Does Co-administration of Lactate to an Oral Glucose Tolerance Test Lower the Glucose Response?
To investigate whether co-administration of lactate with a glucose load affects postprandial glucose levels/handling, gastrointestinal hormones, gastric emptying, and appetite sensations in individuals with pre-diabetes when compared to placebo.
Hypothesis:
Oral lactate administration improves/lowers glucose excursions following an oral glucose tolerance test (OGTT) by stimulating insulin secretion and delaying glucose absorption.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The participants will be instructed to avoid hard-to-moderate physical activity for 48 hours before each of the two trial days. They will be instructed to eat the same diet 72 hours before the two trial days at the screening visit and to register it in MyFood24 which is an electronic foodlog.
Trial days:
The two trial days will be completely alike, besides the interventions consisting of either:
- Placebo in an OGTT (300 mL salt water, NaCl) =CTR, or
- Lactate in an OGTT (300 mL lactate drink = 25 g D/L-lactate bound to Na) =LAC with a stable isotope glucose tracer (D2-glucose) added to each of the interventions to measure glucose uptake. 1500 mg of paracetamol will be added to measure ventricular emptying rate using the acetaminophen test.
An H3-glucose tracer will be continuously infused to measure glucose turnover. Glucose tolerance and absorption together with hepatic glucose production and insulin secretion will be quantified using the oral minimal model.
After this, the participant can lie in their bed. Blood samples will be collected continuously during the day. Appetite sensations will be measured by a visual analogue scale (VAS). After 4 hours the trial day is finished, and the participants can go home.
They will be instructed to collect two fecal samples after each of the trial days, which will be analysed for fecal microbiota composition (16S rRNA gene sequencing and quantitative PCR) and fecal fermentation metabolite profiles by our collaborator Clarissa Schwab.
Analyses Blood sample analyses will be made for the concentration of lactate, insulin, GLP-1, GIP, ghrelin, LEAP-2, glucagon, c-peptide, blood glucose, triglycerides, cholesterol, and other relevant metabolites and hormones. Supplementary ventricular emptying rate will be compared between CTR and LAC. [3H ]-glucose-tracer will be infused for six hours (bolus 12 mCi, infusion 0,12 mCi/min) to determine glucose metabolism.
Statistics and power calculation We will use simple paired t-tests and two-way repeated measure ANOVA analyses for comparing the two groups.
Based on a previous study we will need 12 individuals to detect a difference of 15% in integrated glucose concentrations and 40% in disposition index after the OGTT (α=0.05, β=0.80). This is similar to the effect size observed in studies investigating the treatment with a dipeptidyl peptidase-4 inhibitor (a weak insulin secretagogue).
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Natasa brkovic Zubanovic
- Phone Number: 004561698000
- Email: natasa.bz@clin.au.dk
Study Contact Backup
- Name: Esben Søndergaard
- Phone Number: 004528730943
- Email: esben.sondergaard@clin.au.dk
Study Locations
-
-
Central Jutland
-
Aarhus, Central Jutland, Denmark, 8200
- Steno Diabetes Centre, Aarhus University Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
>40 years
- Written and oral consent
- HbA1c 39-47 mmol/L
Exclusion Criteria:
- Medicine with an impact on blood glucose and glucose metabolism
- Newly started medicine (<3 months prior to the inclusion time)
- Medicine changes (<3 months prior to the inclusion time and planned changes during the trial)
- Affected screening blood sample as evaluated by PI
- Hba1c > 47
- Allergy to paracetamol
- Doesn't speak or understand Danish.
- Special diets
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: LAC
|
Lactate in an OGTT (300 mL lactate drink = 25 g D/L-lactate bound to Na) =LAC with a stable isotope glucose tracer (D2-glucose) added to measure glucose.
Placebo in an OGTT (300 mL salt water, NaCl) =CTR with a stable isotope glucose tracer (D2-glucose) added to measure glucose.
|
|
Placebo Comparator: CTR
|
Lactate in an OGTT (300 mL lactate drink = 25 g D/L-lactate bound to Na) =LAC with a stable isotope glucose tracer (D2-glucose) added to measure glucose.
Placebo in an OGTT (300 mL salt water, NaCl) =CTR with a stable isotope glucose tracer (D2-glucose) added to measure glucose.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Difference in integrated glucose concentrations between CTR and LAC following an OGTT
Time Frame: 0-240 minutes after the OGTT
|
0-240 minutes after the OGTT
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Difference in glucose absorption
Time Frame: 0-240 minutes after the OGTT
|
Oral minimal model
|
0-240 minutes after the OGTT
|
|
Difference in insulin sensitivity
Time Frame: 0-240 minutes after the OGTT
|
Oral minimal model
|
0-240 minutes after the OGTT
|
|
Difference in insulin secretion
Time Frame: 0-240 minutes
|
Oral minimal model
|
0-240 minutes
|
|
Difference in free fatty acids concentration
Time Frame: 0-240 minutes after the OGTT
|
0-240 minutes after the OGTT
|
|
|
Difference in ventricular emptying rate
Time Frame: 0-240 minutes after the OGTT
|
Acetaminophen test
|
0-240 minutes after the OGTT
|
|
Difference in subjective appetite sensation
Time Frame: 0-240 minutes after the intervention
|
VAS score
|
0-240 minutes after the intervention
|
|
Difference in integrated GLP-1 concentrations
Time Frame: 0-240 minutes after the intervention
|
0-240 minutes after the intervention
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Esben Søndergaard, Aarhus University, Steno Diabetes Center Aarhus
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- LAMETA-OGTT
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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