AzTrials
AzTrials

Glucocorticoid Induced HyperglycemiaPhase 4NCT07599891

Comparing the Safety and Efficacy of Insulin GLARGINE and DEGLUDEC in Glucocorticoid Induced HYPERGLYCEMIA in Hospitalized Patients".

A Phase 4 study testing Degludec insulin and Glargine insulin in people with Glucocorticoid Induced Hyperglycemia, run by Max Healthcare Insititute Limited at 1 site in India.

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

Glucocorticoids (GC) represent therapeutic agents of great importance in the treatment and prophylaxis of multiple inflammatory and non-inflammatory conditions. Despite their efficacy, the use of GCs is associated with a variety of side effects, one of the immediate ones being the development of glucocorticoids… Read more about this study

Who is it for?
Any age
Conditions the study is for
Glucocorticoid Induced Hyperglycemia
What is being tested?
Degludec insulin and Glargine insulin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
79 participants
Where
1 siteIndia
Study dates
1 Sep 2023to 31 Mar 2025
Phase
Phase 4
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 Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Non pregnant adult patients
  • with or without Type 2 diabetes
  • above the age of 18 years
  • on glucocorticoid dose equivalent to >20 mg and <160 mg prednisolone daily for any indication
  • with glucocorticoid induced hyperglycemia (random blood glucose >200 mg/dl)
  • who are requiring basal bolus insulin regimen

Who cannot join

None listed.

Trial locations and contacts

1 site in 1 country.

India1 site
  • Max Institute of Medical Education

    New Delhi, Saket, 110017

Other trials in India

About this study

Official title: Randomized Controlled Trial Comparing the Safety and Efficacy of Insulin Glargine and Insulin Degludec in Glucocorticoid Induced Hyperglycemia in Hospitalized Patients

Glucocorticoids (GC) represent therapeutic agents of great importance in the treatment and prophylaxis of multiple inflammatory and non-inflammatory conditions. Despite their efficacy, the use of GCs is associated with a variety of side effects, one of the immediate ones being the development of glucocorticoids induced hyperglycemia.

GCs decrease peripheral insulin sensitivity, increase hepatic gluconeogenesis, trigger insulin resistance, as well as inhibit pancreatic insulin production.([1] It has been shown that acute and chronic hyperglycemia that are present in many cases in the hospital setting are important risk factors for prolonged hospital stays, infectious complications, poorer surgical outcomes, and increased mortality.

In-hospital glucocorticoid induced hyperglycemia is usually managed with optimization of oral anti-diabetic drugs and basal bolus insulin, which has been well established over sliding scale insulin as the preferred regimen for GIH. Through this study we aim to compare to different basal insulins, glargine and degludec in terms of their efficacy and safety (hypoglycemic events) in this setting.

Read the detailed description

This study protocol describes a randomized controlled trial conducted at Max Super Specialty Hospital to compare the safety and efficacy of insulin glargine and insulin degludec in the management of glucocorticoid-induced hyperglycemia (GIH) among hospitalized patients. The study is being undertaken as a DNB thesis in the Department of Endocrinology under the guidance of Dr. Ambrish Mithal and colleagues.

Glucocorticoids are widely used in hospitalized patients for inflammatory, autoimmune, respiratory, infectious, and malignant conditions. However, they commonly cause hyperglycemia by increasing insulin resistance, enhancing hepatic gluconeogenesis, promoting lipolysis and proteolysis, and impairing pancreatic beta-cell insulin secretion. Approximately 40-50% of hospitalized patients receiving steroids develop GIH, which is associated with poor clinical outcomes such as prolonged hospitalization, infections, delayed wound healing, intensive care admission, and increased mortality.

The study aims to compare insulin glargine, a long-acting basal insulin with approximately 24-hour duration, and insulin degludec, an ultra-long-acting basal insulin with about 42-hour duration. Degludec is hypothesized to provide similar glycemic control with fewer hypoglycemic episodes because of its flatter and more stable pharmacokinetic profile.

The primary objective is to compare the efficacy of glargine and degludec in reducing mean glucose levels in patients with GIH. Secondary objectives include comparing the incidence of hypoglycemia and identifying predictors of glycemic control.

