to adhering to the study protocol. Examples of such conditions include but are not limited to:

    • Clinically significant active disease of the gastrointestinal, cardiovascular, hepatic, neurological, renal, genitourinary, or hematological systems;
    • History of such an illness or disease
    • Diminished mental capacity, psychological or behavioral dysfunction, unwilling or resistant to protocol requirements, language barriers

Sites / Locations

  • Mills-Peninsula Medical Center, Diabetes Research Institute
  • Barbara Davis Center for Diabetes
  • Atlanta Diabetes Associates
  • Endocrine Research Solutions, Inc.
  • Diabetes & Endocrinology Consultants, PC
  • Texas Diabetes & Endocrinology, PA
  • Texas Diabetes & Endocrinology, PA

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

HDV-Insulin Lispro and Insulin Degludec dose reduced by 40%

HDV-Insulin Lispro and Insulin Degludec dose reduced by 10%

Arm Description

HDV-Insulin Lispro and Insulin Degludec dose reduced by 40%

HDV-Insulin Lispro and Insulin Degludec dose reduced by 10%

Outcomes

Primary Outcome Measures

Basal, bolus and total insulin doses (UOM=units) during the last 2 weeks of the treatment period
Basal, bolus and total insulin doses (UOM=units) during the last 2 weeks of the treatment period
Basal/bolus ratios during the last 2 weeks of the treatment period
Basal/bolus ratios during the last 2 weeks of the treatment period

Secondary Outcome Measures

Full Information

First Posted
April 15, 2019
Last Updated
March 31, 2020
Sponsor
Diasome Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT03938740
Brief Title
Comparison of Different Insulin Dosing Algorithms Using Hepatic Directed Vesicle-Insulin Lispro and Insulin Degludec
Official Title
An Exploratory Randomized Open-Label 2-Arm Comparison of Insulin Dosing Algorithms Using Hepatic Directed Vesicle-Insulin Lispro and Insulin Degludec to Determine Optimum Basal Insulin Dosing Regimens in Type 1 Diabetes Mellitus Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
March 18, 2019 (Actual)
Primary Completion Date
December 6, 2019 (Actual)
Study Completion Date
March 18, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Diasome Pharmaceuticals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Multi-center, open-label, multiple dose safety, tolerability and efficacy study
Detailed Description
This is a 24-week, open-label, multiple dose safety, tolerability and efficacy study. There is a 12-week run-in phase when all subjects receive Insulin Lispro and Insulin Degludec for 12 weeks. After completing the run-in period, subjects then are randomized to a treatment group of either HDV- Insulin lispro + Insulin Degludec (Degludec dose reduced by 40%) or HDV-Insulin lispro+ Insulin Degludec (Degludec dose reduced by 10%) for 12 weeks of treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus, Type 1

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
61 (Actual)

