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Trial registered on ANZCTR
Registration number
ACTRN12606000270516
Ethics application status
Approved
Date submitted
21/04/2005
Date registered
21/04/2005
Date last updated
5/11/2010
Type of registration
Prospectively registered
Titles & IDs
Public title
High blood sugar levels and insulin treatment in preterm babies. The HINT trial.
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Scientific title
Randomised controlled trial on the effect of tight glycaemic control with insulin in hyperglycaemic very low birth weight (VLBW) preterm neonates on growth.
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Secondary ID [1]
63
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Perinatal Trials Registry: PTR544
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Universal Trial Number (UTN)
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Trial acronym
HINT trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Neonatal Hyperglycaemia
59
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Condition category
Condition code
Reproductive Health and Childbirth
69
69
0
0
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Complications of newborn
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Blood
70
70
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0
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Other blood disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Continuous intravenous insulin infusion starting at 0.05 units/kg.hour, titrated to maintain target blood glucose levels. In the intervention group insulin will be started in hyperglycaemic babies after two concecutive blood glucose levels of > 8.5 mmol/l, 4 hours apart. The insulin will be titrated to maintain the blood glucose level from 4-6 mmol/l.
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Intervention code [1]
1106
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Treatment: Drugs
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Comparator / control treatment
n the control group insulin will only be started in hyperglycaemic babies who are over 3 days old, and have persistently elevated blood gluocose levels > 10 mmol/l, and unable to tolerate 100 cal/kg.day. Once insuin is started the dose will be titrated to maintain the blood glucose level 8-10 mmol/l. The trial will continue until 36 weeks post menstrual age.
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Control group
Active
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Outcomes
Primary outcome [1]
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Lower leg growth rate
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Assessment method [1]
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Timepoint [1]
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Twice a week until 36 weeks post menstrual age
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Secondary outcome [1]
196
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1. Number of episodes of sepsis
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Assessment method [1]
196
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Timepoint [1]
196
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Until 36 weeks post menstrual age.
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Secondary outcome [2]
197
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2. Need for and number of blood transfusions
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Assessment method [2]
197
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Timepoint [2]
197
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Until 36 weeks post menstrual age.
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Secondary outcome [3]
198
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3. Myocardial hypertrophy
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Assessment method [3]
198
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Timepoint [3]
198
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At randomisation, 2 and 4 weeks post randomisation and 36 weeks post menstrual age.
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Secondary outcome [4]
199
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4. Cortisol level at randomisation and insulin like growth factor - 1 (IGF-1) + insulin levels.
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Assessment method [4]
199
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Timepoint [4]
199
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At randomisation, 7 and 14 days post randomisation and 36 weeks post menstrual age.
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Secondary outcome [5]
200
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5. Incidence of hypoglycaemia (blood glucose level < 2.6 mmol/l)
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Assessment method [5]
200
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Timepoint [5]
200
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Until 36 weeks post menstrual age.
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Eligibility
Key inclusion criteria
Babies <30 weeks gestation or <1500g and 2 consecutive blood glucose measurements of >8.5 mmol/l, 4 hours apart.
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Minimum age
Not stated
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Maximum age
30
Weeks
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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
Hyperglycemia secondary to an accidental overdose. Babies with major congenital malformation. Imminent death
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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)
Central randomisation by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Stratified allocation, by gender and birth weight for gestational age ( > or < 10 th centile)
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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
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/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
18/07/2005
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
88
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
327
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New Zealand
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State/province [1]
327
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Funding & Sponsors
Funding source category [1]
98
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Charities/Societies/Foundations
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Name [1]
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Auckland Medical Research Foundation
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Address [1]
98
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PO Box 110 139
Auckland Hospital
Auckland 1148,
New Zealand
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Country [1]
98
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New Zealand
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Funding source category [2]
99
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Charities/Societies/Foundations
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Name [2]
99
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Starship Foundation
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Address [2]
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Park Road
Grafton
Auckland 1023
New Zealand
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Country [2]
99
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New Zealand
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Funding source category [3]
100
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Charities/Societies/Foundations
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Name [3]
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Paykel Trust
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Address [3]
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PO Box 37 760 Parnell
Auckland 1151, New Zealand
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Country [3]
100
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Jane Alsweiler
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Address
Newborn Services, Level 9, Support Building, Auckland City Hospital, Private Bag 92024, Auckland 1023, New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Frank Bloomfield,
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Address [1]
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Newborn Services, Level 9, Support Building, Auckland City Hospital, Private Bag 92024, Auckland, New Zealand
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Country [1]
75
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New Zealand
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Secondary sponsor category [2]
76
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Individual
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Name [2]
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Professor Jane Harding
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Address [2]
76
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Vice Chancellors Office, Old Government House, Symond St,
University of Auckland, Private Bag 92019, Auckland
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Country [2]
76
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
670
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Auckland City Hospital
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Ethics committee address [1]
670
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Ethics committee country [1]
670
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New Zealand
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Date submitted for ethics approval [1]
670
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Approval date [1]
670
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Ethics approval number [1]
670
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NTX/05/06/054
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Summary
Brief summary
Many very preterm and small babies develop high blood sugar levels in the first few days to weeks after birth. Recent studies in critically ill adults with high blood sugar levels have shown that treatment with insulin to keep blood sugar levels in the normal range improved survival and reduced complications, regardless of whether the patients were diabetic or not. However, we do not know if the same is true for preterm babies. The purpose of this study is therefore to find out if babies with high blood sugar levels do better if their blood sugar level is kept in the normal range (4-6 mmol/l) with insulin treatment compared with the current practice of aiming for a blood sugar level less than 10 mmol/l. This study is a pilot study to determine if treatment is feasible in the newborn and improves growth. If successful, this would lead to a multi centre trial to determine if this treatment decreases mortality or improves neurodevelopmental outcome at 2 years of age.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
36168
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Email
36168
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Contact person for public queries
Name
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Dr Jane Alsweiler
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Address
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Newborn Services
Level 9
Support Building
Auckland City Hospital
Park Road
Grafton Auckland
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Country
10295
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New Zealand
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Phone
10295
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+64 9 3797440 ext 25365
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Fax
10295
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+64 9 3072804
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Email
10295
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[email protected]
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Contact person for scientific queries
Name
1223
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Dr Jane Alsweiler
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Address
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Newborn Services
Level 9, Support Building
Auckland City Hospital
Park Road
Grafton
Auckland
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Country
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New Zealand
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Phone
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+64 9 3797440 ext 25365
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Fax
1223
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+64 9 3072804
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Email
1223
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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
A C-Peptide-Based Model of Pancreatic Insulin Secretion in Extremely Preterm Neonates in Intensive Care.
2016
https://dx.doi.org/10.1177/1932296815596175
Embase
Long-Term Outcomes of Hyperglycemic Preterm Infants Randomized to Tight Glycemic Control.
2018
https://dx.doi.org/10.1016/j.jpeds.2017.09.081
Embase
Effects of Neonatal Hyperglycemia on Retinopathy of Prematurity and Visual Outcomes at 7 Years of Age: A Matched Cohort Study.
2020
https://dx.doi.org/10.1016/j.jpeds.2020.04.059
N.B. These documents automatically identified may not have been verified by the study sponsor.
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