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DiabetesPhase 3BEGIN™NCT00982228

Comparison of NN1250 Plus Insulin Aspart With Insulin Glargine Plus Insulin Aspart in Type 1 Diabetes

A Phase 3 study testing insulin degludec, insulin glargine and insulin aspart in people with Diabetes and Diabetes Mellitus, Type 1, run by Novo Nordisk A/S at 91 sites in 6 countries.

Completed

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

Official record
Search all trials

Trial summary

This trial is conducted in Africa, Europe and the United States of America (USA). The aim of the trial is to compare NN1250 (insulin degludec, soluble insulin basal analogue (SIBA)) plus insulin aspart with insulin glargine (IGlar) plus insulin aspart in patients with type 1 diabetes. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Diabetes, Diabetes Mellitus, Type 1
What is being tested?
insulin degludec, insulin glargine and insulin aspart
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
629 participants
Where
91 sitesin 6 countries
Study dates
1 Sep 2009to 8 Nov 2010
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Type 1 diabetes mellitus for at least 12 months
  • Current treatment with any basal bolus insulin for at least 12 months
  • HbA1c below or equal to 10.0%
  • BMI (Body Mass Index) below or equal to 35.0 kg/m^2
  • For the extension trial only: Completion of the 52 week treatment period in trial NN1250-3583 (NCT00982228)

Who cannot join

  • Use of any other antidiabetic drug than insulin within the last 3 months
  • Cardiovascular disease within the last 6 months
  • Uncontrolled treated/untreated severe hypertension
  • Recurrent severe hypoglycemia or hypoglycemic unawareness or hospitalisation for diabetic ketoacidosis during the previous 6 months
  • Pregnancy, breast-feeding, the intention of becoming pregnant or not using adequate contraceptive measures according to local requirements
  • Cancer and medical history of cancer

Trial locations and contacts

91 sites in 6 countries.