8. Arms, Groups, and Interventions

Arm Title
HDV-Insulin Lispro and Insulin Degludec dose reduced by 40%
Arm Type
Experimental
Arm Description
HDV-Insulin Lispro and Insulin Degludec dose reduced by 40%
Arm Title
HDV-Insulin Lispro and Insulin Degludec dose reduced by 10%
Arm Type
Experimental
Arm Description
HDV-Insulin Lispro and Insulin Degludec dose reduced by 10%
Intervention Type
Drug
Intervention Name(s)
HDV-Insulin Lispro and Insulin Degludec (-40%)
Intervention Description
HDV-Insulin Lispro and Insulin Degludec (-40%)
Intervention Type
Drug
Intervention Name(s)
HDV-Insulin Lispro and Insulin Degludec (-10%)
Intervention Description
HDV-Insulin Lispro and Insulin Degludec (-10%)
Primary Outcome Measure Information:
Title
Basal, bolus and total insulin doses (UOM=units) during the last 2 weeks of the treatment period
Description
Basal, bolus and total insulin doses (UOM=units) during the last 2 weeks of the treatment period
Time Frame
24 weeks
Title
Basal/bolus ratios during the last 2 weeks of the treatment period
Description
Basal/bolus ratios during the last 2 weeks of the treatment period
Time Frame
24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female of age 18 to 65 years, inclusive. If female of child-bearing potential, must agree for the duration of the study. to use adequate contraceptive measures, such as, intra-uterine device [IUD], oral or injectable contraceptives, or barrier method plus spermicide. Has at Screening been diagnosed as T1DM for at least 12 months. Has at Screening C-peptide ≤0.8 ng/mL (single retest allowed). Has at Screening been on treatment with rapid analog insulin for the previous six (6) months. Has at Screening willingness to use continuous glucose monitoring (CGM) technology throughout study. Is, for the duration of the study, willing to use insulin lispro as the only analog bolus insulin and insulin degludec as the only basal insulin. Has at Screening a BMI ≥18.0 kg/m2 and ≤33.0 kg/m2. Has at Screening HbA1c ≥6.5% and ≤8.5%. Exclusion Criteria: Has known or suspected allergy to any component of any of the study drugs in this trial. Is, at Screening, pregnant or breast-feeding, or intends to become pregnant at any time during the duration of the study. Has, at Screening, as judged by the Site Investigator, a history or current evidence of any of the following complications of diabetes: proliferative retinopathy or maculopathy, severe neuropathy (in particular, autonomic neuropathy), symptomatic gastroparesis. Is, at Screening, judged by the Site Investigator to have a current addiction to alcohol or substances of abuse. Is, at Screening, using one or more drugs that may interfere with the interpretation of trial results or are known to cause clinically relevant interference with insulin action, glucose utilization, or recovery from hypoglycemia (e.g., beta blockers, systemic corticosteroids at pharmacologic doses, cancer chemotherapies.). Has at Screening any of the following findings, unless approved by both the Site Investigator and the Medical Monitor: Uncontrolled hypertension, defined as diastolic blood pressure ≥ 100 mmHg and/or systolic blood pressure ≥ 160 mmHg after 5 minutes in the sitting position; History of or findings on EKG of cardiac arrhythmia or conduction defect; Clinically significant abnormalities on Screening laboratory studies Has, within one (1) month prior to Screening, used either oral anti-diabetic medication or non-insulin anti-diabetic injection therapies (e.g. SGLT-2 inhibitors, pramlintide, GLP-1 agonists, etc.). Has, within one (1) month prior to Screening, received any investigational drug. Has, within two (2) months prior to Screening, used an insulin pump delivery system. Has, within three (3) months prior to Screening, smoked tobacco or used any smokeless tobacco or nicotine delivery system (inhaled, oral or buccal). Has at Screening, as judged by the Site Investigator, any condition (intrinsic or extrinsic) that could reasonably be expected to interfere with trial participation, confound evaluation of the data, or pose additional risk to adhering to the study protocol. Examples of such conditions include but are not limited to: Clinically significant active disease of the gastrointestinal, cardiovascular, hepatic, neurological, renal, genitourinary, or hematological systems; History of such an illness or disease Diminished mental capacity, psychological or behavioral dysfunction, unwilling or resistant to protocol requirements, language barriers
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marc Penn, MD, PhD
Organizational Affiliation
Diasome Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Mills-Peninsula Medical Center, Diabetes Research Institute
City
San Mateo
State/Province
California
ZIP/Postal Code
94401
Country
United States
Facility Name
Barbara Davis Center for Diabetes
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Atlanta Diabetes Associates
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30318
Country
United States
Facility Name
Endocrine Research Solutions, Inc.
City
Roswell
State/Province
Georgia
ZIP/Postal Code
30076
Country
United States
Facility Name
Diabetes & Endocrinology Consultants, PC
City
Morehead City
State/Province
North Carolina
ZIP/Postal Code
28557
Country
United States
Facility Name
Texas Diabetes & Endocrinology, PA
City
Austin
State/Province
Texas
ZIP/Postal Code
78749
Country
United States
Facility Name
Texas Diabetes & Endocrinology, PA
City
Round Rock
State/Province
Texas
ZIP/Postal Code
78681
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Comparison of Different Insulin Dosing Algorithms Using Hepatic Directed Vesicle-Insulin Lispro and Insulin Degludec

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