Glycemic Control and Complications in Diabetes Mellitus Type 2 (VADT)
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Purpose
This study is a prospective, 2-arm, randomized controlled trial to determine whether glycemic control, achieved through intensification of treatment, is effective in preventing clinical macrovascular complications in patients with type 2 DM who are no longer responsive to oral agents alone. The study consists of a two-year accrual period and five years of follow-up (7 years total) of 1700 patients across 20 centers. We have powered the study to detect a 25% reduction in the primary event rate. Additional study goals are to determine whether the expenditures, discomfort, and adverse effects associated with intensive intervention are justified in terms of their clinical benefits, considering both macrovascular and microvascular complications.
| Condition | Intervention | Phase |
|---|---|---|
|
Type 2 Diabetes Mellitus |
Drug: Insulin Drug: Glimepiride Drug: Rosiglitazone Drug: Metformin |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | CSP #465 - Glycemic Control and Complications in Diabetes Mellitus Type 2 (VADT) |
- The primary outcome is the occurrence of any one of the following: myocardial infarction, surgery for atherosclerotic disease, stroke, congestive heart failure, or amputation for ischemic gangrene. [ Time Frame: Time to first primary event (survival analysis). ] [ Designated as safety issue: No ]
| Enrollment: | 1791 |
| Study Start Date: | December 2000 |
| Study Completion Date: | May 2008 |
| Primary Completion Date: | May 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
Standard glycemic control to maintain HbA1c between 8.0-9.0%.
|
Drug: Insulin Drug: Glimepiride Drug: Rosiglitazone Drug: Metformin |
|
Experimental: 2
Intensive glycemic control lower HbA1c below 7.0%.
|
Drug: Insulin Drug: Glimepiride Drug: Rosiglitazone Drug: Metformin |
Show Detailed Description
Eligibility| Ages Eligible for Study: | 40 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with type 2 DM who are no longer responsive to maximum dose of one or more oral agents.
Exclusion Criteria:
- Angina pectoris, Canadian Class I-II,
- congestive heart failure, Class III-IV,
- stroke, incapacitating or in last 6 months,
- AMI or invasive cardiovascular procedure within the past six months,
- ongoing diabetic gangrene,
- BMI > 40,
- hemoglobinopathy that interferes with A1c monitoring,
- serum creatinine > 1.6 mg/dL,
- fasting C-peptide < 0.21 pmol/ml,
- ALT > 3 times normal or serum bilirubin > 1.9 mg/dL,
- malignancy or noncardiac life-threatening diseases making life expectancy < 5 years,
- autonomic neuropathy,
- symptomatic pancreatic insufficiency (endocrine or exocrine),
- recurrent seizures within the past year,
- hypopituitarism,
- pregnancy, lactation, or planning a pregnancy,
- active psychosis or substance abuse,
- lack of access to a person who can assist or be called in an emergency,
- underlying conditions that in the site PI's judgment may prevent adherence to protocol,
- current participation in another clinical trial.
Contacts and Locations
Show 21 Study Locations| Study Chair: | Carlos Abraira, MD | VA Medical Center, Miami |
More Information
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Department of Veterans Affairs |
| ClinicalTrials.gov Identifier: | NCT00032487 History of Changes |
| Other Study ID Numbers: | 465 |
| Study First Received: | March 21, 2002 |
| Last Updated: | February 7, 2012 |
| Health Authority: | United States: Federal Government United States: Food and Drug Administration |
Keywords provided by Department of Veterans Affairs:
|
DM glycemic control insulin type 2 diabetes mellitus |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Glimepiride Rosiglitazone Insulin Metformin |
Hypoglycemic Agents Physiological Effects of Drugs Pharmacologic Actions Immunosuppressive Agents Immunologic Factors Anti-Arrhythmia Agents Cardiovascular Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 19, 2013