91 sites in 6 countries

United States59 sites
  • Novo Nordisk Investigational Site

    Atlanta, Georgia, 30318

  • Novo Nordisk Investigational Site

    Aurora, Colorado, 80045-7402

  • Novo Nordisk Investigational Site

    Aurora, Colorado, 80045

  • Novo Nordisk Investigational Site

    Birmingham, Alabama, 35209

  • Novo Nordisk Investigational Site

    Brockton, Massachusetts, 02301

  • Novo Nordisk Investigational Site

    Chapel Hill, North Carolina, 27517

  • Novo Nordisk Investigational Site

    Chattanooga, Tennessee, 37404

  • Novo Nordisk Investigational Site

    Chattanooga, Tennessee, 37411

  • Novo Nordisk Investigational Site

    Chesterfield, Missouri, 63017

  • Novo Nordisk Investigational Site

    Chicago, Illinois, 60611-2661

  • Novo Nordisk Investigational Site

    Columbus, Ohio, 43203

  • Novo Nordisk Investigational Site

    Concord, California, 94520

  • Novo Nordisk Investigational Site

    Dallas, Texas, 75230

  • Novo Nordisk Investigational Site

    Dallas, Texas, 75231

  • Novo Nordisk Investigational Site

    Dallas, Texas, 75246

  • Novo Nordisk Investigational Site

    Dover, New Hampshire, 03820

  • Novo Nordisk Investigational Site

    Eagan, Minnesota, 55123

  • Novo Nordisk Investigational Site

    Flint, Michigan, 48503-5904

  • Novo Nordisk Investigational Site

    Flushing, New York, 11365

  • Novo Nordisk Investigational Site

    Fresno, California, 93720

  • Novo Nordisk Investigational Site

    Great Falls, Montana, 59405

  • Novo Nordisk Investigational Site

    Greenbrae, California, 94904

  • Novo Nordisk Investigational Site

    Hollywood, Florida, 33021

  • Novo Nordisk Investigational Site

    Honolulu, Hawaii, 96814

  • Novo Nordisk Investigational Site

    Huntington Beach, California, 92648

  • Novo Nordisk Investigational Site

    Huntsville, Alabama, 35801

  • Novo Nordisk Investigational Site

    Hyattsville, Maryland, 20782

  • Novo Nordisk Investigational Site

    Jefferson City, Missouri, 65109

  • Novo Nordisk Investigational Site

    La Mesa, California, 91942

  • Novo Nordisk Investigational Site

    Lake Mary, Florida, 32746

  • Novo Nordisk Investigational Site

    Lawrenceville, Georgia, 30046

  • Novo Nordisk Investigational Site

    Lawrenceville, New Jersey, 08648

  • Novo Nordisk Investigational Site

    Lexington, Kentucky, 40503

  • Novo Nordisk Investigational Site

    Lexington, Kentucky, 40536-0284

  • Novo Nordisk Investigational Site

    Livonia, Michigan, 48154

  • Novo Nordisk Investigational Site

    Los Gatos, California, 95032

  • Novo Nordisk Investigational Site

    Lubbock, Texas, 79423

  • Novo Nordisk Investigational Site

    Miami, Florida, 33136

  • Novo Nordisk Investigational Site

    Milwaukee, Wisconsin, 53209

  • Novo Nordisk Investigational Site

    Oklahoma City, Oklahoma, 73104

  • Novo Nordisk Investigational Site

    Omaha, Nebraska, 68114

  • Novo Nordisk Investigational Site

    Omaha, Nebraska, 68124

  • Novo Nordisk Investigational Site

    Peoria, Arizona, 85381

  • Novo Nordisk Investigational Site

    Pittsburgh, Pennsylvania, 15212

  • Novo Nordisk Investigational Site

    Pittsburgh, Pennsylvania, 15224-2215

  • Novo Nordisk Investigational Site

    Raleigh, North Carolina, 27609

  • Novo Nordisk Investigational Site

    Rapid City, South Dakota, 57701

  • Novo Nordisk Investigational Site

    Renton, Washington, 98057

  • Novo Nordisk Investigational Site

    Rochester, New York, 14607

  • Novo Nordisk Investigational Site

    Rockville, Maryland, 20852

  • Novo Nordisk Investigational Site

    Round Rock, Texas, 78681

  • Novo Nordisk Investigational Site

    Saint Charles, Missouri, 63303

  • Novo Nordisk Investigational Site

    Santa Barbara, California, 93105

  • Novo Nordisk Investigational Site

    Scarborough, Maine, 04074-9302

  • Novo Nordisk Investigational Site

    St. George, Utah, 84790

  • Novo Nordisk Investigational Site

    Tustin, California, 92780

  • Novo Nordisk Investigational Site

    Ventura, California, 93003

  • Novo Nordisk Investigational Site

    Vincennes, Indiana, 47591-1029

  • Novo Nordisk Investigational Site

    Walnut Creek, California, 94598-3347

Other trials in United States

Russia8 sites
  • Novo Nordisk Investigational Site

    Moscow, 117036

  • Novo Nordisk Investigational Site

    Moscow, 119034

  • Novo Nordisk Investigational Site

    Moscow, 127486

  • Novo Nordisk Investigational Site

    Novosibirsk, 630047

  • Novo Nordisk Investigational Site

    Saint Petersburg, 194354

  • Novo Nordisk Investigational Site

    Saint-Peterburg, 190068

  • Novo Nordisk Investigational Site

    Tyumen, 625023

  • Novo Nordisk Investigational Site

    Yaroslavl, 150062

Other trials in Russia

United Kingdom8 sites
  • Novo Nordisk Investigational Site

    Aberdeen, AB25 1LD

  • Novo Nordisk Investigational Site

    Birmingham, B9 5SS

  • Novo Nordisk Investigational Site

    Bradford, BD9 6RJ

  • Novo Nordisk Investigational Site

    Glasgow, G21 3UW

