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Type 1 DiabetesPhase 2NCT04449692

Low-dose Dasiglucagon for Prevention of Insulin-Induced Hypoglycemia in People With Type 1 Diabetes

A Phase 2 study testing Dasiglucagon and Carbohydrate (dextrose tablets) in people with Type 1 Diabetes and Hypoglycemia, run by Steno Diabetes Center Copenhagen at 1 site in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of the study is to compare the efficacy of low-dose dasiglucagon (Zealand Pharma, Denmark) to oral carbohydrate consumption for prevention of s.c. insulin-induced hypoglycemia in CSII- and MDI-treated people with type 1 diabetes. Read more about this study

Who is it for?
Ages 18 to 64 years
Conditions the study is for
Type 1 Diabetes, Hypoglycemia
What is being tested?
Dasiglucagon and Carbohydrate (dextrose tablets)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteDenmark
Study dates
2 Jul 2020to 4 Jan 2021
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 64 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Age 18-64 years
  • Duration of T1D ≥ 3 years
  • Use of CSII or MDI therapy for ≥ 6 months
  • Current use of Novorapid (change from another fast-acting insulin to Novorapid prior to study initiation is allowed)
  • HbA1c ≤ 8.0%
  • Regular use of carbohydrate counting in the judgement of the investigator

Who cannot join

  • Use of anti-diabetic medicine (other than insulin), corticosteroids or other drugs affecting glucose metabolism during the study period or within 30 days prior to study start
  • History of allergy or intolerance to glucagon or glucagon-like products
  • Patients with pheochromocytoma
  • Clinically significant ECG abnormalities
  • Females who are pregnant, breast-feeding or intend to become pregnant or are not using adequate contraceptive methods (sterilization, intrauterine device, contraceptive pill, patch or injection)
  • Inability to understand the individual information and to give informed consent
  • Current participation in another clinical trial that, in the judgment of the principle investigator, will compromise the results of the study or the safety of the subject
  • Other concomitant medical or psychological condition that, according to the investigator's assessment, makes the individual unsuitable for study participation

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Steno Diabetes Center Copenhagen

    Gentofte Municipality, 2820

Other trials in Denmark

About this study

The aim of the study is to compare the efficacy of low-dose dasiglucagon (Zealand Pharma, Denmark) to oral carbohydrate consumption for prevention of s.c. insulin-induced hypoglycemia in CSII- and MDI-treated people with type 1 diabetes.

Read the detailed description

Near-normalization of blood glucose levels through intensive insulin therapy has shown to reduce the risk of diabetes late complications, but the approach is associated with two major side effects: hypoglycemia and weight gain. Although management of hypoglycemia through oral carbohydrate consumption is generally effective, the approach can lead to excessive carbohydrate intake and cause rebound hyperglycemia. It has previously been demonstrated that subcutaneous (s.c.) low-dose glucagon can be utilized to effectively treat mild hypoglycemia in people with type 1 diabetes. However, the instability in aqueous solution of currently available glucagon and the need for reconstitution with sterile water immediately prior to administration has limited its clinical role outside emergency settings. Due to the stability and ready-to-use formulation, dasiglucagon does not hold the limitations known for the currently available glucagon preparations.

The aim of this randomized, partially single-blinded, three-arm cross-over study is to compare the efficacy of low-dose dasiglucagon (80 and 120 μg) to oral carbohydrate (15 g) consumption for prevention of s.c. insulin-induced hypoglycemia in CSII- and MDI-treated people with type 1 diabetes. On each study visit (separated by ≥ 3 days), an initial insulin bolus will be administered (at t = 0) aiming for a plasma glucose (PG) level of 3.0 mmol/l. When reaching 4.5 mmol/l, the intervention (s.c. dasiglucagon or oral carbohydrates) will be administered (t-intervention = 0), whereafter PG will me monitored for an additional 180 min.

