Working… Menu

Endothelial Effects of Basal Insulin: Detemir Versus Glargine

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. Identifier: NCT00699686
Recruitment Status : Completed
First Posted : June 18, 2008
Last Update Posted : August 17, 2010
Information provided by:
University of Padova

Brief Summary:

Endothelial progenitor cell (EPC) level represents a surrogate marker of cardiovascular risk and an indicator of the ongoing vascular damage. Moreover, EPCs are involved in the pathogenesis of virtually all diabetic complications. Therefore, ways to modulate EPCs are currently considered of utmost importance, especially in high-risk subjects. While many drugs with pleiotropic vasculoprotective effects have shown ability to positively modulate EPCs, there is no data on the effects of specific insulin formulations.

This is a human randomised cross-over comparison trial. The purpose is to compare the effects of two basal insulin analogues (detemir and glargine) added to oral antidiabetic therapy in poorly-controlled type 2 patients with cardiovascular disease on endothelial function and EPC levels.

The aim is to test whether optimized glycemic control with add-on basal insulin analogues improves endothelial damage and regeneration in type 2 diabetes with macroangiopathy and to compare the effects of glargine vs detemir on markers of endothelial damage and regeneration.

EPC level is the most innovative outcome measure of this study and represents the primary endpoint. Endothelial dysfunction/damage, evaluated using soluble markers, will be the secondary outcome. Given the supposed inverse correlation between EPC and endothelial damage, it is expected that EPC increase reflects amelioration in endothelial biology, a result that may have significant clinical implications in this cohort of high-risk patients.

Condition or disease Intervention/treatment Phase
Type 2 Diabetes Endothelial Dysfunction Cardiovascular Disease Drug: Glargine Drug: Detemir Phase 4

  Show Detailed Description

Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 50 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Effects of Optimized Glycemic Control Achieved With add-on Basal Insulin Therapy on Indexes of Endothelial Damage and Regeneration in Type 2 Diabetic Patients With Macroangiopathy. A Randomized Cross-over Trial Comparing Detemir vs Glargine
Study Start Date : May 2008
Actual Primary Completion Date : March 2010
Actual Study Completion Date : March 2010

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Active Comparator: Glargine
During this arm/phase patients take subcutaneous glargine daily for 3 months.
Drug: Glargine
Daily bedtime subcutaneous insulin Glargine in individualized doses.
Other Name: Lantus

Experimental: Detemir
During this arm/phase, patients take insulin Detemir subcutaneously for 3 months.
Drug: Detemir
Daily bedtime subcutaneous insulin Detemir in individualized doses.
Other Name: Levemir

Primary Outcome Measures :
  1. Change in endothelial progenitor cell count [ Time Frame: Basal, 3 months, 6 months ]

Secondary Outcome Measures :
  1. Change in markers of endothelial damage [ Time Frame: Basal, 3 months, 6 months ]
  2. Frequence of hypoglycemias [ Time Frame: during 1st and 2nd arms ]
    The frequency of hypoglycemia will be reported for patients on glargine or detemir during the 1st and 2nd period of treatment.

  3. Change in body weight [ Time Frame: After the 1st and 2nd arms ]
    Change in body weight will be assessed after each arm during treatment with glargine or detemir

Information from the National Library of Medicine

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, Learn About Clinical Studies.

Layout table for eligibility information
Ages Eligible for Study:   35 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Type 2 diabetes
  • Macroangiopathy (coronary, or peripheral, or cerebrovascular)
  • On oral antidiabetic therapy
  • HbA1c > 7.0%

Exclusion Criteria:

  • Type 1 diabetes
  • Acute diabetic decompensation
  • Use of glitazones
  • Cancer
  • Acute disease or infection
  • Chronic renal failure (serum creatinin > 2.0 mg/dl)
  • Advanced liver disease (Child B-C)
  • Immune disease, organ transplantation, immunosuppression
  • Recent surgery (within 3 months)
  • Recent cardiovascular events (within 3 months)
  • Inability to provide informed consent
  • Pregnancy and lactation

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 identifier (NCT number): NCT00699686

Layout table for location information
Dipartimento di Medicina Clinica e Sperimentale, Divisione di Malattie del Metabolismo
Padova, Italy, 35100
Sponsors and Collaborators
University of Padova
Layout table for investigator information
Principal Investigator: Angelo Avogaro, M.D. University of Padova, Medical School


Publications automatically indexed to this study by Identifier (NCT Number):
Layout table for additonal information
Responsible Party: Angelo Avogaro, University of Padova, Medical School Identifier: NCT00699686     History of Changes
Other Study ID Numbers: LIBRA
First Posted: June 18, 2008    Key Record Dates
Last Update Posted: August 17, 2010
Last Verified: August 2010
Keywords provided by University of Padova:
Cardiovascular disease
Stem cells
Additional relevant MeSH terms:
Layout table for MeSH terms
Cardiovascular Diseases
Insulin, Globin Zinc
Insulin Glargine
Insulin Detemir
Hypoglycemic Agents
Physiological Effects of Drugs