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| Name | Class |
|---|---|
| Technical University of Denmark | OTHER |
| Novo Nordisk A/S | INDUSTRY |
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The concept consists of an initial period (two weeks) of intensive data capture by use of continuous glucose monitoring (CGM) during basal insulin initiation, followed by a second period (variable duration) of basal insulin titration guided by self monitored blood glucose. Data captured during the first period are used as input to an algorithm that estimates the optimal daily dose for the individual patient. The estimated optimal daily dose is used to guide the titration of the basal insulin during the second period. The goal is to safely and successfully achieve blood glucose targets. The concept is based on the use of basal insulin degludec (Tresiba, Novo Nordisk A/S).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| The Starter Kit Algorithm | Experimental | Basal insulin initiation and titration using the Starter Kit Algorithm at two weeks, followed by standard of care titration during the following the next 10 weeks (maximum), or until optimal daily dose is considered identified. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Starter Kit Algorithm | Device | Long acting insulin titration to target |
|
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy of estimate 1 | Accuracy of the estimated optimal daily dose (calculated by the Starter Kit algorithm based on continuous glucose monitoring (CGM) data collected during day 1-14) compared with the observed optimal daily dose in percentage deviation. In this context, optimal daily dose is the dose considered to keep fasting glucose levels below 6 mmol/L. | through study completion, 12 weeks |
| Accuracy of estimate 2 | The number of estimated optimal daily doses by the Starter Kit Algorithm at two weeks that fall within a patient specific confidence interval. The confidence interval is determined using the Starter Kit Algorithm at the end of study, one interval for each patient. Upper boundary: the optimal daily dose estimated to bring lowest hour of CGM values within a day to 4.0 mmol/L Lower boundary: the optimal daily dose estimated to bring lowest hour of CGM values within a day to 6.0 mmol/L | through study completion, 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy of estimate 3 | Accuracy of the estimated optimal daily dose (calculated based on self-monitored blood glucose data collected during day 1-14) compared with the observed optimal daily dose. | through study completion, 12 weeks |
| Number of patients in glucose target |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hvidovre University Hospital | Hvidovre | 2650 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31941361 | Result | Aradottir TB, Bengtsson H, Jensen ML, Poulsen NK, Boiroux D, Jensen LL, Schmidt S, Norgaard K. Feasibility of a New Approach to Initiate Insulin in Type 2 Diabetes. J Diabetes Sci Technol. 2021 Mar;15(2):339-345. doi: 10.1177/1932296819900240. Epub 2020 Jan 15. |
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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Number of participants in target at end of study |
| through study completion, 12 weeks |
| Algorithm deviations | Number of titration algorithm deviations due to risk of hypoglycemia (based on evaluation of CGM data) | 12 weeks (total duration of study) |
| Quality of treatment 1 | Qualitative assessment by the investigator of participants who do not reach the observed optimal daily dose within 12 weeks: Frequency of participants who are in need of additional basal insulin to achieve the target blood glucose. | through study completion, 12 weeks |
| Quality of treatment 2 | Qualitative assessment by the investigator of participants who do not reach the observed optimal daily dose within 12 weeks: Frequency of participants who are in need of additional drugs to achieve the target blood glucose. | through study completion, 12 weeks |
| Number of self-monitored blood glucose values ≤3.9 mmol/L | Number of self-monitored blood glucose values ≤3.9 mmol/L | 12 weeks (total duration of study) |
| Number of self-monitored blood glucose values ≤3.0 mmol/L | Number of self-monitored blood glucose values ≤3.0 mmol/L | 12 weeks (total duration of study) |
| Severe hypoglycemia | Number of severe hypoglycemic events (defined as severe cognitive impairment requiring external assistance for recovery). | 12 weeks (total duration of study) |
| Time spent in hypoglycemia | Time spent in hypoglycemia (<3.9 mmol/L) assessed by CGM during the first four study days (days without insulin) and the last four study days (days with optimal daily insulin dose). | 8 days (first four and last four days of study) |
| Time spent in hyperglycemia | Time spent in hyperglycemia (>10 mmol/L) assessed by CGM during the first four study days (days without insulin) and the last four study days (days with optimal daily insulin dose). | 8 days (first four and last four days of study) |
| Time spent in normoglycemia | Time spent in normoglycemia (3.9-10.0 mmol/L) assessed by CGM during the first four study days (days without insulin) and the last four study days (days with optimal daily insulin dose). | 8 days (first four and last four days of study) |
| D004700 | Endocrine System Diseases |