The study population includes non-pregnant adults above 18 years with type 2 diabetes or without diabetes who are admitted under Respiratory Medicine and are receiving glucocorticoids equivalent to more than 20 mg and less than 160 mg prednisolone daily. Patients already on basal insulin, those receiving steroids for less than 48 hours, pregnant patients, or patients with diabetic ketoacidosis (DKA), hyperosmolar hyperglycemic state (HHS), or requiring insulin infusion are excluded.

A total of 112 patients (56 per group) will be enrolled and randomized using the SNOSE (Sequentially Numbered Opaque Sealed Envelope) method into either the insulin glargine or insulin degludec group. Both groups will receive the same rapid-acting bolus insulin (insulin aspart).

Insulin Protocol

The insulin regimen is based on body weight and baseline blood glucose levels:

0.5 units/kg/day for blood glucose <140 mg/dL 0.8 units/kg/day for blood glucose 141-200 mg/dL

1 unit/kg/day for blood glucose >200 mg/dL

Patients already on basal-bolus insulin at home receive 130% of their prior total daily dose.

The total insulin dose is divided into:

Basal insulin (40%) using either insulin glargine or insulin degludec administered at 10 AM, 10 PM, or both depending on glycemic profile.

Bolus insulin (60%) using insulin aspart distributed as:

15% before breakfast 20% before lunch 10% before evening snack 15% before dinner

Correctional insulin doses are added or reduced according to pre-meal glucose levels. For glucose above 200 mg/dL, additional insulin is administered incrementally, while doses are reduced for glucose below 100 mg/dL. Separate lower correction scales are used for patients with chronic liver disease (CLD) or chronic kidney disease (CKD) to minimize hypoglycemia risk.

Blood glucose monitoring is performed using both capillary blood glucose (CBG) testing and continuous glucose monitoring (CGM) before meals, at 10 AM and/or 10 PM, and occasionally at 2 AM. Insulin doses are adjusted daily according to hospital protocol.

Hypoglycemia is defined as blood glucose below 70 mg/dL. Mild hypoglycemia is greater than or equal to 54 mg/dl and below 70 mg/dl; and severe hypoglycemia will be defined as <54 mg/dl or hypoglycemia with severe symptoms and requiring third party assistance. It will be managed according to standardized hospital treatment protocols with repeat glucose monitoring every 15 minutes until recovery.

The study duration is 18 months, and outcomes assessed include mean glucose levels, time in range, glycemic variability, and hypoglycemic events over the first five days of steroid therapy.

Being tested
Degludec insulin, Glargine insulin

What participants receive

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

  • Degludec insulinDrug

    Degludec was used as part of basal bolus insulin regimen in the experimental arm of this study. Glargine was used as active comparator.

  • Glargine insulinDrug

    Glargine was used as part of basal bolus insulin regimen in the active comparator arm of this study.

Study groups in NCT07599891
Study groupRoleWhat they receive
DegludecExperimentalDegludec was used as a basal insulin against active comparator glargine.
Receives: Drug: Degludec insulin
GlargineActive comparatorGlargine is an established treatment for glucocorticoid induced hyperglycemia, hence was used as active comparator in this study.
Receives: Drug: Glargine insulin

What is being measured

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

  1. basal insulin dose - on Day 1 and Day 5 of basal bolus treatment

    Basal insulin dose measured in units on Day 1 and Day 5 of basal bolus treatment - expressed in IU

    Measured: for 5 days while admitted to the hospital, from Day 1 of initiation of basal bolus insulin in hospital, to Day 5 of treatment

  2. Bolus insulin dose on Day 1 and Day 5 of treatment

    Insulin dose of bolus insulin - on Day 1 and Day 5 of treatment , expressed in IU.

    Measured: for 5 days while admitted in hospital, from Day 1 of initiation of basal bolus insulin to Day 5 of basal bolus insulin

  3. Estimated average glucose on Day 1 and Day 5 of basal bolus insulin treatment - in mg/dl

    Estimated average glucose on Day 1 and Day 5 of basal bolus insulin treatment - in mg/dl

    Measured: for 5 days while admitted in hospital, from Day 1 of initiation of basal bolus insulin to Day 5 of basal bolus insulin

  4. Time in range

    Time in range - as measured on continuous glucose monitor - in percentage

    Measured: for 5 days while admitted in hospital, from Day 1 of initiation of basal bolus insulin to Day 5 of basal bolus insulin