  • Novo Nordisk Investigational Site

    Guildford, GU2 7XX

  • Novo Nordisk Investigational Site

    Leeds, LS9 7TF

  • Novo Nordisk Investigational Site

    Llantrisant, CF72 8XR

  • Novo Nordisk Investigational Site

    Sheffield, S5 7AU

Other trials in United Kingdom

France7 sites
  • Novo Nordisk Investigational Site

    Boisguillaume, 76233

  • Novo Nordisk Investigational Site

    Brest, 29609

  • Novo Nordisk Investigational Site

    Grenoble, 38043

  • Novo Nordisk Investigational Site

    La Rochelle, 17019

  • Novo Nordisk Investigational Site

    Montpellier

  • Novo Nordisk Investigational Site

    Nice, 06002

  • Novo Nordisk Investigational Site

    Paris, 75877

Other trials in France

Germany6 sites
  • Novo Nordisk Investigational Site

    Aschaffenburg, 63739

  • Novo Nordisk Investigational Site

    Bad Kreuznach, 55545

  • Novo Nordisk Investigational Site

    Dormagen, 41539

  • Novo Nordisk Investigational Site

    Hamburg, 21073

  • Novo Nordisk Investigational Site

    Hamburg, 22607

  • Novo Nordisk Investigational Site

    Saint Ingbert, 66386

Other trials in Germany

South Africa3 sites
  • Novo Nordisk Investigational Site

    Cape Town, Western Cape, 7130

  • Novo Nordisk Investigational Site

    Cape Town, Western Cape, 7925

  • Novo Nordisk Investigational Site

    Johannesburg, Gauteng, 1724

Other trials in South Africa

About this study

Official title: NN1250-3583: A 52 Week Randomised, Controlled, Open Label, Multicentre, Multinational, Parallel, Treat-to-target Trial Comparing Efficacy and Safety of SIBA and Insulin Glargine Both Administered Once Daily in a Basal-bolus Regimen With Insulin Aspart as Mealtime Insulin in Subjects With Type 1 Diabetes (BEGIN™: BB T1 LONG) / NN1250-3644: An Extension Trial to Trial NN1250-3583 Comparing Safety and Efficacy of NN1250 With Insulin Glargine, Both With Insulin Aspart as Meal-time Insulin, in Type 1 Diabetes (BEGIN™: T1)

This trial is conducted in Africa, Europe and the United States of America (USA).

The aim of the trial is to compare NN1250 (insulin degludec, soluble insulin basal analogue (SIBA)) plus insulin aspart with insulin glargine (IGlar) plus insulin aspart in patients with type 1 diabetes.

The main period is registered internally at Novo Nordisk as NN1250-3583 while the extension period is registered as NN1250-3644.

Being tested
insulin degludec, insulin glargine, insulin aspart
Medical subject headings
Diabetes Mellitus, Diabetes Mellitus, Type 1

What participants receive

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

  • insulin degludecDrug

    Injected subcutaneously once daily. Dose was individually adjusted.

  • insulin glargineDrug

    Injected subcutaneously once daily. Dose individually adjusted.

  • insulin aspartDrug

    Injected subcutaneously as mealtime insulin. Dose was individually adjusted.

Study groups in NCT00982228
Study groupRoleWhat they receive
IDeg ODExperimentalNot described
Receives: Drug: insulin degludec; Drug: insulin aspart
IGlar ODActive comparatorNot described
Receives: Drug: insulin glargine; Drug: insulin aspart

What is being measured

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

  1. Main Trial (Primary Endpoint): Change in Glycosylated Haemoglobin (HbA1c) After 52 Weeks of Treatment

    Change from baseline in HbA1c after 52 weeks of treatment

    Measured: Week 0, Week 52

  2. Extension Trial (Primary Endpoint): Rate of Treatment Emergent Adverse Events (AEs)

    Corresponds to rate of AEs per 100 patient years of exposure. Severity assessed by investigator. Mild: no or transient symptoms, no interference with subject's daily activities. Moderate: marked symptoms, moderate interference with subject's daily activities. Severe: considerable interference with subject's daily activities, unacceptable. Serious AE: AE that at any dose results in any of the following: death, a life-threatening experience, in-subject hospitalization/prolongation of existing hospitalisation, persistent/significant disability/incapacity/congenital anomaly/birth defect.

    Measured: Week 0 to Week 104 + 7 days follow up

  3. Extension Trial (Primary Endpoint): Rate of Confirmed Hypoglycaemic Episodes

    Rate of confirmed hypoglycaemic episodes per 100 patient years of exposure (PYE). Confirmed hypoglycaemic episodes consisted of severe hypoglycaemia as well as minor hypoglycaemic episodes. Severe hypoglycaemic episodes are defined as requiring assistance to administer carbohydrate, glucagon, or other resuscitative actions. Minor hypoglycaemic episodes are defined as able to treat her/himself and plasma glucose below 3.1 mmol/L.

    Measured: Week 0 to Week 104 + 7 days follow up

  4. Extension Trial (Primary Endpoint): Cross-reacting Antibodies to Human Insulin

    The unit for measuring antibody levels is amount of tracer bound to the antibodies in the precipitate (B) expressed in percentage of the total amount of tracer (T) added to the mixture (%B/T). Samples were taken before 1st dosing and after a 1-week wash-out period.

