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Feasibility Study of the Effect of Intra-Dermal Insulin Injection on Blood Glucose Levels After Eating

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00553488
First Posted: November 5, 2007
Last Update Posted: August 22, 2008
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by:
Becton, Dickinson and Company
  Purpose
This study is to determine the effect of intra-dermal (ID) administration of regular and of rapid-acting insulin, before eating, on blood glucose levels for several hours after a standard meal (a mixed, liquid meal). Insulin will also be given normally, subcutaneously, for control or comparison purposes. The hypothesis or expectation is that ID insulin will work more quickly and control blood glucose levels better than SC injection.

Condition Intervention Phase
Diabetes Mellitus, Type 1 Drug: Regular insulin (Humulin) Drug: Insulin lispro (Humalog) Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Mono Center Open Labeled, Randomized Study Examining the Effects of Intra-Dermal vs Subcutaneous Application of Regular Insulin or Rapid Acting Insulin Analogue on Postprandial Glycemic Excursions in Patients With Type 1 Diabetes

Resource links provided by NLM:


Further study details as provided by Becton, Dickinson and Company:

Primary Outcome Measures:
  • Area Under Curve (AUC) of the blood glucose (BG) profile after the meal, with and without baseline correction. [ Time Frame: 90 mins ]

Secondary Outcome Measures:
  • Maximal BG (BGmax) [ Time Frame: Approximately 4 hours per injection ]
  • Total BG-AUC0-4 h [ Time Frame: Approximately 4 hrs per injection ]
  • Minimal BG (BGmin, time to BGmin (tBGmin) [ Time Frame: Approximately 4 hrs per injection ]
  • Insulin pharmacokinetics [ Time Frame: Approximately 4 hrs per injection ]
  • Number and seriousness of adverse events [ Time Frame: Approximately 4 hrs per injections ]
  • Vital signs, examination of insulin application [ Time Frame: Approximately 4 hrs per injection ]
  • Time to BGmax (tBGmax) [ Time Frame: Approximately 4 hours per injection ]

Enrollment: 30
Study Start Date: September 2007
Study Completion Date: January 2008
Primary Completion Date: December 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1
Regular insulin SC at -17 mins
Drug: Regular insulin (Humulin)
Insulin will be given either subcutaneously or intra-dermally, and at two different times prior to the liquid meal (T zero). At -17 mins, regular insulin will be given either SC or ID. At -2 mins, regular insulin will be given ID; also insulin lispro will be given either SC or ID. Each patient will receive 1 injection on 5 different study days.
Active Comparator: 2
Regular insulin ID at -17 mins
Drug: Regular insulin (Humulin)
Insulin will be given either subcutaneously or intra-dermally, and at two different times prior to the liquid meal (T zero). At -17 mins, regular insulin will be given either SC or ID. At -2 mins, regular insulin will be given ID; also insulin lispro will be given either SC or ID. Each patient will receive 1 injection on 5 different study days.
Active Comparator: 3
Regular insulin ID at -2 mins
Drug: Regular insulin (Humulin)
Insulin will be given either subcutaneously or intra-dermally, and at two different times prior to the liquid meal (T zero). At -17 mins, regular insulin will be given either SC or ID. At -2 mins, regular insulin will be given ID; also insulin lispro will be given either SC or ID. Each patient will receive 1 injection on 5 different study days.
Active Comparator: 4
Insulin lispro given SC at -2 mins
Drug: Insulin lispro (Humalog)
Insulin will be given either subcutaneously or intra-dermally, and at two different times prior to the liquid meal (T zero). At -17 mins, regular insulin will be given either SC or ID. At -2 mins, regular insulin will be given ID; also insulin lispro will be given either SC or ID. Each patient will receive 1 injection on 5 different study days.
Experimental: 5
Insulin lispro given ID at -2 mins
Drug: Insulin lispro (Humalog)
Insulin will be given either subcutaneously or intra-dermally, and at two different times prior to the liquid meal (T zero). At -17 mins, regular insulin will be given either SC or ID. At -2 mins, regular insulin will be given ID; also insulin lispro will be given either SC or ID. Each patient will receive 1 injection on 5 different study days.

Detailed Description:
Previous studies have shown that intra-dermal (ID) insulin administration results in a more rapid onset of action in comparison to subcutaneous (SC) administration as measured by glucose infusion rate (GIR) under glucose clamp conditions.The aim of this study is to investigate whether ID administration of regular human insulin or rapid-acting insulin analogue leads to reduced postprandial glycemic excursions in comparison to SC application under highly standardized experimental conditions. Effects on the occurrence of hypoglycemia will also be investigated, as well as pK and pD comparisons between different insulin formulations administered ID. This is a mono-center, open-label, randomized, 5-period crossover study in patients with type 1 diabetes
  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 55 Years   (Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Type 1 diabetes for 1-15 years, on multiple daily injections (MDI) or insulin pump (CSII) in stable control with HbA1c <= 9.0%.
  • Able to attend clinic for 5 different days

Exclusion Criteria:

  • BMI > 32 kg/m2
  • Evidence of gastroparesis or impaired renal function or lipodystrophy
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00553488


Locations
Germany
Profil Institut fur Stoffwechselforschung GmbH
Neuss, Germany, D-41460
Sponsors and Collaborators
Becton, Dickinson and Company
Investigators
Principal Investigator: Christoph Kapitza, MD Profil Institut fur Stoffwechselforschung GmbH
  More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Laurence Hirsch, Vice-President, Global Medical Affairs, Diabetes Care, BD
ClinicalTrials.gov Identifier: NCT00553488     History of Changes
Other Study ID Numbers: BDT-ADD-07-002
EudraCT number 2007-003924-39
First Submitted: October 12, 2007
First Posted: November 5, 2007
Last Update Posted: August 22, 2008
Last Verified: August 2008

Keywords provided by Becton, Dickinson and Company:
diabetes
insulin
subcutaneous
intra-dermal
blood glucose

Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 1
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Autoimmune Diseases
Immune System Diseases
Insulin, Globin Zinc
Insulin
Insulin Lispro
Hypoglycemic Agents
Physiological Effects of Drugs