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A Comparison of Two Initial Dosing Formulas

This study has been completed.
Information provided by (Responsible Party):
Allen B. King, MD, Diabetes Care Center Identifier:
First received: June 17, 2011
Last updated: August 23, 2013
Last verified: August 2013
This study will evaluate two methods of starting basal insulin to see which method may achieve a faster-to-goal titration.

Condition Intervention
Diabetes Mellitus, Type 2 Drug: Insulin detemir

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Comparison of Two Initial Dosing Formulas for Basal Insulin in Type 2 Diabetes Mellitus

Resource links provided by NLM:

Further study details as provided by Allen B. King, MD, Diabetes Care Center:

Primary Outcome Measures:
  • Days to reach the titration target [ Time Frame: 12 weeks ]
    The number of days for the subject to reach the titration target blood sugar of 110 ml/dl

Secondary Outcome Measures:
  • The frequency of reported and documented (<70 mg/dl) hypoglycemic events per 24 hour period [ Time Frame: 12 weeks ]

Enrollment: 20
Study Start Date: June 2011
Study Completion Date: December 2011
Primary Completion Date: December 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Insulin determir Drug: Insulin detemir
Subjects will be randomized to weight based method of 0.1 U/kg for basal insulin or a starting dose based upon an insulin challenge. Subject will record morning fasting blood sugar daily. Using a three day average, the subject will titrate the dose of basal insulin either increasing or lowering by three units based upon target blood glucose of 110 mg/dl.

Detailed Description:
The current recommended starting dose of basal insulin in type 2 diabetes is either a fixed dose, e.g. 10 U, or a weight-based formulas, 0.1-0.2 U/kg. The estimate of eventual titration dose to attempt to reach a fasting glucose goal is 0.49 U/kg. Those many weeks of dosage upward titration are required. The investigators propose to compare the current recommended weight based, 0.1 U/kg to a correction factor derived formula. Starting with an insulin tolerance test estimation of basal dose, one would arrive at the eventual titrated basal insulin dose in significantly less days than starting at a starting dose estimate of 0.1 U/kg. Further, there would be no significant increase in overall reported hypoglycemia.

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

Inclusion Criteria:

  1. Type 2 diabetes
  2. Age 18 years and above
  3. Concurrently on ± sulfonylureas ± thiazolidinedione ± DDP IV inhibitors ± metformin ± glinides
  4. A1c ≥ 7.0% but ≤ 10%
  5. Capable of self monitoring glucose ≥4/day
  6. Previously compliant with clinical recommendations
  7. Fasting blood glucose ≥ 150 mg/dl
  8. BMI ≤ 45 kg/m2

Exclusion Criteria:

  1. Urinary ketosis
  2. Currently or expected alteration in insulin sensitivity such as major surgery, infection, renal failure (creatinine >1.5 mg/dl), glucocorticoid treatment, recent (within 2 weeks) serious hypoglycaemic episode (requires assistant of another)
  3. Currently participating in another clinical trial
  4. Known or suspected allergy to insulin determir
  5. Using insulin
  6. Pregnancy or nursing or the intention of becoming pregnant or not using adequate
  7. Significant liver or heart failure.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01377155

United States, California
Diabetes Care Center
Salinas, California, United States, 93901
Sponsors and Collaborators
Diabetes Care Center
Principal Investigator: Allen B King, MD Diabetes Care Center
  More Information

Responsible Party: Allen B. King, MD, Principal Investigator, Diabetes Care Center Identifier: NCT01377155     History of Changes
Other Study ID Numbers: DCC 03-11
Study First Received: June 17, 2011
Last Updated: August 23, 2013

Keywords provided by Allen B. King, MD, Diabetes Care Center:
basal insulin
diabetes mellitus type two

Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases
Insulin, Globin Zinc
Insulin Detemir
Hypoglycemic Agents
Physiological Effects of Drugs processed this record on September 21, 2017