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CompletedNCT01618214Updated Feb 24, 2017Results posted

Comparison of Subject-driven Titration of Biphasic Insulin Aspart (BIAsp) 30 Twice Daily Versus Investigator-driven Titration of BIAsp 30 Twice Daily Both in Combination With Oral Antidiabetic Drugs in Subjects With Type 2 Diabetes

A Phase 4 interventional study of biphasic insulin aspart 30 in Diabetes and Diabetes Mellitus, Type 2, sponsored by Novo Nordisk A/S. Completed at 22 sites in China. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2017-02-24.

Sponsored by Novo Nordisk A/S · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
344
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

This trial is conducted in Asia. The aim of this trial is to compare BIAsp 30 twice daily individually adjusted by the subject versus BIAsp 30 twice daily individually adjusted by the investigator both combined with oral antidiabetic drugs (OADs) in subjects with type 2 diabetes inadequately controlled with premixed human insulin. Subjects to continue their OAD background treatment: Metformin plus/minus alpha-glucosidase inhibitor.

02

Conditions studied

  • Diabetes
  • Diabetes Mellitus, Type 2
03

In context

Diabetes Mellitus

10,925 studies on the registry are indexed under Diabetes Mellitus; 1,319 are open to participants now.

This study's enrollment of 344 is above the median of 80 across 8,367 interventional studies indexed under Diabetes Mellitus.

Browse Diabetes Mellitus studies →

Lead sponsor

Novo Nordisk A/S is the lead sponsor of 1,370 studies on the registry; 102 are open to participants now.

Of its 198 completed or terminated interventional studies of FDA-regulated products, 94 (47%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Informed consent obtained before any trial-related activities. Trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial
  • Type 2 diabetes mellitus (diagnosed clinically) for at least 12 months
  • Currently treated with premixed/self-mixed human insulin (proportion of short-acting insulin is equal to or lower than 30%) BID (twice daily) combined with metformin with or without alpha-glucosidase inhibitor for at least 3 months prior to screening visit (Visit 1) with the minimum dose stated: Metformin: at least 1500 mg/day or maximum tolerated dose at least 1000 mg/day (with unchanged dosing within 3 months prior to Visit 1) OR alpha-glucosidase inhibitors: acarbose or miglitol at least 150 mg/day, or voglibose at least 0.6 mg/day
  • Total daily insulin dose below 1.4 IU/Kg
  • HbA1c above or equal to 7.0% and below or equal to 9.5% (central laboratory)
  • Body Mass Index (BMI) below or equal to 35.0 kg/m\^2

Exclusion criteria

Exclusion Criteria:

  • Treatment with any insulin secretagogue, thiazolidinedione (TZD), dipeptidyl peptidase-4 (DPP-4) inhibitors and Glucagon-like peptide-1 (GLP-1) receptor agonists within the last 3 months prior to Visit 1
  • Previous use of insulin intensification treatment (premixed insulin thrice daily, basal bolus regimen, and continuous subcutaneous insulin infusion (CSII)) for more than 14 days
  • Previous use of any insulin other than premixed/self-mixed human insulin (proportion of short acting insulin equal to or lower than 30%) BID within 3 month prior to Visit 1
  • Recurrent severe hypoglycaemia (more than 1 severe hypoglycaemic episode, during the last 12 months) or hypoglycaemic unawareness as judged by the investigator or hospitalisation for diabetic ketoacidosis during the previous 6 months
  • Known proliferative retinopathy or maculopathy requiring treatment
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Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
344 participants (actual)

Study arms

  • Experimental
    Subject-driven titration

    Drug: biphasic insulin aspart 30

  • Active comparator
    Investigator-driven titration

    Drug: biphasic insulin aspart 30

Interventions

  • Drugbiphasic insulin aspart 30

    Dose individually adjusted, administered subcutaneously (s.c., under the skin) twice daily.

06

What researchers measure

Primary outcomes

  1. Change From Baseline in HbA1c (Glycosylated Haemoglobin)

    Estimated mean change from baseline in HbA1c after 20 Weeks of treatment in full analysis set (FAS).

    Time frame: Week 0, week 20

Secondary outcomes

  1. Percentage of Subjects Achieving HbA1c Below 7.0%

    Time frame: After 20 weeks of treatment

  2. Percentage of Subjects Achieving HbA1c Below or Equal to 6.5%

    Time frame: After 20 weeks of treatment

  3. Change From Baseline in FPG (Fasting Plasma Glucose)

    Time frame: Week 0, week 20

  4. Incidence of Hypoglycaemic Episodes (All, Major, Minor and Symptoms Only)

    Definition of a treatment emergent hypoglycemic episode: an episode occurred after the first administration of insulin or oral anti-diabetic drug, and no later than the last day on trial product. Severe hypoglycemic episode was that requiring assistance to administer carbohydrate, glucagon, or other resusciative actions. Minor hypoglycemic episode was the one with plasma glucose value \< 3.1 mmol/L, either with symptoms that could be handled by subject, or without symptoms.

