Type 1 Diabetes Clinical Trial
Official title:
A Comparison of Insulin Detemir in a BID Insulin Regimen Versus a TID Insulin Regimen in Children With Type 1 Diabetes: A Randomized Controlled Trial
The purpose of this study is to determine whether there is a difference in blood sugar control (as measured by hemoglobin A1c (HA1c)), in children given twice daily insulin injections incorporating a new long acting insulin analogue (detemir) compared to children using their current three times a day insulin injections (with intermediate and rapid acting insulin).
Children with type 1 diabetes (DM1) can only be treated with subcutaneous insulin at the
present time in Canada. It has been shown that intensive insulin treatment using at least
three times daily (TID) insulin injections achieves superior blood glucose control with less
long term complications of diabetes than conventional insulin treatment using once daily
(OD) or twice daily (BID) insulin injections. However, many patients find it difficult to
adhere to TID insulin injections since it is an invasive and painful therapy, which results
in frequent insulin omission.
This study is a randomized controlled open-labeled non-inferiority trial to compare the
glycemic control as measured by HbA1c after 6 months of a BID insulin regimen using detemir
insulin, or the currently used TID insulin with intermediate acting insulin (Novolin NPH or
Humulin N). Patients will be randomized to either the active control group (standard TID
regimen) or the treatment group (BID regimen with new long acting insulin analogue). A
run-in period of 1 month will be used to facilitate the change in insulin regimen. Insulin
doses will be adjusted by weekly phone contact with the research nurse for one month prior
to baseline blood work. Patients will continue on the same diet and exercise routine as
recommended by their usual diabetes team. They will also be seen every 3 months by the
research nurse to review blood glucose, assess height and weight and arrange for blood work
to be done in conjunction with their routine bloodwork. All patients will continue to be
seen by their usual diabetologist, nurse, and dietician at their regularly scheduled clinic
visits (every 3 months).
Outcomes include: HA1c between groups at 6 months (surrogate marker of metabolic control for
diabetes measured through a venous or capillary blood sample), frequency of adverse events
(severe hypoglycemia, mild hypoglycemia, episodes of diabetic ketoacidosis, weight gain),
diabetes quality of life for youth (DQOL).
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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