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Absorption of Insulin Following Subcutaneous Bolus Administration With Different Bolus Durations

Primary Purpose

Type 1 Diabetes

Status
Completed
Phase
Phase 1
Locations
Austria
Study Type
Interventional
Intervention
Insulin LISPRO
Sponsored by
Medical University of Graz
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Type 1 Diabetes focused on measuring insulin pump therapy, insulin bolus, rapid acting insulin, insulin lispro, pharmacodynamics, pharmacokinetics, glucose clamp

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Informed consent obtained after being advised of the nature of the study
  • Male or female aged 18-60 years (both inclusive)
  • Type 1 diabetes treated with multiple daily insulin injection or continuous subcutaneous insulin infusion for 12 months
  • Fasting C-peptide < 0.3nmol/L
  • Body mass index 20.0-30.0 kg/m² (both inclusive)
  • HbA1c < 10%

Exclusion Criteria:

  • Female of childbearing potential who is pregnant, breast-feeding or intend to become pregnant or is not using adequate contraceptive methods
  • Skin pathology or condition prohibiting needle insertion/insulin administration as judged by the investigator
  • History of bleeding disorder
  • Current participation in another clinical study
  • Use of insulin lispro >2 weeks
  • Significant acute or chronic illness that might interfere with subject safety or integrity of results as judged by the investigator
  • Smoker (defined as >5 cigarettes/d)
  • Lipodystrophy
  • Current treatment with systemic (oral or i.v.) corticosteroids, monoamine oxidase (MAO) inhibitors, non-selective beta-blockers, growth hormone, herbal products or non-routine vitamins. Furthermore, thyroid hormones are not allowed unless the use of these has been stable during the past 3 months
  • Significant history of alcoholism or drug abuse or a positive result in urine drug/alcohol screen

Study Day Exclusion Criteria:

  • Strenuous exercise within the last 24 hours prior to the clamp visit
  • Non-fasting (i.e. consumption of food or beverages, other than water, later than 22:00 hours the evening before the visit) except if slight intake of rapidly absorbable carbohydrates has been necessary in order to prevent hypoglycaemia
  • Injection of long-acting insulin (e.g. insulin glargine or insulin detemir) later than 12:00 hours (noon), 2 days before the clamp visit
  • Injection of NPH insulin or other intermediate-acting insulin products later than 12:00 hours (noon) on the day before the clamp visit
  • Injection of any short acting insulin (aspart, lispro, glulisine) or more than 6 IU of human insulin between 22:00 hours and 03:00 hours the night before the clamp visit
  • Injection of any insulin later than 03:00 hours the night before the clamp visit
  • Infusion of any insulin later than 03:00 hours the night before the clamp visit for subjects using continuous subcutaneous insulin infusion (CSII)
  • Positive result of alcohol breath test
  • Any medical condition that, in the opinion of the Investigator, could interfere with insulin pharmacokinetics and/or glucose metabolism

Sites / Locations

  • Medical University of Graz

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

1 bolus of insulin lispro with short bolus duration

1 bolus of insulin lispro with long bolus duration

Arm Description

Subcutaneous administration of insulin lispro as a bolus of 15 IU over a period of 30 seconds

Subcutaneous administration of insulin lispro as a bolus of 15 IU over a period of 10 minutes

Outcomes

Primary Outcome Measures

tmax(GIR); time to maximum glucose infusion rate

Secondary Outcome Measures

GIRmax, maximum glucose infusion rate

Full Information

First Posted
February 13, 2013
Last Updated
February 25, 2014
Sponsor
Medical University of Graz
Collaborators
European Commission
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1. Study Identification

Unique Protocol Identification Number
NCT01792323
Brief Title
Absorption of Insulin Following Subcutaneous Bolus Administration With Different Bolus Durations
Official Title
Subcutaneous Insulin Absorption Following Bolus Administrations With an Insulin Pump - Comparison of Bolus Administrations With Different Bolus Durations
Study Type
Interventional

2. Study Status

Record Verification Date
February 2014
Overall Recruitment Status
Completed
Study Start Date
August 2011 (undefined)
Primary Completion Date
November 2011 (Actual)
Study Completion Date
January 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Medical University of Graz
Collaborators
European Commission

