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SIMPLE
CompletedPhase 4Results postedThe Effect of Simple Basal Insulin Titration, Metformin Plus Liraglutide for Type 2 Diabetes With Very Elevated HbA1c - The SIMPLE Study
The Effect of Simple Insulin Detemir Titration, Metformin Plus Liraglutide Compared to Simple Insulin Detemir Titration Plus Insulin Aspart and Metformin for Type 2 Diabetes With Very Elevated HbA1c - The SIMPLE Study: A 26 Week, Randomized, Open Label, Parallel-group, Intention to Treat Study
Lead sponsor
Asset
Liraglutide
Subcutaneous · GLP-1 agonist
Listed sites
1
Recruiting sites
—
Enrollment
157
actual
Study population
Type 2 diabetes
Key I/E criterion
•HbA1c ≥10%
Primary endpoint
•HbA1c, change
Footprint
Where this trial recruits
Site locations as reported to ClinicalTrials.gov. Site count is not enrollment count; per-site enrollment is not available from source.
Identifiers
Registered as
Timeline
Milestones
Assets
Investigational agents
Study populations
Who this study enrolls
Eligibility
Who can enroll
Inclusion criteria
1. Clinical diagnosis of type 2 diabetes with confirmed HbA1c level >10% at time of enrollment, regardless of prior or current treatment regimens, or time since diagnosis.
Exclusion criteria
1. Age <18 as the feasibility and safety of this treatment regimen should be first established in the adult population; if successful, a subsequent pediatric study will be proposed;
2. Type 1 diabetes as purposefully withholding meal-time insulin is contraindicated;
3. Clinical state requiring inpatient admission/treatment;
4. Contraindication or strong cautions to any of the study medications:
1. Creatinine above 1.4 mg/dl for women and 1.5 mg/dl for men (per metformin label)
2. History of lactic acidosis (per metformin label)
3. Advanced hepatic or cardiac disease (per metformin label)
4. Age >80 years (per metformin label)
5. Chronic alcohol use (>14 drinks/week)
6. History of pancreatitis (per liraglutide label)
7. Personal or family history of medullary thyroid cancer or MEN syndrome (per liraglutide label)
8. Pregnancy and lactation (per liraglutide label)
5. Any serious or unstable medical condition as it would interfere with treatment assignment as well as outcome measurement;
6. Any scheduled elective procedures/surgeries;
7. Active infections, including osteomyelitis;
8. Not willing to participate, unable to keep projected appointments, unwillingness to receive injectable treatment; unwillingness to perform 7-point glucose profiles over 2 consecutive days the weeks prior to Randomization (visit 1)and the week prior to visit 6
9. Non English speaking.
Endpoints (16)
What's being measured
Protocol endpoints and posted registry outcome measures, grouped into outcome categories. Composite endpoints show their component event types. Standard codes (LOINC, SNOMED CT) are shown where available.
Coverage by outcome category
Weight & body composition
2 endpointsMean Change From Randomization in Body Weight
Time frame:Week 0 (Randomization) , Week 26
Body weight, absolute change (kg)
change from baseline, improvement
Posted result
| Group | Value (mean), kilogram | 95% CI |
|---|---|---|
| Control: Metformin, Insulin Detemir, Insulin Aspart | 3.1 | 1.7 – 4.6 |
| Metformin, Insulin Determir, Liraglutide | -0.6 | -0.9 – 2.1 |
Mean Change From Randomization in Body Weight
Time frame:Week 0 (Randomization) , Week 26
Body weight, absolute change (kg)
change from baseline, improvement
Glycemic / diabetes
8 endpointsMean Change From Randomization in A1c at Week 26
Time frame:Baseline and Week 26
HbA1c, change
change from baseline, improvement
LOINC 4548-4
Posted result
| Group | Value (mean), Percentage of glycosylated hemoglobin | 95% CI |
|---|---|---|
| Control: Metformin, Insulin Detemir, Insulin Aspart | 3.4 | 2.4 – 3.7 |
| Metformin, Insulin Determir, Liraglutide | 4.1 | 3.5 – 4.8 |
Mean Change From Randomization in A1c at Week 26
Time frame:Baseline and Week 26
HbA1c, change
change from baseline, improvement
LOINC 4548-4
Composite End-point
Time frame:Week 0 (Randomization) , Week 26
threshold achievement, improvement
componentsHbA1c <7.0% achievement, Severe hypoglycemia, Body weight, % change
Posted result
| Group | Value (number), percentage of participants | 95% CI |
|---|---|---|
| Control: Metformin, Insulin Detemir, Insulin Aspart | 16 | — |
| Metformin, Insulin Determir, Liraglutide | 34 | — |
Percentage of Participants Reaching Target A1c of <7% at Week 26
Time frame:Week 26
HbA1c <7.0% achievement
threshold achievement, improvement
