Impacts of PIO/MET Following Short-term Intensive Insulin Treatment in Newly Diagnosed Type 2 Diabetes

Type 2 Diabetes Mellitus Clinical Trial

Official title:

Impacts of Sequential Treatment Using Fixed Dose Pioglitazone/Metformin Combination Following Short-term Intensive Insulin Treatment on Long-term Blood Glucose Control and β-Cell Function in Patients With Newly Diagnosed Type 2 Diabetes

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03196362
• Other study ID #: 20160145
• Status: Recruiting
• Phase: Phase 4
• First received: June 20, 2017
• Last updated: June 20, 2017
• Start date: December 1, 2016
• Est. completion date: December 31, 2018

Study information

• Verified date: June 2017
• Source: Sun Yat-sen University
• Contact: Liehua Liu, PHD
• Phone: +8613751748843
• Email: turkey310[@]163.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Short-term intensive insulin therapy (SIIT) induces glycemic remission in patients with newly diagnosed type 2 diabetes. But remission rate reduces over time. This study aims to investigate whether sequential treatments using fixed dose combination of pioglitazone/metformin (15mg/500mg) after SIIT can improve clinical outcomes inpatients with newly diagnosed type 2 diabetes.

We plan to include 50 patients with newly diagnosed type 2 diabetes who are drug naïve and meet the inclusive criteria will be enrolled. After baseline assessments, SIIT will be applied to all patients using insulin pump to achieve and maintain euglycemia for 2 weeks. After completion of intensive treatment, insulin pump will be stopped. Patients were randomly assigned into either of the following two groups: PIO/MET group: pioglitazone/metformin (15mg/500mg) will be orally administrated twice daily to the subjects for 12 weeks; placebo group: placebo is given twice daily to all subjects for 12 weeks. Afterwards, patients will be followed up for 48 weeks. Primary endpoint is difference in remission rate at the end of study. Secondary endpoints include proportion of patients who achieve glycosylated hemoglobin A1C <7% at the end of study; differences in β-cell function , insulin sensitivity and incidence of adverse events among treatment groups.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 50
• Est. completion date: December 31, 2018
• Est. primary completion date: September 30, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 25 Years to 65 Years

Eligibility

Inclusion Criteria:

1. Patients with newly diagnosed type 2 diabetes who have never received any hypoglycemic treatment;

2. Fasting plasma glucose (FPG) between 7.0 mmol/l (126 mg/dl) and 16.7 mmol/l (300 mg/dl); glycosylated hemoglobin A1C>8.5%;

3. Aged between 25 and 65 years,

4. Body mass index (BMI) 22-35 kg/m2.

Exclusion Criteria:

1. Type 1 diabetes or special type of diabetes;

2. Acute diabetic complications of diabetes (DKA, HHS and lactic acidosis etc.)

3. Serious microvascular complications: proliferative stage of retinopathy; urine AER >300 mg/g or urine protein positive, quantification >0.5 g/d; uncontrolled painful diabetic neuropathy and significant diabetic autonomic neuropathy;

4. Severe macrovascular complications: acute cerebrovascular accident, acute coronary syndrome, vascular intervention for peripheral arterial disease or amputation requiring hospitalization within 12 months prior to enrollment;

5. Persistently increased blood pressure >180/110 mmHg;

6. Blood creatinine clearance less than 50 ml/min, alanine aminotransferase =2.5×upper limit of normal, total bilirubin =1.5×upper limit of normal;

7. Hemoglobin <100 g/L or need regular blood transfusion;

8. Use of drugs that may influence blood glucose within 12 weeks;

9. Systemic infection or serious concomitant disease; patients with malignancy or chronic diarrhea;

10. Uncontrolled endocrine gland dysfunction;

11. Patients with mental or communication disorders;

12. Chronic cardiac insufficiency, heart function class III and above;

13. Pregnant women, lactating women and women of child bearing age who are not willing to take contraception during the study;

14. Subjects who don't cooperate, cannot be followed up or have difficulty in completing the study considered by the investigator.

Related Conditions & MeSH terms

• Diabetes Mellitus
• Diabetes Mellitus, Type 2
• Type 2 Diabetes Mellitus

Intervention

Drug:
• Pioglitazone + Metformin
One tablet of fixed dose of Pioglitazone/ Metformin (15mg/30mg) will be given twice daily
• Placebo Oral Tablet
One tablet of placebo will be given twice daily

Locations

Country	Name	City	State
China	endocrinology department of the first affiliated hospital of Sun Yat-sen University	Guangzhou	Guangdong

Sponsors (1)

Lead Sponsor	Collaborator
Sun Yat-sen University

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Remission rate	Remission rate at the end of the study in each group	48 weeks
Secondary	ß-cell function	Difference in ß-cell secretion capacity at the end of follow up between treatment groups	48 weeks
Secondary	Insulin sensitivity	Difference in insulin sensitivity at the end of follow up between treatment groups	48 weeks
Secondary	glycemic control	proportion of patients who achieve A1C<7% at the end of follow-up	48 weeks
Secondary	Adverse events	difference in AEs at the end of follow-up between treatment groups	48 weeks