Study of Effectiveness of Liraglutide Added to High Dose Insulin in Type II Diabetics

Sponsor

Mountain Diabetes and Endocrine Center (Other)

Overall Status

Completed

CT.gov ID

NCT01654120

Collaborator

(none)

Enrollment

Location

Arms

Duration (Months)

1.6

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The purpose of this study is to determine the effect of adding liraglutide to high dose insulin therapy compared to high dose insulin therapy alone in patients with insulin-treated Type 2 diabetes with insulin requirements of > 100 units of insulin per day.

Condition or Disease	Intervention/Treatment	Phase
Diabetes Mellitus, Type II	Drug: Liraglutide Drug: Insulin	Phase 4

Detailed Description

40 subjects with Type 2 diabetes using > 100 units of insulin per day with or without metformin with HbA1c > 6.5% will be randomized into 2 treatment groups: treatment group will have liraglutide added to insulin and control group will have insulin uptitration only for 6 months. Primary endpoint to be compared between groups will be HbA1c at 6 months. Secondary endpoints will include weight, total daily insulin dose, percent time in euglycemic, hyperglycemic, and hypoglycemic ranges by continuous glucose monitor (CGM), and effect on GlycoMark and hs-CRP. Safety endpoints will include incidence of hypoglycemia and incidence of gastrointestinal side effects.

Study Design

Study Type:

Interventional

Actual Enrollment :

37 participants

Allocation:

Randomized

Intervention Model:

Crossover Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

Liraglutide and Insulin-001 A Randomized Prospective Trial of Liraglutide Added to High-Dose Insulin Therapy vs. High-Dose Insulin Therapy Alone in Insulin-Resistant Patients With Type 2 Diabetes

Study Start Date :

Dec 1, 2011

Actual Primary Completion Date :

Nov 1, 2013

Actual Study Completion Date :

Nov 1, 2013

Arms and Interventions

Arm	Intervention/Treatment
Experimental: liraglutide plus insulin Patients were randomized to receive liraglutide plus insulin (LIRA) for 12 months.	Drug: Liraglutide SC, 1.8mg,QD, six months to one year Other Names: Victoza Drug: Insulin SC, will be titrated during the study, 4 times a day, 1 year Other Names: U-500 Levemir Novolog
Active Comparator: Insulin titration only Patients were randomized to receive insulin only (control) for 6 months. The controls were then crossed over to receive liraglutide plus insulin for 6 months after the initial control period.	Drug: Insulin SC, will be titrated during the study, 4 times a day, 1 year Other Names: U-500 Levemir Novolog

Arm

Intervention/Treatment

Experimental: liraglutide plus insulin

Patients were randomized to receive liraglutide plus insulin (LIRA) for 12 months.

Drug: Liraglutide

SC, 1.8mg,QD, six months to one year

Other Names:

Victoza

Drug: Insulin

SC, will be titrated during the study, 4 times a day, 1 year

Other Names:

U-500

Levemir

Novolog

Active Comparator: Insulin titration only

Patients were randomized to receive insulin only (control) for 6 months. The controls were then crossed over to receive liraglutide plus insulin for 6 months after the initial control period.

Drug: Insulin

SC, will be titrated during the study, 4 times a day, 1 year

Other Names:

U-500

Levemir

Novolog

Outcome Measures

Primary Outcome Measures

Change from baseline in HbA1c at six months [baseline and six months]
Glycemic control as measured by HbA1c

Secondary Outcome Measures

Hypoglycemia [6 months and 12 months]
The frequency and severity of hypoglycemia in each treatment arm by glucose meter download and by percent time spent in the hypoglycemic range (BG < 70 mg/dl) by CGM will be assessed at six and 12 months
Total Daily Insulin Dose (TDID) [3, 6, 9, and 12 months]
TDID will be determined in each treatment arm for statistical comparisons at three and six months, and for entire cohort at nine and 12 months.
Weight [baseline, 3, 6, 9, and 12 months]
Weight will be statistically compared to baseline and between treatment arms at three and six months, and for entire cohort between baseline, six, nine and 12 months.
GlycoMark [baseline, 3, 6, 9, and 12 months]
Postprandial glycemic control as assessed by GlycoMark and CGM will be compared between study groups at three and six months, and for entire cohort compared to baseline at nine and 12 months.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 80 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Male and female patients with Type 2 diabetes with HbA1c from 6.5 to 10% treated with intensive insulin therapy (MDI or CSII, including U-500 insulin-treated patients) using > 100 units of insulin, with or without a stable dose of oral insulin sensitizing medications, for at least three months.
Aged 18 to 80 years.
Females of child-bearing potential must be using adequate form of contraception.
Patient willing to monitor BG four times daily, use CGM, and comply with study-related protocol.

Exclusion Criteria:

Type 1 diabetes.
Use of any GLP-1 receptor agonist within previous three months.
Use of DPP-4 inhibitors or oral insulin secretagogues within the previous three months.
Use of glucocorticoids (except inhaled).
Use of any experimental drug within previous three months.
Known or suspected allergy to liraglutide, Novolog or Levemir.
Personal or family history of medullary carcinoma of the thyroid or MEN-2.
Concomitant chronic renal disease with creatinine > 1.5%.
Concomitant chronic hepatic, gastrointestinal or other illness (including pancreatitis or active cardiovascular disease except stable exertional angina).
Inability or unwillingness to monitor BG, use CGM, or comply with study protocol.
Women of child-bearing potential unwilling to use adequate contraception, intending to become pregnant or breast-feeding.