    Time frame: Week 0 to week 20 (inclusive).

07

Results

Posted May 8, 2014

Participant flow

Subjects were recruited from 23 sites in 1 country.

Participant flow — Overall Study
MilestoneSubject-driven TitrationInvestigator-driven Titration
Started172172
Exposed172172
Completed162159
Not completed1013
Withdrew: Adverse event31
Withdrew: Lack of efficacy11
Withdrew: Protocol violation14
Withdrew: Withdrawal criteria12
Withdrew: Unclassified45

Outcome measures

PrimaryChange From Baseline in HbA1c (Glycosylated Haemoglobin)

Estimated mean change from baseline in HbA1c after 20 Weeks of treatment in full analysis set (FAS).

Time frame:
Week 0, week 20
Reported as:
Mean · percentage of glycosylated haemoglobin
Change From Baseline in HbA1c (Glycosylated Haemoglobin)
percentage of glycosylated haemoglobinSubject-driven TitrationInvestigator-driven Titration
Change From Baseline in HbA1c (Glycosylated Haemoglobin)-1.32 ± 0.86-1.31 ± 0.96
Statistical analysis
  • Subject-driven Titration vs Investigator-driven Titration · Regression, Linear · Mean difference (final values): -0.02 · 95% CI -0.19 to 0.14
SecondaryPercentage of Subjects Achieving HbA1c Below 7.0%
Time frame:
After 20 weeks of treatment
Reported as:
Number · percentage (%) of subjects
Percentage of Subjects Achieving HbA1c Below 7.0%
percentage (%) of subjectsSubject-driven TitrationInvestigator-driven Titration
Percentage of Subjects Achieving HbA1c Below 7.0%64.558.1
SecondaryPercentage of Subjects Achieving HbA1c Below or Equal to 6.5%
Time frame:
After 20 weeks of treatment
Reported as:
Number · percentage (%) of subjects
Percentage of Subjects Achieving HbA1c Below or Equal to 6.5%
percentage (%) of subjectsSubject-driven TitrationInvestigator-driven Titration
Percentage of Subjects Achieving HbA1c Below or Equal to 6.5%35.537.2
SecondaryChange From Baseline in FPG (Fasting Plasma Glucose)
Time frame:
Week 0, week 20
Reported as:
Mean · mmol/L
Change From Baseline in FPG (Fasting Plasma Glucose)
mmol/LSubject-driven TitrationInvestigator-driven Titration
Change From Baseline in FPG (Fasting Plasma Glucose)-1.26 ± 2.59-1.48 ± 3.01
SecondaryIncidence of Hypoglycaemic Episodes (All, Major, Minor and Symptoms Only)

Definition of a treatment emergent hypoglycemic episode: an episode occurred after the first administration of insulin or oral anti-diabetic drug, and no later than the last day on trial product. Severe hypoglycemic episode was that requiring assistance to administer carbohydrate, glucagon, or other resusciative actions. Minor hypoglycemic episode was the one with plasma glucose value \< 3.1 mmol/L, either with symptoms that could be handled by subject, or without symptoms.

Time frame:
Week 0 to week 20 (inclusive).
Reported as:
Number · events per patient per year
Incidence of Hypoglycaemic Episodes (All, Major, Minor and Symptoms Only)
events per patient per yearSubject-driven TitrationInvestigator-driven Titration
All hypoglycemic events10.0410.90
Severe hypoglycemic events0.020.02
Minor hypoglycemic events1.701.66
Probable symptomatic hypoglycemia0.450.56

Adverse events

Collected over The reported treatment emergent adverse event was defined as an event that had onset date on or after the first day of exposure to randomised treatment and no later than the last day of randomised treatment, up to 20 weeks.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Subject-driven Titration—4/172 (2.3%)1/172 (0.6%)
Investigator-driven Titration—7/172 (4.1%)13/172 (7.6%)
Most frequent serious events
Showing 10 of 12
Most frequent serious events
EventSubject-driven TitrationInvestigator-driven Titration
Coronary artery diseaseCardiac disorders1/1720/172
MeniereEar and labyrinth disorders0/1721/172
GastritisGastrointestinal disorders0/1721/172
Brain contusionInjury, poisoning and procedural complications1/1720/172
Heat StrokeInjury, poisoning and procedural complications0/1721/172
Patella fractureInjury, poisoning and procedural complications1/1720/172
Thermal burnInjury, poisoning and procedural complications0/1721/172
Intervertebral disc protrusionMusculoskeletal and connective tissue disorders0/1721/172
Spinal osteoarthritisMusculoskeletal and connective tissue disorders0/1721/172
Adenosquamous cell lung cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)1/1720/172
Most frequent other events
Most frequent other events
EventSubject-driven TitrationInvestigator-driven Titration
InfluenzaInfections and infestations1/17213/172

