Pharmacokinetic Comparison of Intradermal Versus Sub-cutaneous Insulin and Glucagon Delivery in Type 1 Diabetes

This study is currently recruiting participants.
Verified September 2012 by Massachusetts General Hospital
Sponsor:
Information provided by (Responsible Party):
Steven J. Russell, MD, PhD, Massachusetts General Hospital
ClinicalTrials.gov Identifier:
NCT01684956
First received: August 23, 2012
Last updated: September 12, 2012
Last verified: September 2012
  Purpose

The investigators are doing this research study to find out if the type of needle used to administer them affects the speed with which insulin and glucagon get into the blood. The investigators will compare a traditional insulin needle to an injection device, called the MicronJet, that uses microneedles to deliver medication into the top layer of your skin.


Condition Intervention Phase
Type 1 Diabetes
Procedure: Intradermal injection
Procedure: Subcutaneous injection
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Pharmacokinetics Study
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Pharmacokinetic Comparison of Intradermal Versus Sub-cutaneous Insulin and Glucagon Delivery in Volunteers With Type 1 Diabetes

Resource links provided by NLM:


Further study details as provided by Massachusetts General Hospital:

Primary Outcome Measures:
  • Aggregate mean difference in tmax between the delivery methods (the insulin and glucagon data will be evaluated separately) [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Aggregate mean difference in t1/2max between the methods [ Designated as safety issue: No ]
  • Aggregate mean difference in Cmax between the methods [ Designated as safety issue: No ]
  • Aggregate mean difference in area under the curve (AUC) between methods [ Designated as safety issue: No ]
  • AUC of 0-1 hour (and by subtraction hours 1-5) [ Designated as safety issue: No ]
  • AUC of 0-2 hours (and by subtraction hours 2-5) [ Designated as safety issue: No ]
  • Time to 50% of Total AUC (or said another way, time to 50% exposure) [ Designated as safety issue: No ]
  • Fraction of subjects with difference in tmax between the methods of > 25% [ Designated as safety issue: No ]
  • Fraction of "dry" injections with no reflux of fluid from the injection site [ Designated as safety issue: No ]
  • Difference in mean visual analog pain score between the two methods [ Designated as safety issue: No ]
  • Difference in mean visual analog pain score between insulin and glucagon with subcutaneous injection [ Designated as safety issue: No ]
  • Difference in mean visual analog pain score between insulin and glucagon with intradermal injection [ Designated as safety issue: No ]

Estimated Enrollment: 20
Study Start Date: August 2012
Estimated Study Completion Date: August 2013
Estimated Primary Completion Date: August 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Intradermal first
Intradermal injection experiment first, followed by subcutaneous injection experiment
Procedure: Intradermal injection Procedure: Subcutaneous injection
Experimental: Subcutaneous first
Subcutaneous injection experiment first, followed by intradermal injection experiment
Procedure: Intradermal injection Procedure: Subcutaneous injection

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Age 18 years or older with clinical type 1 diabetes for at least two years
  • Diabetes managed using an insulin infusion pump and rapid- or very-rapid-acting insulins including insulin aspart (Novolog), insulin lispro (Humalog), and insulin glulisine (Apidra).
  • Body mass index (BMI) between 20 and 35.
  • Total daily dose (TDD) of insulin that is less than 1 U/kg.
  • Ability to consume a sufficient amount of carbohydrates over 2-3 hours to cover 5 units of rapid acting insulin

Exclusion Criteria:

  • Unable to provide informed consent
  • Unable to comply with study procedures
  • Inadequate venous access as determined by study nurse or physician at time of screening
  • Pregnancy
  • History of gastric banding, gastric bypass, or other gastrointestinal condition that may prevent a subject from consuming a normal sized meal
  • Hemoglobin less than 12
  • History of pheochromocytoma (fractionated metanephrines will be tested in patients with history increasing the risk for a catecholamine secreting tumor to include episodic or treatment refractory hypertension defined as requiring 4 or more medications to achieve normotension, paroxysms of tachycardia, pallor, or headache, or personal or family history of MEN 2A, MEN 2B, neurofibromatosis, or von Hippel-Lindau disease)
  • History of adverse reaction to glucagon (including allergy) besides nausea and vomiting
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01684956

Contacts
Contact: Mallory A HIllard, BA 617-643-2019 kgrennan@partners.org
Contact: Kerry B Grennan, NP 617-724-7700 mahillard@partners.org

Locations
United States, Massachusetts
Massachusetts General Hospital Recruiting
Boston, Massachusetts, United States, 02114
Contact: Steven J Russell, MD PhD     617-726-8722     SJRUSSELL@PARTNERS.ORG    
Sponsors and Collaborators
Massachusetts General Hospital
Investigators
Principal Investigator: Steven J Russell, MD, PhD Massachusetts General Hospital
  More Information

No publications provided

Responsible Party: Steven J. Russell, MD, PhD, Associate Professor, Massachusetts General Hospital
ClinicalTrials.gov Identifier: NCT01684956     History of Changes
Other Study ID Numbers: 2012P001098
Study First Received: August 23, 2012
Last Updated: September 12, 2012
Health Authority: United States: Institutional Review Board

Keywords provided by Massachusetts General Hospital:
intradermal
pharmacokinetics
microneedle
insulin
glucagon

Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 1
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Autoimmune Diseases
Immune System Diseases
Glucagon
Glucagon-Like Peptide 1
Insulin
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Pharmacologic Actions
Gastrointestinal Agents
Therapeutic Uses
Incretins
Hypoglycemic Agents

ClinicalTrials.gov processed this record on May 16, 2013