A Study for Patients With Type 1 Diabetes

Eli Lilly and Company138 enrolled

Overview

Comparison of blood glucose levels in patients with Type 1 diabetes when they take a new basal insulin analog and when they take insulin glargine

Prestudy treatment for patients who enter this study will be once daily insulin glargine along with mealtime insulins. Patients will continue to use their mealtime insulins throughout the study. The study will consist of 16 weeks of treatment and 4 weeks of follow-up. The 16 weeks of treatment will consist of two 8-week periods (Periods 1 and 2) during which patients will receive insulin glargine for 8 weeks and LY2605541 for 8 weeks in a random sequence. During the 4-week follow-up period, patients will return to insulin glargine or another basal insulin recommended by the investigator.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

138

Conditions

Diabetes Mellitus, Type 1

Interventions

LY2605541DRUG

Administered subcutaneously every morning with dose titration based on blood glucose measures for 8 weeks in each of 2 study periods.

Insulin glargineDRUG

Administered subcutaneously every morning with dose titration based on blood glucose measures for 8 weeks in each of 2 study periods.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Type 1 diabetes mellitus (T1DM) for at least 1 year and using insulin glargine for at least 6 months with a maximum daily dose of 1 unit per kilogram (U/kg). * Hemoglobin A1c (HbA1c) of no greater than 10.5% before randomization * Body mass index (BMI) 19 to 45 kilogram per square meter (kg/m²) * Capable and willing to prepare and inject insulin with a syringe, monitor own blood glucose, complete the study diary, be receptive to diabetes education, comply with study requirements, and receive telephone calls during treatment * Women of childbearing potential must test negative for pregnancy before receiving treatment and agree to use reliable birth control until completing the follow-up Exclusion Criteria: * Twice daily use of insulin glargine within 30 days prior to the study * Use of any oral or injectable medication intended for the treatment of diabetes mellitus other than insulins in the 3 months prior to the study * Use of an insulin pump * More than 1 episode of severe hypoglycemia within 3 months prior to the study, or currently diagnosed as having hypoglycemia unawareness * 2 or more emergency room visits or hospitalizations due to poor glucose control in the 6 months preceding the study * Known hypersensitivity or allergy to any of the study insulins or their excipients * Blood transfusion or severe blood loss within 3 months prior to the study or known hemoglobinopathy, hemolytic anemia, or sickle cell anemia, or any other traits of hemoglobin abnormalities known to interfere with the HbA1c methodology * Irregular sleep/wake cycle * Pregnant or intend to become pregnant during the study * Women who are breastfeeding * Use of prescription or over-the-counter medications to promote weight loss within 3 months prior to the study * Current participation in a weight loss program or plans to do so during the study * Use of chronic (lasting longer than 14 consecutive days) systemic glucocorticoid therapy currently or within 4 weeks prior to the study * Cardiac disease with a marked impact on physical functioning * Clinically significant electrocardiogram (ECG) abnormalities at screening * Fasting triglycerides greater than 500 milligram per deciliter (mg/dL) * Liver disease * History of renal transplantation, current renal dialysis, or creatinine greater than 2.0 mg/dL (177 micromole per liter \[μmol/L\]) * Malignancy other than basal cell or squamous cell skin cancer, currently or within the last 5 years * Treatment with any antibody-based therapy within 6 months prior to the study

Locations (13)

Outcomes

Primary Outcomes

Daily Average Blood Glucose (Avg. BG) at Week 8 Endpoint as Measured by the 8-Point Self-Monitored Blood Glucose (SMBG) Profiles

It is the Avg. of the 8-point SMBG profiles, BG of morning fasting, midday \& evening pre-meal, 2-hour postprandial after each of the 3 main meals, bedtime, 0300 hours. Least squares (LS) mean of daily Avg. BG is from mixed-model repeated measures (MMRM), which includes fixed effects of treatment (LY2605541, Glargine); Treatment Sequence; treatment period; dose conversion (pre-interim analysis \[IA\], post-IA); stratification variables (country, baseline daily basal insulin dose group, and baseline Hemoglobin \[HbA1c\] group); visit; visit and treatment interaction; a random effect for participant.

Time frame: Week 8 of each treatment period

Secondary Outcomes

Change From Baseline in Daily Average Blood Glucose (Avg. BG) at Week 8 Endpoint as Measured by the 8-Point Self-Monitored Blood Glucose (SMBG) Profiles

It is the Avg. of the 8-point SMBG profiles, BG of morning fasting, midday \& evening pre-meal, 2-hour postprandial after each of the 3 main meals, bedtime, 0300 hours. LS mean of daily Avg. BG is from MMRM, which includes fixed effects of treatment (LY2605541, Glargine); Treatment Sequence; treatment period; dose conversion (pre-IA, post-IA); stratification variables (country, baseline daily basal insulin dose group, and baseline HbA1c group); visit; visit and treatment interaction; a random effect for participant.