    Measured: Week 0, Week 106

Secondary outcomes (6)
  1. Extension Trial (Primary Endpoint): Rate of Nocturnal Confirmed Hypoglycaemic Episodes

    Rate of confirmed hypoglycaemic episodes per 100 patient years of exposure (PYE). Confirmed hypoglycaemic episodes consisted of severe hypoglycaemia as well as minor hypoglycaemic episodes. Severe hypoglycaemic episodes are defined as requiring assistance to administer carbohydrate, glucagon, or other resuscitative actions. Minor hypoglycaemic episodes are defined as able to treat her/himself and plasma glucose below 3.1 mmol/L. Nocturnal hypoglycaemic episodes are defined as occuring between 00:01 and 05:59 a.m.

    Measured: Week 0 to Week 104 + 7 days follow up

  2. Extension Trial (Secondary Endpoint): Change in Glycosylated Haemoglobin (HbA1c) After 104 Weeks of Treatment

    Change from baseline in HbA1c after 104 weeks of treatment

    Measured: Week 0, Week 104

  3. Extension Trial (Secondary Endpoint): Mean of 9-point Self Measured Plasma Glucose Profile (SMPG) at Week 104 of Treatment

    Mean of 9-point self-measured plasma glucose profile (SMPG) after 104 weeks of treatment. Plasma glucose measured: before breakfast, 90 minutes after start of breakfast, before lunch, 90 minutes after start of lunch, before dinner, 90 minutes after start of dinner, bedtime, at 4 am and before breakfast.

    Measured: Treatment week 104

  4. Main Trial (Secondary Endpoint): Rate of Confirmed Hypoglycaemic Episodes

    Rate of confirmed hypoglycaemic episodes per 100 patient years of exposure (PYE). Confirmed hypoglycaemic episodes consisted of severe hypoglycaemia as well as minor hypoglycaemic episodes. Severe hypoglycaemic episodes are defined as requiring assistance to administer carbohydrate, glucagon, or other resuscitative actions. Minor hypoglycaemic episodes are defined as able to treat her/himself and plasma glucose below 3.1 mmol/L.

    Measured: Week 0 to Week 52 + 7 days follow up

  5. Main Trial (Secondary Endpoint): Rate of Nocturnal Confirmed Hypoglycaemic Episodes

    Rate of confirmed hypoglycaemic episodes per 100 patient years of exposure (PYE). Confirmed hypoglycaemic episodes consisted of severe hypoglycaemia as well as minor hypoglycaemic episodes. Severe hypoglycaemic episodes are defined as requiring assistance to administer carbohydrate, glucagon, or other resuscitative actions. Minor hypoglycaemic episodes are defined as able to treat her/himself and plasma glucose below 3.1 mmol/L. Nocturnal hypoglycaemic episodes are defined as occuring between 00:01 and 05:59 a.m.

    Measured: Week 0 to Week 52 + 7 days follow up

  6. Main Trial (Secondary Endpoint): Mean of 9-point Self Measured Plasma Glucose Profile (SMPG) at Week 52

    Mean of 9-point self-measured plasma glucose profile (SMPG) after 52 weeks of treatment. Plasma glucose measured: before breakfast, 90 minutes after start of breakfast, before lunch, 90 minutes after start of lunch, before dinner, 90 minutes after start of dinner, bedtime, at 4 am and before breakfast.

    Measured: Week 52

Timeline

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

  1. First posted23 Sep 2009 (estimated)
  2. Study start1 Sep 2009
  3. Primary completion8 Nov 2010
  4. Study completion8 Nov 2010

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
629 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00982228
Sponsor's protocol ID
NN1250-3583
Other IDs
2008-005774-13, U1111-1111-8789, 2009-015755-24, U1111-1116-1578, 2009, 2008
Acronym
BEGIN™
Status last verified
Mar 2017
First submitted
22 Sep 2009
Last updated
6 Apr 2017
Data monitoring committee
No

Publications

  • Ratner RE, Gough SC, Mathieu C, Del Prato S, Bode B, Mersebach H, Endahl L, Zinman B. Hypoglycaemia risk with insulin degludec compared with insulin glargine in type 2 and type 1 diabetes: a pre-planned meta-analysis of phase 3 trials. Diabetes Obes Metab. 2013 Feb;15(2):175-84. doi: 10.1111/dom.12032. Epub 2012 Dec 3.

