This study will look at control of blood sugar levels in persons with type 2 diabetes mellitus currently on chronic dialysis. Researchers will compare blood sugar levels in people taking semaglutide to people taking "dummy" medicine. The treatment participants get will be decided randomly. Participants will need to inject the study medication once a week. The study will last for 1 year and a month. Participants will be asked to wear a sensor that measures blood sugar levels for a period of 10 days at five different time points during the study.
The researchers also have a Data Safety Monitoring Plan in place.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
43
Semaglutide will be injected into a skin fold, in the stomach, thigh or upper arm once a week at the same day of the week (to the extent possible) throughout the trial. Subjects will start semaglutide treatment at 0.25 mg; dose will gradually be increased every 4 weeks up to 1.0 mg.
Placebo will be injected into a skin fold, in the stomach, thigh or upper arm once a week at the same day of the week (to the extent possible) throughout the trial. Participants will receive placebo at an equivalent dose to semaglutide.
University of North Carolina
Chapel Hill, North Carolina, United States
Davita UT Southwestern - Oak Cliff
Dallas, Texas, United States
DaVita UT Southwestern - East Dallas
Dallas, Texas, United States
DaVita UT Southwestern - Preston
Dallas, Texas, United States
Change in TIR (70-180 mg/dl)
Measured in percentage by Continuous glucose monitor (CGM)
Time frame: Baseline, 52 weeks
Change in Time in high range (180-250 mg/dl)
Measured in percentage by Continuous glucose monitor (CGM)
Time frame: Baseline, 52 weeks
Change in Time in very high range (>250 mg/dl)
Measured in percentage by Continuous glucose monitor (CGM)
Time frame: Baseline, 52 weeks
Change in Time in low range (54-69 mg/dl)
Measured in percentage by Continuous glucose monitor (CGM)
Time frame: Baseline, 52 weeks
Change in Time in very low range (<54 mg/dl)
Measured in percentage by Continuous glucose monitor (CGM)
Time frame: Baseline, 52 weeks
Proportion of participants with TIR 70-180 mg/dl for 70% of the day
Measured in percentage by CGM
Time frame: 52 weeks
Proportion of participants with TIR 70-180 mg/dl with more than equal to 5% improvement from baseline
Measured in percentage by CGM
Time frame: 52 weeks
Proportion of participants with Time below range <70 mg/dL for <4% of each day
Measured in percentage by CGM
Time frame: 52 weeks
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DaVita UT Southwestern - Irving
Irving, Texas, United States
Proportion of participants with Time below range <54 mg/dL for <1% of each day
Measured in percentage by CGM
Time frame: 52 weeks
Proportion of participants with Time above range >180 mg/dL for <25% of each day
Measured in percentage by CGM
Time frame: 52 weeks
Change in haemoglobin A1c (HbA1c)
Measured in percentage
Time frame: Baseline, 52 weeks
Total daily dose of insulin
Measured as units/day
Time frame: 52 weeks
Number of oral glucose lowering agents
Measured as count
Time frame: 52 weeks
Proportion of participants with >10 points improvement in % TIR 70-180 mg/dL without an increase in time below range <54 mg/dL of >0.5%
Measured in percentage
Time frame: 52 weeks
Proportion of participants with mean glucose <154 mg/dL and <1% time below range <54 mg/dL
Measured in percentage
Time frame: 52 weeks
Number of participants with Severe hypoglycemia
Measured in count
Time frame: 52 weeks
Change in body weight
Measured in kilograms
Time frame: Baseline, 52 weeks
Change in waist circumference
Measured in centimeters
Time frame: Baseline, 52 weeks
Change in percentage total body fat
Measured in percentage
Time frame: Baseline, 52 weeks
Change in percentage lean mass
Measured in percentage
Time frame: Baseline, 52 weeks
Change in Inter-dialysis weight gain
Measured in kilograms
Time frame: Baseline, 52 weeks
Number of participants hospitalized
Measured in count
Time frame: 52 weeks
Total number of days spent in hospital
Measured in count
Time frame: 52 weeks
Total score of Diabetes Treatment Satisfaction questionnaire
Patient reported outcomes is assessed by Diabetes Treatment Satisfaction Score questionnaire which assesses patient satisfaction with diabetes treatment. It is composed of eight questions, each of which is scored by patients on a scale ranging from zero (e.g., "very dissatisfied", "very inconvenient") to six (e.g., "very satisfied", "very convenient"). Treatment satisfaction is assessed as the sum of the scores of the six questions on the first factor, with a higher score indicating higher treatment satisfaction.
Time frame: 52 weeks
Total score of EQ-5D-5L
The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state. The EQ VAS records the patient's self-rated health on a vertical visual analogue scale, where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'. The VAS can be used as a quantitative measure of health outcome that reflect the patient's own judgement. Possible scores range from 0-100, where higher score indicate better outcome
Time frame: 52 weeks
Total score of Kidney disease QoL short form
The KDQOL-SF is a self-report measure developed for individuals with kidney disease and those on dialysis. It is a shorter version of a measure developed by the same authors. It includes 43 kidney disease-targeted items, such as the effects of the disease of activities of daily living, work status, and social interaction, and 36 items that provide a measure of physical and mental health, and 1 overall health rating item ranging from 0 ("worst possible health") to 10 ("best possible health.").
Time frame: 52 weeks