Time frame: Baseline, Week 8 of each treatment period

Change From Baseline in Hemoglobin (HbA1c) at Week 8 Endpoint of Period I

HbA1c is a form of hemoglobin which is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. LS mean of the change from baseline to 8-week at Period I is from MMRM approach, which includes fixed effects of treatment (LY2605541, Glargine); dose conversion (pre-IA, post-IA); stratification variables (country, baseline daily basal insulin dose group); baseline HbA1c; visit; interaction between visit and treatment; and a random effect for participant.

Time frame: Baseline, Week 8 (Period I)

Data from ClinicalTrials.gov

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For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.

Chula Vista, California, United States

Atlanta, Georgia, United States

Idaho Falls, Idaho, United States

Topeka, Kansas, United States

Metairie, Louisiana, United States

Baltimore, Maryland, United States

Minneapolis, Minnesota, United States

Austin, Texas, United States

Dallas, Texas, United States

Renton, Washington, United States

...and 3 more locations

Percentage of Participants With HbA1c <7.0% and HbA1c ≤6.5% at Week 8 Endpoint of Period I

HbA1c is a form of hemoglobin which is measured primarily to identify the average plasma glucose concentration over prolonged periods of time.

Time frame: Week 8 (Period I)

Percentage of Participants With HbA1c <7.0% and HbA1c ≤6.5% at Week 8 Endpoint Who Did Not Experience a Hypoglycemic Episode During Treatment (Period I)

HbA1c is a form of hemoglobin which is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. Hypoglycemia episode is defined as any time a participant feels that he/she is experiencing a sign or symptom that is associated with hypoglycemia or has a BG level of ≤3.9 millimole/Liter (mmol/L) (≤70 milligram/deciliter \[mg/dL\]) even if it was not associated with signs, symptoms, or treatment (consistent with current guidelines \[ADA 2005\]).

Time frame: Week 8 (Period I)

8-Point Self-Monitored Blood Glucose (SMBG) Measures at Week 8 Endpoint

8-point SMBG profiles are measured at morning fasting BG (FBG), midday pre-meal BG, evening pre-meal BG, 2-hour postprandial BG after each of the 3 main meals, bedtime BG, 0300 hours BG. LS mean is obtained from MMRM approach, which includes fixed effects of treatment (LY2605541, Glargine); treatment sequence; treatment period; dose conversion (pre-IA, post-IA); stratification variables (country, baseline daily basal insulin dose group, and baseline HbA1c group); visit; interaction between visit and treatment; and a random effect for participant.

Time frame: Week 8 of each treatment period

Daily Basal Insulin Dose at Week 2 and Week 8 Endpoint

LS mean is obtained from MMRM approach, which includes fixed effects of treatment (LY2605541, Glargine); treatment sequence; treatment period; dose conversion (pre-IA, post-IA); stratification variables (country, baseline daily basal insulin dose group, and baseline HbA1c group); visit; interaction between visit and treatment; and a random effect for participant.

Time frame: Week 2 and Week 8 of each treatment period

Pharmacokinetics - Drug (LY2605541) Concentration at Steady State (Css) at Week 8 Endpoint

The drug (LY2605541) concentration at steady state (Css) is calculated from the clearance (Liter/hour) and the final dose of the participants. Clearance was estimated using population-based approaches.

Time frame: Week 8 of each treatment period

Percentage of Participants With Antibody Status Change From Baseline to Week 8, Week 16 and Week 20

Negative is defined as either 'negative' from lab or percent binding \<1.16%. Positive is defined as the percent binding is ≥1.16%. The antibody status change is from negative to positive or positive to negative.

Time frame: Week 8, Week 16 and Week 20

Percentage of Participants With Hypoglycemia Baseline Through Week 8

Hypoglycemia episode is defined as any time a participant feels that he/she is experiencing a sign or symptom that is associated with hypoglycemia or has a BG level of ≤3.9 millimole per Liter (mmol/L) (≤70 milligram per deciliter \[mg/dL\]) even if it was not associated with signs, symptoms, or treatment (consistent with current guidelines \[ADA 2005\].

Time frame: Baseline through Week 8 of each treatment period

Rate of Hypoglycemia Per 30 Days Baseline Through Week 8

Hypoglycemia episode is defined as any time a participant feels that he/she is experiencing a sign or symptom that is associated with hypoglycemia or has a BG level of ≤3.9 mmol/L (≤70 mg/dL) even if it was not associated with signs, symptoms, or treatment (consistent with current guidelines \[ADA 2005\]. Hypoglycemia rate per 30 days is calculated as the number of hypoglycemia/number of days at risk\*30.

Time frame: Baseline through Week 8 of each treatment period

Glycemic Variability in Fasting Blood Glucose (FBG) at Week 8 Endpoint

Within-patient glycemic variability was assessed as the standard deviation of fasting blood glucose each day between Week 6 and Week 8. LS mean is obtained from MMRM approach, which includes fixed effects of treatment (LY2605541, Glargine); treatment sequence; treatment period; dose conversion (pre-IA, post-IA); stratification variables (country, baseline daily basal insulin dose group, and baseline HbA1c group); visit; interaction between visit and treatment; and a random effect for participant.

Time frame: Week 8 of each treatment period