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Trial registered on ANZCTR
Registration number
ACTRN12610000157077
Ethics application status
Approved
Date submitted
10/02/2010
Date registered
16/02/2010
Date last updated
11/07/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Metformin in the Prevention of Gestational Diabetes: The MPG Trial
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Scientific title
Metformin in the Prevention of recurrent Gestational Diabetes: A Double-blind Randomised Trial of Metformin versus placebo in pregnant women with previous gestational diabetes to prevent recurrent gestational diabetes.
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Universal Trial Number (UTN)
U1111-1113-2319
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Trial acronym
MPG
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Recurrent gestational Diabetes
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Condition category
Condition code
Reproductive Health and Childbirth
256608
256608
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0
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Antenatal care
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Metabolic and Endocrine
256609
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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
Participants are randomised to receive placebo or extended release (XR)metformin 500mg. From the time of randomisation (between 12 and 16 weeks gestation) the participant starts on one tablet orally per day. Dose is increased by one tablet per week up to 4 tablets daily (2000mg) or as tolerated. Participants continue on this dose until delivery.
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Intervention code [1]
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Prevention
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Intervention code [2]
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Treatment: Drugs
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Comparator / control treatment
Placebo - sugar pill, dosing schedule is the same as for the intervention.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Diagnosis of recurrent Gestational Diabetes - as determined either by Oral Glucose Tolerance Test or by high blood glucose levels on home blood glucose monitoring.
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Assessment method [1]
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Timepoint [1]
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26-28 weeks and 35-36 gestation
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Secondary outcome [1]
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Pregnancy hypertensive complication (with or without proteinuria) - as adjudged by the criteria of the Australian Society for the Study of Hypertension in Pregnancy (ASSHP).
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Assessment method [1]
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Timepoint [1]
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Any stage after randomisation
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Secondary outcome [2]
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Neonatal outcomes - composite of neonatal hypoglycaemia (heel prick testing of blood glucose levels in the neonate), respiratory distress (need for oxygen), need for phototherapy (diagnosis of hyperbilirubinaemia from a blood test), birth trauma, 5 minute apgar score<7, and prematurity.
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Assessment method [2]
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Timepoint [2]
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At birth
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Secondary outcome [3]
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Fetal macrosomia and neonatal adiposity. Fetal ultrasound will be used to assess growth of baby before birth. After birth the baby will be weighed on scales and skinfold thicknesses measured using skinfold callipers.
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Assessment method [3]
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Timepoint [3]
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Measured at birth and at 6 weeks post partum (for neonatal adiposity).
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Eligibility
Key inclusion criteria
Previous gestational diabetes,
Current viable, singleton pregnancy,
Gestational age=12 weeks 0 days to 15 weeks 6 days.
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Minimum age
18
Years
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Maximum age
45
Years
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Known Type 1, Type 2 or current gestational diabetes.
Abnormal renal or liver function, hypoxic cardio-repsiratory disease, malabsorption or significant gatro intestinal disorder, excessive alcohol intake, recreational drug use in pregnancy, known fetal anomaly, multiple gestation
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Study design
Purpose of the study
Prevention
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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)
Eligible women are informed about the study. They are encouraged to discuss their participation with a family member, friend or health professional. After giving their consent potential subjects will undergo an Oral Glucose Tolerance Test (OGTT) to confirm that they do not already have recurrent gestational diabetes. Randomisation will be via telephone to central randomisation service. The subject will be randomised to intervention (metformin XR 500-2000mg) or placebo. Neither subject nor trial staff will know whether the subject is receiving placebo or metformin.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised random number generation.
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Masking / blinding
Blinded (masking 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
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/03/2010
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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
266
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
2383
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5006
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Funding & Sponsors
Funding source category [1]
256208
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Charities/Societies/Foundations
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Name [1]
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Australian Diabetes Society/Servier National Diabetes Strategy Grant
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Address [1]
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145 Macquarie Street
Sydney, NSW 2000
Tel: 61-2-9256 5462
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Country [1]
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Australia
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Funding source category [2]
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Commercial sector/Industry
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Name [2]
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Merck Serono
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Address [2]
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Merck Sante S.A.S.
