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Trial registered on ANZCTR
Registration number
ACTRN12610000574044
Ethics application status
Not yet submitted
Date submitted
14/07/2010
Date registered
16/07/2010
Date last updated
16/07/2010
Type of registration
Prospectively registered
Titles & IDs
Public title
Proof-of-Concept Study of Insulin Glargine as Basal Insulin Support for Recovering Critically Ill Patients
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Scientific title
Proof-of-Concept Study of Insulin Glargine as Basal Insulin Support for patients with stress diabetes in the Intensive Care and the High Dependency Units and Validation of an Insulin Glargine Pharmacokinetics Model
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Secondary ID [1]
252221
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none
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
stress diabetes in critical illness
257743
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Condition category
Condition code
Metabolic and Endocrine
257917
257917
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Recovering critically ill patients who meets the study inclusion criteria will be given insulin glargine once a day. The dose will be determined by a titration algorithm. Blood samples will be taken for assays of plasma insulin and C-peptide 3 times a day for the first two days a patient is receiving glargine. The samples will be taken before glargine injection, 6 hours from time of injection, and 14 hours from time of injection. The patient will continue to receive glargine for blood glucose control unless the dose become less than 10U. When the patient begins to consume meals (as oppose to naso-gastric feed), blood samples will be taken 8 times a day for the first two days. These samples will be taken before glargine injection and breakfast, before lunch, before dinner, 30 mins from start of dinner, 1 hr from start of dinner, 1.5 hrs from start of dinner, 2 hrs from start of dinner, and 4 hrs from start of dinner. Photos will be taken of the meal before and after mealtime to determine nutrition intake.
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Intervention code [1]
256806
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Treatment: Drugs
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Intervention code [2]
256807
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Treatment: Other
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Intervention code [3]
256808
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Other interventions
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Comparator / control treatment
standard intensive care blood glucose control protocol without the use of glargine
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Control group
Active
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Outcomes
Primary outcome [1]
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Goodness of blood glucose control - median and range of blood glucose levels
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Assessment method [1]
258777
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Timepoint [1]
258777
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at termination of study
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Primary outcome [2]
258778
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amount of total insulin administered
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Assessment method [2]
258778
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Timepoint [2]
258778
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at termination of study
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Primary outcome [3]
258779
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nursing effort as assessed by blood glucose measurement frequency plus insulin dosing adjustment frequency
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Assessment method [3]
258779
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Timepoint [3]
258779
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at termination of study
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Secondary outcome [1]
264838
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Glargine pharmacokinetics mathematical model validation assessed by data fitting accuracy
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Assessment method [1]
264838
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Timepoint [1]
264838
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at termination of study
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Secondary outcome [2]
264839
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Mathematical meal model validation assessed by data fitting accuracy
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Assessment method [2]
264839
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Timepoint [2]
264839
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at termination of study
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Secondary outcome [3]
264840
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Mathematical endogenous insulin production model validation assessed by data fitting accuracy
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Assessment method [3]
264840
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Timepoint [3]
264840
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at termination of study
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Eligibility
Key inclusion criteria
- Stable hourly insulin requirement, equal to or less than 3U of intravenous insulin per hour, for at least 12 hours.
- Stable naso-gastric feed rate, equal to or greater than 60% of the calculated goal feed. (Goal feed is calculated using individual patient’s age, gender and frame size.)
- No acute renal failure (creatinine < 250 micromol/L)
- Less than 1000ml of fluid given as intravenous boluses in the past 24 hours, indicating stable interstitial volume.
- Resolving multiple organ failure (Sequential Organ Failure Assessment Score SOFA<=6).
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Minimum age
No limit
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
insulin dependent diabetes, absence of an arterial line, not expected to survive for more than 3 days at the time of screening
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
sealed envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
permuted block randomisation
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Pharmacokinetics / pharmacodynamics
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
23/08/2010
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
2764
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New Zealand
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State/province [1]
2764
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Funding & Sponsors
Funding source category [1]
257284
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Government body
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Name [1]
257284
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Canterbury Medical Research Foundation
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Address [1]
257284
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24 St Asaph Street
Christchurch 8011
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Country [1]
257284
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New Zealand
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Primary sponsor type
Government body
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Name
Canterbury District Health Board/Christchurch Hospital
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Address
Riccarton Avenue
Private Bag 4710
Christchurch 8140
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Country
New Zealand
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Secondary sponsor category [1]
256529
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University
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Name [1]
256529
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University of Canterbury
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Address [1]
256529
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Private Bag 4800
Christchurch 8140
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Country [1]
256529
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New Zealand
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Secondary sponsor category [2]
256530
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University
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Name [2]
256530
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University of Otago Christchurch
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Address [2]
256530
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2 Riccarton Avenue
PO Box 4345
Christchurch 8140
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Country [2]
256530
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New Zealand
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
259309
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Upper South Regional Ethics Committee
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Ethics committee address [1]
259309
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C/- Ministry of Health 4th floor 250 Oxford Terrace PO Box 3877 Christchurch 8011
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Ethics committee country [1]
259309
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New Zealand
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Date submitted for ethics approval [1]
259309
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19/07/2010
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Approval date [1]
259309
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Ethics approval number [1]
259309
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Summary
Brief summary
Intravenous insulin is commonly used to maintain normoglycaemic in the Christchurch Hospital Intensive Care Unit (ICU). The current standard protocol, SPRINT, uses intravenous insulin injections every 1-2 hours and controls the blood glucose levels very effectively. However, once patients leave the ICU, the standard protocols in the general wards are to use subcutaneous insulin, often due to the lack of intravenous lines and nursing resource. Currently, the guidelines for switching patients from intravenous to subcutaneous insulin are unclear, resulting in inconsistent levels of care. Therefore ward patients do not continue to benefit from tight blood glucose control. There is a need for a system, which can maintain good blood glucose control outside of ICU that can follow patients from ICU to less acute wards, while keeping nursing effort to a minimum. This study will first validate the Glargine pharmacokinetics model developed by the investigator’s group and test the effectiveness of Glargine as basal insulin support in the ICU populations. These steps are necessary before expending glycaemic control to less acute wards.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
31395
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Address
31395
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Country
31395
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Phone
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Fax
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Email
31395
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Contact person for public queries
Name
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Dr. Geoffrey M Shaw
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Address
14642
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Intensive Care Unit
Christchurch Hospital
Riccarton Avenue
Private Bag 4710
Christchurch 8140
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Country
14642
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New Zealand
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Phone
14642
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+64 3 3640640 x88581
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Fax
14642
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Email
14642
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[email protected]
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Contact person for scientific queries
Name
5570
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Prof. J Geoffrey Chase
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Address
5570
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Department of Mechanical Engineering
University of Canterbury
Private Bag 4800
Christchurch 8140
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Country
5570
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New Zealand
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Phone
5570
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+64 3 3642987 x7224
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Fax
5570
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Email
5570
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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