A Study of the Rules for Insulin Dosing in Patients Using Multiple Daily Injections
Primary Purpose
Diabetes Mellitus Type 1
Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Lispro Insulin and glargine insulin
Sponsored by
About this trial
This is an interventional treatment trial for Diabetes Mellitus Type 1 focused on measuring diabetes mellitus type 1, continuous glucose monitoring
Eligibility Criteria
Inclusion Criteria:
- Age: >17 years
- Type 1 diabetes
- Diabetes duration > 3 months
- On treatment with multiple daily injections either one or more basal insulin injections each day for 6 weeks
- HbA1c <9.0%
- Stable HbA1c in the proceeding 3 months (i.e., change <1%)
- Demonstrated adherence to visits and instructions
- Attend a class in meal carbohydrate content estimation or have demonstrated knowledge of carbohydrate counting
Exclusion Criteria:
- Major stress event during or for 6 weeks before the evaluation
- Taking a medication that can alter insulin sensitivity
- Within one week of menses
- Unstable eating or activity pattern
- Pregnancy
- Weight gain of > 1.5 kg during the preceding 3 months
- Serum creatinine of >1.5 mg/dl
- Active liver disease
- Evidence of autonomic neuropathy, especially gastroparesis
- Any antidiabetic medication other than insulin
- Treatment with continuous subcutaneous insulin infusion
Sites / Locations
- Diabetes Care CenterRecruiting
Outcomes
Primary Outcome Measures
Determine the mean value for the slop between the variables of total daily dose versus total basal dose.
Secondary Outcome Measures
Determine the slope between the other variables: weight, total daily dose, total basal dose, insulin correction carbohydrate rate, correction factor
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01045954
Brief Title
A Study of the Rules for Insulin Dosing in Patients Using Multiple Daily Injections
Official Title
A Study of the Rules for Insulin Dosing in Patients Using Multiple Daily Injections
Study Type
Interventional
2. Study Status
Record Verification Date
January 2010
Overall Recruitment Status
Unknown status
Study Start Date
January 2010 (undefined)
Primary Completion Date
August 2010 (Anticipated)
Study Completion Date
October 2010 (Anticipated)
3. Sponsor/Collaborators
Name of the Sponsor
Diabetes Care Center
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study will be conducted in subjects with Type 1 diabetes mellitus on multiple daily insulin injections to determine the correct insulin dosing formulas. Subjects will be evaluated using continuous glucose monitoring.
Detailed Description
Subjects with stable type 1 diabetes mellitus on multiple daily insulin injections including basal and bolus will be selected in order to determine the correct insulin dosing formulas. Subjects will be placed on continuous glucose sensor (CGMS) and an isocaloric diet. Subjects will have the CGMS downloaded daily and the insulin doses adjusted if necessary. Subject will do four SMBGs daily to calibrate CGMS and on last day a 7-point SMBG. subjects will be on lispro and glargine insulin. Basal insulin will be once a day.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus Type 1
Keywords
diabetes mellitus type 1, continuous glucose monitoring
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
50 (Anticipated)
8. Arms, Groups, and Interventions
Intervention Type
Drug
Intervention Name(s)
Lispro Insulin and glargine insulin
Intervention Description
Continuous glucose sensor will be inserted. Subject will be on an isocaloric diet and CGM downloaded daily. Insulin basal and bolus will be adjusted based upon treatment goals until goals reached
Primary Outcome Measure Information:
Title
Determine the mean value for the slop between the variables of total daily dose versus total basal dose.
Time Frame
Two weeks
Secondary Outcome Measure Information:
Title
Determine the slope between the other variables: weight, total daily dose, total basal dose, insulin correction carbohydrate rate, correction factor
Time Frame
Two weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age: >17 years
Type 1 diabetes
Diabetes duration > 3 months
On treatment with multiple daily injections either one or more basal insulin injections each day for 6 weeks
HbA1c <9.0%
Stable HbA1c in the proceeding 3 months (i.e., change <1%)
Demonstrated adherence to visits and instructions
Attend a class in meal carbohydrate content estimation or have demonstrated knowledge of carbohydrate counting
Exclusion Criteria:
Major stress event during or for 6 weeks before the evaluation
Taking a medication that can alter insulin sensitivity
Within one week of menses
Unstable eating or activity pattern
Pregnancy
Weight gain of > 1.5 kg during the preceding 3 months
Serum creatinine of >1.5 mg/dl
Active liver disease
Evidence of autonomic neuropathy, especially gastroparesis
Any antidiabetic medication other than insulin
Treatment with continuous subcutaneous insulin infusion
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gary W Wolfe, RN
Phone
831-769-9355
Email
gwolfe@diabetescarecenter.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Allen B. King, MD
Organizational Affiliation
Diabetes Care Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Diabetes Care Center
City
Salinas
State/Province
California
ZIP/Postal Code
93901
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gary S Wolfe, RN
Phone
831-769-9355
Email
gwolfe@diabetescarecenter.com
First Name & Middle Initial & Last Name & Degree
Allen B King, MD
First Name & Middle Initial & Last Name & Degree
Dawn Clark, NP
12. IPD Sharing Statement
Citations:
Citation
Walsh J, Roberts R. Pumping Insulin. 3rd Edition, San Diego, Torrey Pines Press. 2000
Results Reference
background
Citation
Bode BW. Insulin Pump Therapy. In, Therapy for diabetes Mellitus and Related Disorders, fourth edition, Lebovitz H. Ed, Alexandria, VA, American Diabetes Association, 2004, p224-231
Results Reference
background
PubMed Identifier
19888378
Citation
King AB, Armstrong DU. A prospective evaluation of insulin dosing recommendations in patients with type 1 diabetes at near normal glucose control: bolus dosing. J Diabetes Sci Technol. 2007 Jan;1(1):42-6. doi: 10.1177/193229680700100107.
Results Reference
background
PubMed Identifier
19888377
Citation
King AB, Armstrong DU. A prospective evaluation of insulin dosing recommendations in patients with type 1 diabetes at near normal glucose control: Basal dosing. J Diabetes Sci Technol. 2007 Jan;1(1):36-41. doi: 10.1177/193229680700100106.
Results Reference
background
Citation
Davidson PC, Hebblewhite HR, Bode BW, et al. Statistically based CSII parameters correction factor, CF (1700 rule) carbohydrate-to-insulin ratio, CIR (2.8 rule) and basal-to-total ration. Diabetes Technol Ther. 2003; 3:237
Results Reference
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A Study of the Rules for Insulin Dosing in Patients Using Multiple Daily Injections
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