Intensive Insulin Glulisine Therapy in Patients With Type 2 Diabetes Inadequately Controlled With Basal Insulin and Oral Glucose-lowering Drugs (CHANGING)

Inclusion criteria:

• in the run-in period:

  1. Uncontrolled Type 2 diabetes mellitus defined as HbA1c level between 7,5% and 10% assessed over the past 6 months
  2. Male or female patients from 18-75 years old inclusive
  3. Body Mass Index (BMI) between 25 and 40 kg/m2
  4. Currently treated with a basal insulin (NPH, insulin zinc or insulin detemir), plus at least 1g metformin daily, and other Oral Glucose Lowering Drug (OGLD) if any for at least 3 months
  5. Signed Informed consent obtained prior to any study procedures

• in the treatment period:

  1. HbA1c level between 7,5% and 10% assessed between week -2 and week 0
  2. Serum creatinine <= 135 µmol/L in men and <= 110 µmol/L in women
  3. Alanine aminotransferase (ALT) and/or Aspartate aminotransferase (AST) <= 3 times the upper limit of normal
  4. Negative pregnancy test for women of childbearing potential

Exclusion criteria:

1. Type 1 diabetes mellitus
2. Active proliferative diabetic retinopathy, defined as the application of photocoagulation or surgery performed within 6 months before study entry or any other unstable (rapidly progressing) retinopathy that may require photocoagulation or surgery during the study (confirmed by an optic fundus performed over the past 2 years)
3. Clinically relevant cardiovascular, hepatic, neurological, endocrine, or other major disease making implementation of the protocol or interpretation of the study results difficult
4. History of impaired hepatic function defined as Alanine aminotransferase (ALT) and/or Aspartate aminotransferase (AST) greater than three times the upper limit of normal
5. History of impaired renal function defined as serum creatinine >135 µmol/l in men and > 110 µmol/l in women
6. History of drug or alcohol abuse
7. Type 2 Diabetes Mellitus (T2DM) patients treated exclusively with OGLDs
8. T2DM patients treated with an insulin other than basal insulin (Premix, rapid insulin, fast-acting insulin analogue)
9. Previous treatment with insulin glulisine
10. Concomitant treatment with thiazolidinediones, exenatide or pramlintide
11. Treatment with systemic corticosteroids within 3 months prior to study entry
12. Treatment with any investigational product within 2 months prior to study entry
13. History of hypersensitivity to the study drugs or to drugs with a similar chemical structure
14. Presence of mental condition that, in the opinion of the investigator, indicates that participation in the study is not in the best interest of the patient
15. Presence of geographic or social conditions that would restrict or limit the patient participation for the duration of the study
16. Pregnant or breast feeding women
17. Women of childbearing potential not protected by effective contraceptive method of birth control

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.