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Hospital Insulin Protocol Aims for Glucose Control in Corticosteroid-induced Hyperglycemia

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ClinicalTrials.gov Identifier: NCT01184014
Recruitment Status : Completed
First Posted : August 18, 2010
Results First Posted : November 18, 2013
Last Update Posted : June 13, 2018
Sponsor:
Collaborators:
International Diabetes Center at Park Nicollet
Sanofi
Information provided by (Responsible Party):
HealthPartners Institute

Brief Summary:
The objective of this study is to determine the best insulin regimen for hospitalized patients who receive high doses of steroids who have high blood glucose.

Condition or disease Intervention/treatment Phase
Hyperglycemia Drug: NPH insulin plus Complete Insulin Orders Drug: Complete Insulin Orders Phase 4

Detailed Description:
The overall study objective of this research is to establish the efficacy and assure the safety of achieving glycemic control in hospitalized patients who receive greater than physiologic doses of steroids. This study will compare 2 methods of achieving glycemic control in hospitalized patients who develop steroid-induced hyperglycemia (blood glucose (BG) >180 mg/dL): 1) a study-specific steroid NPH dosing algorithm plus standard recommended care (Experimental group) vs. 2) the standard recommended care (Methodist Hospital Complete Insulin Orders (Control group).

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 72 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Hospital Insulin Protocol Aims for Glucose Control in Corticosteroid-induced Hyperglycemia
Study Start Date : August 2010
Actual Primary Completion Date : August 2012
Actual Study Completion Date : August 2012

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Experimental group
a study-specific steroid (NPH) dosing algorithm plus standard recommended care. The intervention is Neutral Protamine Hagedorn (NPH) insulin plus complete insulin orders (CIO).
Drug: NPH insulin plus Complete Insulin Orders
NPH dosed per study-specific algorithm which incorporates total daily dosage of steroid to determine NPH dose. Complete insulin orders include background, meal-time and correction factor.
Other Names:
  • lantus
  • glargine
  • humalog
  • lispro

Active Comparator: Control group
the standard recommended care (Methodist Hospital Complete Insulin Orders)
Drug: Complete Insulin Orders
3-part insulin which includes background, meal-time and correction factor
Other Names:
  • lantus
  • glargine
  • humalog
  • lispro




Primary Outcome Measures :
  1. Mean Blood Glucose of All Readings [ Time Frame: starting 3 hours after the initial index BG>180 measure, across the entire hospital stay or up through 5 days if hospital LOS is > 5 days ]
    Starting 3 hours after the initial index blood glucose (BG) >180 measure, across the entire hospital stay or up through 5 days if hospital length of stay (LOS) is > 5 days



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Men or women aged ≥18 years who receive steroids in doses greater than physiologic replacement levels of ≥ 10 mg Prednisone or its equivalent of dexamethasone or methylprednisolone.
  • Have signed the consent form for the study
  • Have a BG > 180 mg/dL any time during the first 24 hour of steroid administration that is above physiological replacement ( ≥ 10 mg Prednisone or equivalent)
  • Are scheduled to be in hospital ≥ 2 days.

Exclusion Criteria:

  • Unable to read or understand English
  • History of psychiatric disability affecting informed consent or compliance with drug intake
  • Type 1 diabetes
  • Acute or chronic renal failure (creatinine clearance < 30 mL/min estimated by method of Cockcroft and Gault)
  • Patients in Hospice Care
  • Age <18 years
  • Previously enrolled in this study.
  • Not appropriate for the steroid protocol in judgment of the principal investigator and/or attending physician.

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): NCT01184014


Locations
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United States, Minnesota
Park Nicollet Health Services Methodist Hospital
Saint Louis Park, Minnesota, United States, 55416
Sponsors and Collaborators
HealthPartners Institute
International Diabetes Center at Park Nicollet
Sanofi
Investigators
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Principal Investigator: Richard M Bergenstal, MD International Diabetes Center at Park Nicollet

Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: HealthPartners Institute
ClinicalTrials.gov Identifier: NCT01184014     History of Changes
Other Study ID Numbers: 04000-10-C
First Posted: August 18, 2010    Key Record Dates
Results First Posted: November 18, 2013
Last Update Posted: June 13, 2018
Last Verified: November 2013
Keywords provided by HealthPartners Institute:
corticosteroid
hyperglycemia
hospital
corticosteroid induced hyperglycemia in the hospital
Additional relevant MeSH terms:
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Hyperglycemia
Glucose Metabolism Disorders
Metabolic Diseases
Insulin
Insulin, Globin Zinc
Insulin Glargine
Insulin Lispro
Insulin, Isophane
Hypoglycemic Agents
Physiological Effects of Drugs