LOINC 4548-4
Posted result
| Group | Value (number), percentage of participants | 95% CI |
|---|---|---|
| Control: Metformin, Insulin Detemir, Insulin Aspart | 20 | — |
| Metformin, Insulin Determir, Liraglutide | 44 | — |
Percentage of Participants Reaching Pre-specified "Treatment Failure" Outcome
Time frame:week 13
threshold achievement, event
LOINC 4548-4
Posted result
| Group | Value (number), percentage of participants | 95% CI |
|---|---|---|
| Control: Metformin, Insulin Detemir, Insulin Aspart | 16.1 | — |
| Metformin, Insulin Determir, Liraglutide | 7.4 | — |
Composite End-point
Time frame:Week 0 (Randomization) , Week 26
threshold achievement, improvement
componentsHbA1c <7.0% achievement, Severe hypoglycemia, Body weight, % change
Percentage of Participants Reaching Target A1c of <7% at Week 26
Time frame:Week 26
HbA1c <7.0% achievement
threshold achievement, improvement
LOINC 4548-4
Percentage of Participants Reaching Pre-specified "Treatment Failure" Outcome
Time frame:week 13
threshold achievement, event
LOINC 4548-4
Patient-reported / QoL
4 endpointsChange in Diabetes Quality of Life (DQOL)Questionnaire Score- Least Squares Means
Time frame:Week 0 (Randomization) , Week 26
change from baseline, improvement
Posted result
| Group | Value (least_squares_mean), score on a scale | 95% CI |
|---|---|---|
| Control: Metformin, Insulin Detemir, Insulin AspartGeneral Health Perception | -0.3 | -0.6 – -0.1 |
| Current Health Perception | -0.5 | -0.9 – -0.1 |
| Treatment Satisfaction | -0.3 | -0.5 – -0.04 |
| Diabetes Related Worry | 0.03 | -0.1 – 0.2 |
| Social or Vocational Worry | -0.02 | -0.3 – 0.3 |
| Hypoglycemia Fear | 0.3 | 0.04 – 0.5 |
| Glycemic Control Perception | -1.1 | -1.6 – -0.7 |
| Satisfaction with Insulin Treatment | -1.3 | -1.8 – -0.8 |
| Willingness to Continue Insulin Treatment | -0.9 | -1.4 – -0.3 |
| LifeStyle Flexibility | -0.09 | -0.4 – 0.2 |
| Social Stigma | 0.1 | -0.2 – 0.4 |
| Metformin, Insulin Determir, LiraglutideGeneral Health Perception | -0.9 | -1.1 – -0.6 |
| Current Health Perception | -1.1 | -1.5 – -0.7 |
| Treatment Satisfaction | -0.6 | -0.8 – -0.4 |
| Diabetes Related Worry | -0.2 | -0.4 – -0.04 |
| Social or Vocational Worry | -0.2 | -0.4 – 0.08 |
| Hypoglycemia Fear | -0.2 | -0.4 – -0.005 |
| Glycemic Control Perception | -1.6 | -2.0 – -1.2 |
| Satisfaction with Insulin Treatment | -1.7 | -2.2 – -1.2 |
| Willingness to Continue Insulin Treatment | -1.1 | -1.7 – -0.6 |
| LifeStyle Flexibility | -0.2 | -0.4 – 0.1 |
| Social Stigma | 0.01 | -0.3 – 0.4 |
Change in Short Form-36 (SF-36) Questionnaire Score
Time frame:Week 0 (Randomization) , Week 26
SF-36 total
change from baseline, improvement
Posted result
| Group | Value (least_squares_mean), score on a scale | 95% CI |
|---|---|---|
| Control: Metformin, Insulin Detemir, Insulin AspartPhysical Component Summary | -0.1 | -0.4 – 0.2 |
| Mental Component Summary | 0.04 | -0.1 – 0.1 |
| Metformin, Insulin Determir, LiraglutidePhysical Component Summary | 0.007 | -0.3 – 0.3 |
| Mental Component Summary | 0.09 | -0.02 – 0.2 |
Change in Diabetes Quality of Life (DQOL)Questionnaire Score- Least Squares Means
Time frame:Week 0 (Randomization) , Week 26
change from baseline, improvement
Change in Short Form-36 (SF-36) Questionnaire Score
Time frame:Week 0 (Randomization) , Week 26
SF-36 total
change from baseline, improvement
Safety / tolerability / PK
2 endpointsHypoglycemic Episodes
Time frame:Week 0 (Randomization) , Week 2, week 4, week 13, Week 26
Documented hypoglycemia
threshold achievement, event
Posted result
| Group | Value (number), percentage of participants | 95% CI |
|---|---|---|
| Control: Metformin, Insulin Detemir, Insulin Aspart | 66.1 | — |
| Metformin, Insulin Determir, Liraglutide | 35.2 | — |
Hypoglycemic Episodes
Time frame:Week 0 (Randomization) , Week 2, week 4, week 13, Week 26
Documented hypoglycemia
threshold achievement, event
Publications (1)
Bibliography
Records linked to this trial through ClinicalTrials.gov references, PubMed NCT search, and curated study seeds. 'Canonical' marks design/result papers; others are registry references or candidates.
Registry references + supporting bibliography
- BMJ open diabetes research & care2019 (year)PMID31803482doi:10.1136/bmjdrc-2019-000761via clinicaltrials gov reference derived + pubmed nct search
Provenance
Sources
Trial facts come from public ClinicalTrials.gov records. Endpoint categories are Delfa's classification of those records, not a ClinicalTrials.gov field. All figures reflect the July 1, 2026 snapshot.