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Trial registered on ANZCTR
Registration number
ACTRN12614000660684
Ethics application status
Approved
Date submitted
4/03/2014
Date registered
24/06/2014
Date last updated
24/06/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
In search of the most effective protocol to treat hypoglycaemia in type 1 diabetes: a randomised trial testing 3 different hypoglycaemia treatment protocols for resolution of hypoglycaemia and symptoms in adolescents and adults with type 1 diabetes
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Scientific title
In search of the most effective protocol to treat hypoglycaemia in type 1 diabetes: a randomised trial testing 3 different hypoglycaemia treatment protocols for resolution of hypoglycaemia and symptoms in adolescents and adults with type 1 diabetes
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Secondary ID [1]
284183
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Nil
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Universal Trial Number (UTN)
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Trial acronym
SEPTH
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Diabetes
291281
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Condition category
Condition code
Metabolic and Endocrine
291635
291635
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Randomised cross-over trial of 3 treatment doses of glucose for hypoglycaemia (0.2 g/kg, 0.3 g/kg and 15 g).
As per protocol each treatment is administered as glucose tablets at onset of spontaneously occurring hypoglycaemia, and only repeated at 10 minutes if hypoglycaemia has not resolved. As blood glucose is very dynamic "a wash-out" is not really applicable, and hypoglycaemia had always resolved prior to any repeat episodes. Patients record on the treatment sheet when an episode occurs, what treatment is given and then blood glucose at specified intervals - it si unlikely they would complete the data sheet without adhering to treatment for that episode.
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Intervention code [1]
288880
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Treatment: Other
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Comparator / control treatment
Randomised cross-over trial of 3 treatment doses of glucose for hypoglycaemia (0.2 g/kg, 0.3 g/kg and 15 g). 15 g is current standard treatment, 0.2 and 0.3 g/kg are comparator treatments
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
291566
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Blood glucose 10 miuntes after treatment, on supplied (and standardised) glucometer measured by participant
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Assessment method [1]
291566
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Timepoint [1]
291566
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10 minutes
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Secondary outcome [1]
307083
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Change in blood glucose at 10 minutes, on supplied (and standardised) glucometer measured by participant
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Assessment method [1]
307083
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Timepoint [1]
307083
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10 minutes
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Secondary outcome [2]
307084
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Proportion of episodes requiring repeat treatment at 10 minutes (given if glucose on supplied glucometer remained less than 4 mmol/L at 10 minutes)
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Assessment method [2]
307084
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Timepoint [2]
307084
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10 minutes
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Eligibility
Key inclusion criteria
Adults with type 1 diabetes, recieving insulin and having more than one episode of hypoglycaemia per week
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. adrenal insufficiency
2. untreated hypothyroidism
3. clinical autonomic neuropathy
4. coeliac disease
5. Living alone
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Subjects recruited from diabetes clinic. One of three treatments randomly allocated by sealed envelope for each episode requiring treatment (up to 15 per subject)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Details of treatment dose and recording sheet written on each treatment episode form, placed in sealed envelope and then shuffled. for each subject, 5 envelopes for each treatment (15 envelopes altogether) provided. Envelopes then shuffled and numbered from 1 to 15, with subjects instructed to take the next numbered treatment episode envelope. This is simple randomisation, akin to dice-rolling. No stratification required.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/08/2011
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Actual
18/08/2011
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Date of last participant enrolment
Anticipated
1/10/2012
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Actual
22/05/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
30
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
5857
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New Zealand
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State/province [1]
5857
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Funding & Sponsors
Funding source category [1]
288808
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Charities/Societies/Foundations
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Name [1]
288808
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New Zealand Society for the Study of Diabetes Nursing Development Grant
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Address [1]
288808
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c/o Edgar National Centre for Diabetes Research
Department of Medicine
University of Otago
PO Box 56
DUNEDIN 9054
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Country [1]
288808
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New Zealand
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Primary sponsor type
Hospital
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Name
Capital and Coast District Health Board, Wellington Hospital
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Address
Private Bag 7902
Wellington
New Zealand 6021
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Country
New Zealand
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Secondary sponsor category [1]
287507
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None
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Name [1]
287507
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Address [1]
287507
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Country [1]
287507
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290657
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Central Regional Ethics Committee
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Ethics committee address [1]
290657
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Central Regional Ethics Committee Ministry of Health PO Box 5013 1 the Terrace Wellington 6145
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Ethics committee country [1]
290657
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New Zealand
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Date submitted for ethics approval [1]
290657
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Approval date [1]
290657
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12/07/2011
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Ethics approval number [1]
290657
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CEN/10/09/042
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Summary
Brief summary
The best treatment for episodes of hypoglycaemia has not been studied in detail and most guidelines have a small evidence base. The study aimed to investigate whether using an individualised dose of glucose, based on weight, rather than a fixed dose of 15 g, as currently recommended, would be more effective in resolving hypoglycaemia. Adult subjects with T1DM and frequent hypoglycaemia (more than one per week) were enrolled into this study. Treatment for each hypoglycaemia episode, defined as capillary glucose <4.0 mmol/L, was randomly assigned one of three protocols: 0.2 grams/kg and 0.3 grams/kg or15 grams of glucose (Dextro glucose tablets). Each subject received each treatment in random order for up to 15 hypoglycaemia episodes. Glucose was re-tested 10 minutes after treatment, with a repeat dose if < 4 mmol/L. The study shows 0.3 g/kg treatment dose resulted in a greater change in glucose and higher glucose at 10 minutes, with less need for extra treatment.
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Trial website
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Trial related presentations / publications
McTavish L, Wiltshire E, Krebs J. Weight based treatment is more effective for resolving hypoglycaemia in adults: a randomised trial. International Diabetes Federation, World Diabetes Congress, Melbourne, Australia, December 2013. Poster PD-0787
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Public notes
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Contacts
Principal investigator
Name
46630
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Mr Lindsay McTavish
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Address
46630
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Department of Diabetes and Endocrinology
Capital and Coast District Health Board
Wellington Hospital
Private Bag 7902
Wellington 6021
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Country
46630
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New Zealand
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Phone
46630
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+64 4 3855999
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Fax
46630
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Email
46630
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[email protected]
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Contact person for public queries
Name
46631
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Esko Wiltshire
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Address
46631
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Department of Paediatrics
University of Otago Wellington
PO Box 7343
Wellington South 6242
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Country
46631
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New Zealand
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Phone
46631
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+64 4 3855999/6912
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Fax
46631
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Email
46631
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[email protected]
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Contact person for scientific queries
Name
46632
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Esko Wiltshire
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Address
46632
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Department of Paediatrics
University of Otago Wellington
PO Box 7343
Wellington South 6242
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Country
46632
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New Zealand
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Phone
46632
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+64 4 3855999/6912
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Fax
46632
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Email
46632
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Weight-based hypoglycaemia treatment protocol for adults with Type 1 diabetes: A randomized crossover clinical trial.
2015
https://dx.doi.org/10.1111/dme.12730
N.B. These documents automatically identified may not have been verified by the study sponsor.
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