  5. Time above range

    Time above range - as measured on continuous glucose monitor - expressed in percentage

    Measured: for 5 days while admitted in hospital, from Day 1 of initiation of basal bolus insulin to Day 5 of basal bolus insulin

  6. Percent change in coefficient of variation - as measured by continuous glucose monitor - expressed in percentage

    Percent change in coefficient of variation - as measured by continuous glucose monitor - expressed in percentage

    Measured: for 5 days while admitted in hospital, from Day 1 of initiation of basal bolus insulin to Day 5 of basal bolus insulin

  7. Change in Mean amplitude of glycemic excursions (MAGE) - expressed in mg/dl

    MAGE the amplitude of glucose variations over time, calculated using Continuous glucose monitoring data in open source software known as EasyGV - expressed in mg/dl

    Measured: for 5 days while admitted in hospital, from Day 1 of initiation of basal bolus insulin to Day 5 of basal bolus insulin

  8. Change in basal insulin, bolus insulin, and total insulin doses from Day 1 to Day 5 in both groups

    The change in basal insulin, bolus insulin and total insulin dose from Day 1 to Day 5 will be calculated for both glargine and degludec group,

    Measured: for 5 days while admitted in hospital, from Day 1 of initiation of basal bolus insulin to Day 5 of basal bolus insulin

Secondary outcomes (3)
  1. Incidences of fasting hypoglycemia on any Day, between Day 1 and day 5 of basal bolus treatment, occuring fasting state (early morning, between 5-6 am) - expressed in mg/dl

    Fasting Hypoglycemia as measured by glucometer (capillary blood glucose) will be defined as - mild - less than 70 mg/dl but more than or equal to 54 mg/dl; severe -- less than 54 mg/dl, or requirement of third person assistance in correcting hypoglycemia and hypoglycemic symptoms, in the fasting state. Expressed in mg/dl.

    Measured: for 5 days while admitted in hospital during the clinical trial , from Day 1 of initiation of basal bolus insulin to Day 5 of basal bolus insulin

  2. Incidences of non -fasting (random) hypoglycemia on any Day, between Day 1 and day 5 of basal bolus treatment, occuring in non-fasting states

    Non fasting hypoglycemia (random hypoglycemia, in mg/dl) as measured by glucometer (capillary blood glucose) will be defined as - mild - less than 70 mg/dl but more than or equal to 54; severe - less than 54 mg/dl, or requirement of third person assistance in correcting hypoglycemia and hypoglycemic symptoms . It will be expressed as mg/dl.

    Measured: for 5 days while admitted in hospital, from Day 1 of initiation of basal bolus insulin to Day 5 of basal bolus insulin

  3. Time below range

    Time below range, expressed in percentage, as measured by continuous glucose monitor, on Day 1 and Day 5 of basal bolus treatment

    Measured: for 5 days while admitted in hospital, from Day 1 of initiation of basal bolus insulin to Day 5

Timeline

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

  1. First posted20 May 2026
  2. Study start1 Sep 2023
  3. Primary completion31 Mar 2025
  4. Study completion31 Mar 2025

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Hospitalized, non pregnant adult patients (above 18 years of age) with or without diabetes, receiving glucocortcoids (prednisolone dose equivalent of 20-160 mg per day) and having glucocorticoid induced hyperglycemia and requiring basal bolus insulin for the management of the same, were randomized to two groups. One group received glargine, and the other degludec insulin as the basal insulin. Both groups received insulin aspart as the bolus. Weight based insulin dosing was done as per study protocol. Patients from both groups were followed for five days, and blood glucose monitoring was done using capillary blood glucose as well as continuous glucose monitoring
Masking
None (open label)
Enrolment
79 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07599891
Sponsor's protocol ID
:MIME/DNB/SKT-2023-0987
Status last verified
May 2026
First submitted
23 Feb 2026
Last updated
20 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Degludec insulin and Glargine insulin in people with Glucocorticoid Induced Hyperglycemia, run by Max Healthcare Insititute Limited at 1 site in India.

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 0 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 20 May 2026. 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 India. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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?

basal insulin dose - on Day 1 and Day 5 of basal bolus treatment (time frame: for 5 days while admitted to the hospital, from Day 1 of initiation of basal bolus insulin in hospital, to Day 5 of treatment). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 20 May 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in