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CTRI Number  CTRI/2012/04/002548 [Registered on: 09/04/2012] Trial Registered Retrospectively
Last Modified On: 13/01/2024
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Drug 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study
Modification(s)  
Comparing a lower dose of insulin with the standard dose of insulin for the treatment of children presenting with acute severe diabetes (Diabetic ketoacidosis) 
Scientific Title of Study   A RANDOMIZED CONTROLLED TRIAL OF LOW DOSE (0.05 U/KG/HR) VERSUS STANDARD DOSE (0.1 U/KG/HR) INTRAVENOUS INSULIN INFUSION FOR THE TREATMENT OF DIABETIC KETOACIDOSIS IN CHILDREN 
Secondary IDs if Any  
Secondary ID  Registry 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Karthi N 
Address  Senior resident, Dept. Of Pediatrics, Advanced pediatrics centre, PGIMER, Chandigarh 160012

Chandigarh
CHANDIGARH
160012
India 
Phone  9814376716  
Fax    
Email  karthinallasamy@gmail.com  
 
Details Contact Person
Scientific Query

Modification(s)  
Name  Jayashree 
Address  Dept. Of pediatrics, Advanced pediatrics centre, PGIMER, Chandigarh.

Chandigarh
CHANDIGARH
160012
India 
Phone  9815594343  
Fax    
Email  mjshree@hotmail.com  
 
Details Contact Person
Public Query

Modification(s)  
Name  Jayashree 
Address  Dept. Of pediatrics, Advanced pediatrics centre, PGIMER, Chandigarh.

Chandigarh
CHANDIGARH
160012
India 
Phone  9815594343  
Fax    
Email  mjshree@hotmail.com  
 
Source of Monetary or Material Support
Modification(s)  
Postgraduate Institute of Medical Education and Research (PGIMER) 
 
Primary Sponsor
Modification(s)  
Name  Postgraduate Institute of Medical Education and Research PGIMER 
Address  Sector 12, Chandigarh, India - 160012. 
Type of Sponsor  Research institution and hospital 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study
Modification(s)  
No of Sites = 1  
Contact Person  Name of Site  Site Address  Phone/Fax/Email 
Dr Karthi N  PGIMER  Pediatric Emergency and Intensive care units, Advanced pediatrics centre, PGIMER,
Chandigarh
 
9814376716

karthinallasamy@gmail.com 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Institutional Ethics Committee, PGIMER  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  Diabetic ketoacidosis 
 
Intervention / Comparator Agent
Modification(s)  
Type  Name  Details 
Intervention  Regular Insulin  Continuous intravenous insulin infusion (0.05 U/kg/hr) till the resolution of acidosis (pH 7.3; HCO3 15) 
Comparator Agent  Regular insulin  Continuous intravenous insulin infusion(0.1U/kg/hr) till the resolution of acidosis (pH 7.3; HCO3 15) 
 
Inclusion Criteria  
Age From  0.00 Year(s)
Age To  12.00 Year(s)
Gender  Both 
Details  all children aged 12 years and below presenting with diabetic ketoacidosis are enrolled 
 
ExclusionCriteria 
Details  1.Features of cerebral edema at presentation
2.Received insulin infusion before admission
3.Features of sepsis at presentation
4.Anuria for more than 6 hours
 
 
Method of Generating Random Sequence   Permuted block randomization, variable 
Method of Concealment   Sequentially numbered, sealed, opaque envelopes 
Blinding/Masking   Open Label 
Primary Outcome  
Outcome  TimePoints 
Rate of fall in blood glucose   till blood glucose falls to 250mg/dl 
 
Secondary Outcome  
Outcome  TimePoints 
Incidence of cerebral edema  till the end point of study 
incidence of hypoglycemia  till the end point of study 
incidence of hypokalemia  till the end point of study 
Rate of resolution of acidosis  Till the end point of study 
 
Target Sample Size   Total Sample Size="44"
Sample Size from India="44" 
Phase of Trial   N/A 
Date of First Enrollment (India)
Modification(s)  
30/11/2011 
Date of First Enrollment (Global)  No Date Specified 
Estimated Duration of Trial   Years="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Applicable 
Recruitment Status of Trial (India)  Completed 
Publication Details    
Brief Summary
Modification(s)  

This study is planned and being done as a Dissertation for the degree of D.M. (pediatric critical care)

Rationale of the study:  Guidelines recommend insulin infusion at 0.1U/kg/hr for the treatment of DKA.  However even lower insulin doses are found to be effective in physiological and clinical studies for the resolution of ketoacidosis.  Also, a lower dose can produce a slower rate of fall in blood glucose, thereby minimizing the risk of cerebral edema.  The incidence of hypokalemia and hypokalemia during therapy can also be reduced with a lower dose of insulin.

Hypothesis: Administration of Low dose insulin (0.05U/kg/hr) as compared to the standard dose (0.1U/kg/hr) for the treatment of diabetic ketoacidosis in children will not cause a decrease in the rate of fall in blood glucose of > 18mg/dl/hr.

The primary objective of the study is to compare the rate of fall in blood glucose in two groups till the blood glucose value reaches to <250mg/dl.

The secondary objectives being, to compare in the above groups, rate of resolution of acidosis, incidence of cerebral edema, incidence of hypokalemia and hypoglycemia.

 

 

 

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