Being tested
Dasiglucagon, Carbohydrate (dextrose tablets)
Keywords
Type 1 Diabetes, Hypoglycemia, Dasiglucagon
Medical subject headings
Diabetes Mellitus, Type 1, Hypoglycemia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • DasiglucagonDrug

    Abdominal s.c. administration

  • Carbohydrate (dextrose tablets)Other

    Oral administration

Study groups in NCT04449692
Study groupRoleWhat they receive
80 µg s.c. dasiglucagonExperimental80 µg of dasiglucagon will be administered subcutaneously when plasma glucose levels reach 4.5 mmol/l
Receives: Drug: Dasiglucagon
120 µg s.c. dasiglucagonExperimental120 µg of dasiglucagon will be administered subcutaneously when plasma glucose levels reach 4.5 mmol/l
Receives: Drug: Dasiglucagon
15 g oral carbohydrate (dextrose tablets)Active comparator15 g of oral carbohydrate (dextrose tablets) will be administered when plasma glucose levels reach 4.5 mmol/l
Receives: Other: Carbohydrate (dextrose tablets)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Difference between study visits in time (min) in hypoglycemia (plasma glucose < 3.9 mmol/l) from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

Secondary outcomes (24)
  1. Difference between study visits in incidence rate of hypoglycemia (plasma glucose < 3.9 mmol/l) from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  2. Difference between study visits in incidence rate of level 2 hypoglycemia (plasma glucose < 3.0 mmol/l) from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  3. Difference between study visits in incidence rate of rebound hyperglycemia (plasma glucose > 10 mmol/l) from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  4. Difference between study visits in nadir plasma glucose concentration from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  5. Difference between study visits in peak plasma glucose concentration from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  6. Difference between study visits in incremental peak in plasma glucose concentration from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  7. Difference between study visits in mean plasma glucose concentration from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  8. Difference between study visits in time (min) from intervention to first increase in plasma glucose concentration of 1.1 mmol/l

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  9. Difference between study visits in plasma glucose Area Under the Curve (AUC) from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  10. Difference between study visits in time (min) to peak plasma glucose concentration from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  11. Difference between study visits in time (min) in range (plasma glucose ≥ 3.9 mmol/l and 10.0 mmol/l) from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  12. Difference between study visits in time (min) in hyperglycemia (plasma glucose > 10 mmol/l) from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  13. Difference between study visits in time (%) in hypoglycemia (plasma glucose < 3.9 mmol/l) (per protocol) from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  14. Difference between study visits in incidence rate of rescue carbohydrate administration from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  15. Difference between study visits in time (min) to rescue carbohydrate administration from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  16. Difference between study visits in plasma dasiglucagon Area Under the Curve (AUC) from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  17. Difference between study visits in peak plasma dasiglucagon concentration from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  18. Difference between study visits in time to peak plasma dasiglucagon concentration from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  19. Difference between study visits in serum insulin concentration at visit start (t = 0) and immediately before administration of the intervention (t-intervention = 0)

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  20. Difference between study visits in serum insulin AUC from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  21. Difference between study visits in dose (units) of insulin bolus at study start (t = 0)

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  22. Difference between study visits in change in Edinburgh Hypoglycemia Symptoms Scale (EHSS) from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  23. Difference between study visits in change in visual analogue scale (VAS) for nausea, headache, stomach ache, injection site pain, palpitations and hunger from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

  24. Difference between study visits in incidence rate of vomiting from 0-180 minutes post-intervention

    Measured: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Jun 2020
  2. Study start2 Jul 2020
  3. Primary completion4 Jan 2021
  4. Study completion4 Jan 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
Single-blinded, randomized (using blocks of 3/6 and stratification by treatment modality), three-arm crossover study
Masking
Single blind
Who is masked
Participant
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04449692
Sponsor's protocol ID
H-20013256
Other IDs
2020-000551-12, H-20013256
Status last verified
Feb 2021
First submitted
24 Jun 2020
Last updated
9 Feb 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Laugesen C, Ranjan AG, Schmidt S, Norgaard K. Low-Dose Dasiglucagon Versus Oral Glucose for Prevention of Insulin-Induced Hypoglycemia in People With Type 1 Diabetes: A Phase 2, Randomized, Three-Arm Crossover Study. Diabetes Care. 2022 Jun 2;45(6):1391-1399. doi: 10.2337/dc21-2304.

    PubMed 35475907

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Dasiglucagon and Carbohydrate (dextrose tablets) in people with Type 1 Diabetes and Hypoglycemia, run by Steno Diabetes Center Copenhagen at 1 site in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Difference between study visits in time (min) in hypoglycemia (plasma glucose < 3.9 mmol/l) from 0-180 minutes post-intervention (time frame: Study visit 1 (day 1), study visit 2 (estimated day 4) and study visit 3 (estimated day 7)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04449692, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Feb 2021.

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