37 rue Saint-Romain
69008 Lyon
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Country [2]
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France
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Funding source category [3]
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Commercial sector/Industry
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Name [3]
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Novo Nordisk Australasia
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Address [3]
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P.O. Box 7586
Baulkham Hills Business Centre
NSW 2153
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Country [3]
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Australia
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Primary sponsor type
Hospital
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Name
The Women's and Children's Hospital, a facility of the Children, Youth and Women’s Health Service Inc
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Address
72 King William Rd,
NORTH ADELAIDE SA 5006
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
251605
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Country [1]
251605
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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CYWHS Human Research Ethics Committee
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Ethics committee address [1]
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72 King William Rd, NORTH ADELAIDE SA 5006
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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20/10/2008
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Approval date [1]
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18/12/2009
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Ethics approval number [1]
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REC2117/11/11
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Summary
Brief summary
The study wishes to explore whether using metformin from early in the second trimester of pregnancy can reduce the risk of recurrence of gestational diabetes. The primary hypothesis is that "oral metformin, administered from early in the second trimester to women with a past history of gestational diabetes, will reduce the risk of recurrent gestational diabetes". Pregnant women who have had gestational diabetes in a previous pregnancy will be invited to participate. They must be between 12 and 16 weeks gestation at the time of study enrolment. Once a woman has given her informed consent she will undergo an oral Glucose Tolerance Test (oGTT) and a fasting blood sample will be stored for measurement of insulin and other hormones. Any women with a positive oGTT will not be eligible for the study and will be given appropriate counselling and treatment for her recurrent gestational diabetes (rGDM). Those who have a normal oGTT result will be eligible to have medication randomly allocated. Baseline demographic and clinical data will be collected. Women will be randomised to medication. Neither the woman nor the study team will know whether the woman is receiving active treatment or placebo. The woman will take her medication at the rate of one tablet per night for the next week. The dose will be increased by one tablet per week until a dose of four tablets a day is reached, or fewer as tolerated. Standard antenatal care will be received by all women on the study. At 26-28 weeks gestation participants will be weighed, measured and have repeat oGTT and blood sample as above. Any women found to have rGDM will continue with her study medication and receive appropriate counselling and treatment of the rGDM. At 35-36 weeks gestation the participants will again have a fasting blood sample taken, be weighed and measured. Birth of the baby will be planned in conjunction with obstetric team, depending on obstetric and medical factors present at the time. Study medication may be stopped at onset of labour or 12hours prior to a booked caesarean section. A sample of the cord blood will be collected for measurement of glucose, insulin and other hormones. The baby will receive standard care as for the baby of a diabetic mother. The baby will have standard measures done, along with some extra ones for the study. At 6 weeks after birth, the mother and baby will be measured again. The mother will undergo a repeat oGTT, as is standard for women with GDM, to determine if there is any ongoing diabetes or glucose intolerance. At this time a blood sample will again be taken for measurement of insulin and other hormones.
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Trial website
None active
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Trial related presentations / publications
Nil
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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
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Email
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Contact person for public queries
Name
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Suzette Coat
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Address
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University Department of Obstetrics and Gynaecology
72 King William Street,
NORTH ADELAIDE SA 5006
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Country
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Australia
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Phone
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+61 8 8313 1338
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Fax
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+61 8 8313 1333
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Email
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[email protected]
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Contact person for scientific queries
Name
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A/Prof W "Bill" Hague
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Address
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266 Melbourne Street,
NORTH ADELAIDE SA 5006
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Country
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Australia
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Phone
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+61 8 8361 7088
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Fax
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Email
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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
Current supporting documents:
Updated to:
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
23167
Study protocol
[email protected]
23168
Informed consent form
[email protected]
23169
Ethical approval
[email protected]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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