Baseline characteristics

Age, Continuous
Age, Continuous(years)Subject-driven TitrationInvestigator-driven TitrationTotal
Mean54.8 ± 7.353.4 ± 7.554.1 ± 7.4
Gender
Gender(Participants)Subject-driven TitrationInvestigator-driven TitrationTotal
Female79101180
Male9371164
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Subject-driven TitrationInvestigator-driven TitrationTotal
American Indian or Alaska Native000
Asian172172344
Native Hawaiian or Other Pacific Islander000
Black or African American000
White000
More than one race000
Unknown or Not Reported000
Weight
Weight(kg)Subject-driven TitrationInvestigator-driven TitrationTotal
Mean70.3 ± 11.369.5 ± 11.669.9 ± 11.5
Body mass index (BMI)
Body mass index (BMI)(kg/m^2)Subject-driven TitrationInvestigator-driven TitrationTotal
Mean25.76 ± 3.2625.47 ± 3.0125.62 ± 3.14
Glycosylated Haemoglobin (HbA1c)
Glycosylated Haemoglobin (HbA1c)(percentage of glycosylated haemoglobin)Subject-driven TitrationInvestigator-driven TitrationTotal
Mean8.10 ± 0.648.14 ± 0.678.12 ± 0.65
Fasting Plasma Glucose
Fasting Plasma Glucose(mmol/L)Subject-driven TitrationInvestigator-driven TitrationTotal
Mean8.83 ± 2.369.07 ± 2.438.95 ± 2.40
08

Study locations

22 sites
  • Novo Nordisk Investigational Site
    Hefei, Anhui 230001, China
  • Novo Nordisk Investigational Site
    Hefei, Anhui 230022, China
  • Novo Nordisk Investigational Site
    Beijing, Beijing 100029, China
  • Novo Nordisk Investigational Site
    Beijing, Beijing 100088, China
  • Novo Nordisk Investigational Site
    Beijing, Beijing 100700, China
  • Novo Nordisk Investigational Site
    Beijing, Beijing 100730, China
  • Novo Nordisk Investigational Site
    Chongqing, Chongqing 400010, China
  • Novo Nordisk Investigational Site
    ChongQing, Chongqing 404000, China
  • Novo Nordisk Investigational Site
    Guangzhou, Guangdong 510080, China
  • Novo Nordisk Investigational Site
    Shijiazhuang, Hebei 050051, China
  • Novo Nordisk Investigational Site
    Shijiazhuang, Hebei 050082, China
  • Novo Nordisk Investigational Site
    Wuhan, Hubei 430034, China
  • Novo Nordisk Investigational Site
    Tongliao, Inner Mongolia 028007, China
  • Novo Nordisk Investigational Site
    Nanjing, Jiangsu 210011, China
  • Novo Nordisk Investigational Site
    Yangzhou, Jiangsu 225001, China
  • Novo Nordisk Investigational Site
    Nanchang, Jiangxi 330006, China
  • Novo Nordisk Investigational Site
    Changchun, Jilin 130041, China
  • Novo Nordisk Investigational Site
    Siping, Jilin 136000, China
  • Novo Nordisk Investigational Site
    Xi'an, Shaanxi 710032, China
  • Novo Nordisk Investigational Site
    Jinan, Shandong 250013, China
  • Novo Nordisk Investigational Site
    Shanghai, Shanghai 200072, China
  • Novo Nordisk Investigational Site
    Hangzhou, Zhejiang 310003, China
09

References and documents

Publications

  • Yang W, Zhu L, Meng B, Liu Y, Wang W, Ye S, Sun L, Miao H, Guo L, Wang Z, Lv X, Li Q, Ji Q, Zhao W, Yang G. Subject-driven titration of biphasic insulin aspart 30 twice daily is non-inferior to investigator-driven titration in Chinese patients with type 2 diabetes inadequately controlled with premixed human insulin: A randomized, open-label, parallel-group, multicenter trial. J Diabetes Investig. 2016 Jan;7(1):85-93. doi: 10.1111/jdi.12364. Epub 2015 May 25. PubMed 26816605 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Feb 24, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT01618214
Lead sponsor
Novo Nordisk A/S
Responsible party
Sponsor
First posted
Jun 13, 2012
Start date
Jun 2012
Primary completion
Jan 2013
Completion
Jan 2013
Results posted
May 8, 2014
Last update
Feb 24, 2017

Study contacts

Global Clinical Registry (GCR, 1452)
study director · Novo Nordisk A/S

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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