    PubMed 23130654
  • Heller S, Mathieu C, Kapur R, Wolden ML, Zinman B. A meta-analysis of rate ratios for nocturnal confirmed hypoglycaemia with insulin degludec vs. insulin glargine using different definitions for hypoglycaemia. Diabet Med. 2016 Apr;33(4):478-87. doi: 10.1111/dme.13002. Epub 2015 Dec 13.

    PubMed 26484727
  • Sorli C, Warren M, Oyer D, Mersebach H, Johansen T, Gough SC. Elderly patients with diabetes experience a lower rate of nocturnal hypoglycaemia with insulin degludec than with insulin glargine: a meta-analysis of phase IIIa trials. Drugs Aging. 2013 Dec;30(12):1009-18. doi: 10.1007/s40266-013-0128-2.

    PubMed 24170235
  • Einhorn D, Handelsman Y, Bode BW, Endahl LA, Mersebach H, King AB. PATIENTS ACHIEVING GOOD GLYCEMIC CONTROL (HBA1c <7%) EXPERIENCE A LOWER RATE OF HYPOGLYCEMIA WITH INSULIN DEGLUDEC THAN WITH INSULIN GLARGINE: A META-ANALYSIS OF PHASE 3A TRIALS. Endocr Pract. 2015 Aug;21(8):917-26. doi: 10.4158/EP14523.OR. Epub 2015 Jun 29.

    PubMed 26121451
  • Russell-Jones D, Gall MA, Niemeyer M, Diamant M, Del Prato S. Insulin degludec results in lower rates of nocturnal hypoglycaemia and fasting plasma glucose vs. insulin glargine: A meta-analysis of seven clinical trials. Nutr Metab Cardiovasc Dis. 2015 Oct;25(10):898-905. doi: 10.1016/j.numecd.2015.06.005. Epub 2015 Jun 18.

    PubMed 26232910
  • Vora J, Christensen T, Rana A, Bain SC. Insulin degludec versus insulin glargine in type 1 and type 2 diabetes mellitus: a meta-analysis of endpoints in phase 3a trials. Diabetes Ther. 2014 Dec;5(2):435-46. doi: 10.1007/s13300-014-0076-9. Epub 2014 Aug 1.

    PubMed 25081590
  • Aye MM, Atkin SL. Patient safety and minimizing risk with insulin administration - role of insulin degludec. Drug Healthc Patient Saf. 2014 Apr 30;6:55-67. doi: 10.2147/DHPS.S59566. eCollection 2014.

    PubMed 24812526
  • Heller S, Buse J, Fisher M, Garg S, Marre M, Merker L, Renard E, Russell-Jones D, Philotheou A, Francisco AM, Pei H, Bode B; BEGIN Basal-Bolus Type 1 Trial Investigators. Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 1 diabetes (BEGIN Basal-Bolus Type 1): a phase 3, randomised, open-label, treat-to-target non-inferiority trial. Lancet. 2012 Apr 21;379(9825):1489-97. doi: 10.1016/S0140-6736(12)60204-9.

    PubMed 22521071
  • Evans M, Chubb B, Gundgaard J. Cost-effectiveness of Insulin Degludec Versus Insulin Glargine in Adults with Type 1 and Type 2 Diabetes Mellitus. Diabetes Ther. 2017 Apr;8(2):275-291. doi: 10.1007/s13300-017-0236-9. Epub 2017 Feb 16.

    PubMed 28210866

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing insulin degludec, insulin glargine and insulin aspart in people with Diabetes and Diabetes Mellitus, Type 1, run by Novo Nordisk A/S at 91 sites in 6 countries.

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 5 inclusion and 6 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 6 Apr 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 91 sites in United States, Russia, United Kingdom, France, Germany and 1 more country. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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

Are results available for this study?

Yes. Results are posted in the registry (first posted 29 Dec 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Main Trial (Primary Endpoint): Change in Glycosylated Haemoglobin (HbA1c) After 52 Weeks of Treatment (time frame: Week 0, Week 52). The study lists 4 primary outcomes in all. 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 NCT00982228, which also lists 9 linked publications.

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 6 Apr 2017.

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