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To cover meal-related insulin requirements, insulin pumps allow insulin to be delivered at high rates over a short period of time (bolus delivery). The length of this period (bolus duration) usually depends on the chosen bolus size and on the used insulin pump model. This study will evaluate the impact of different bolus durations (i.e., durations commonly employed in commercially available insulin pumps: 2 and 40 seconds for delivering 1 Unit of insulin) on the pharmacokinetic and pharmacodynamic properties of an rapid-acting insulin analogue. Objective: To evaluate in type 1 diabetic patients the pharmacodynamics and pharmacokinetics of rapid-acting insulin (insulin lispro) administered as subcutaneous boluses with different bolus durations. Study design: Single-center, randomized, controlled, two-arm cross-over intervention study Population: Twenty type 1 diabetic subjects Intervention: The investigational treatment is the subcutaneous administration of insulin lispro either as one bolus of 15 IU over a period of 30s or as one bolus of 15 IU over a period of 10 min. Plasma samples to assess pharmacodynamic and pharmacokinetic properties will be taken during an 8-hour clamp experiment. Patients will undergo both investigational treatments in a randomized order; between the two clamp visits there will be a wash-out period of 5-21 days. Main study endpoint: Time to maximum glucose infusion rate

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 1 Diabetes
Keywords
insulin pump therapy, insulin bolus, rapid acting insulin, insulin lispro, pharmacodynamics, pharmacokinetics, glucose clamp

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1 bolus of insulin lispro with short bolus duration
Arm Type
Experimental
Arm Description
Subcutaneous administration of insulin lispro as a bolus of 15 IU over a period of 30 seconds
Arm Title
1 bolus of insulin lispro with long bolus duration
Arm Type
Experimental
Arm Description
Subcutaneous administration of insulin lispro as a bolus of 15 IU over a period of 10 minutes
Intervention Type
Drug
Intervention Name(s)
Insulin LISPRO
Intervention Description
Administration of 15 IU of insulin lispro over a period of 30 seconds
Primary Outcome Measure Information:
Title
tmax(GIR); time to maximum glucose infusion rate
Time Frame
8 hours
Secondary Outcome Measure Information:
Title
GIRmax, maximum glucose infusion rate
Time Frame
8 hours
Other Pre-specified Outcome Measures:
Title
tmax(ins), time to maximum observed plasma insulin lispro concentration
Time Frame
8 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Informed consent obtained after being advised of the nature of the study Male or female aged 18-60 years (both inclusive) Type 1 diabetes treated with multiple daily insulin injection or continuous subcutaneous insulin infusion for 12 months Fasting C-peptide < 0.3nmol/L Body mass index 20.0-30.0 kg/m² (both inclusive) HbA1c < 10% Exclusion Criteria: Female of childbearing potential who is pregnant, breast-feeding or intend to become pregnant or is not using adequate contraceptive methods Skin pathology or condition prohibiting needle insertion/insulin administration as judged by the investigator History of bleeding disorder Current participation in another clinical study Use of insulin lispro >2 weeks Significant acute or chronic illness that might interfere with subject safety or integrity of results as judged by the investigator Smoker (defined as >5 cigarettes/d) Lipodystrophy Current treatment with systemic (oral or i.v.) corticosteroids, monoamine oxidase (MAO) inhibitors, non-selective beta-blockers, growth hormone, herbal products or non-routine vitamins. Furthermore, thyroid hormones are not allowed unless the use of these has been stable during the past 3 months Significant history of alcoholism or drug abuse or a positive result in urine drug/alcohol screen Study Day Exclusion Criteria: Strenuous exercise within the last 24 hours prior to the clamp visit Non-fasting (i.e. consumption of food or beverages, other than water, later than 22:00 hours the evening before the visit) except if slight intake of rapidly absorbable carbohydrates has been necessary in order to prevent hypoglycaemia Injection of long-acting insulin (e.g. insulin glargine or insulin detemir) later than 12:00 hours (noon), 2 days before the clamp visit Injection of NPH insulin or other intermediate-acting insulin products later than 12:00 hours (noon) on the day before the clamp visit Injection of any short acting insulin (aspart, lispro, glulisine) or more than 6 IU of human insulin between 22:00 hours and 03:00 hours the night before the clamp visit Injection of any insulin later than 03:00 hours the night before the clamp visit Infusion of any insulin later than 03:00 hours the night before the clamp visit for subjects using continuous subcutaneous insulin infusion (CSII) Positive result of alcohol breath test Any medical condition that, in the opinion of the Investigator, could interfere with insulin pharmacokinetics and/or glucose metabolism
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Thomas R Pieber, MD
Organizational Affiliation
Medical University of Graz, Internal Medicine, Endocrinology and Metabolism
Official's Role
Principal Investigator
Facility Information:
Facility Name
Medical University of Graz
City
Graz
State/Province
Styria
ZIP/Postal Code
A-8036
Country
Austria

12. IPD Sharing Statement

Links:
URL
http://www.medunigraz.at
Description
Medical University of Graz

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Absorption of Insulin Following Subcutaneous Bolus Administration With Different Bolus Durations

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