- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00153179
Free Fatty Acids and Vascular Function in Subjects With Diabetes
The Impact of Free Fatty Acid Reduction on Vascular Function and Skeletal Muscle Glucose Utilization in Type 2 Diabetes Mellitus
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
During the past two decades, there has been a steady increase in the incidence of diabetes mellitus, such that nearly 17 million people are now afflicted. The vast majority of these have type 2 diabetes. Over the next 40 years, the type 2 diabetic population in the United States is expected to increase to nearly 30 million.
Diabetes substantially increases the risk of atherosclerosis, and thereby, cardiovascular morbidity and mortality. Indeed, cardiovascular disease causes more than 50% of the mortality in patients with diabetes. People with type 2 diabetes manifest two cardinal signs of dysmetabolism: hyperglycemia and insulin resistance. Insulin resistance is a progressive phenomenon that occurs well before the onset of frank diabetes, and results in alterations in insulin signaling. Experimental studies suggest that insulin signaling is required for vascular homeostasis, and its impairment is associated with endothelial dysfunction. In the clinical setting, insulin resistance is associated with atherosclerosis and predicts cardiovascular events independent of hyperglycemia. Therefore, we will study the importance of insulin signaling in endothelial biology in humans and the effects of free fatty acids on endothelial function in people with type 2 diabetes.
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02115
- Brigham & Women's Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- type 2 diabetes mellitus (as defined by the National Diabetes Data Group)
- normal cardiovascular exam
- non smoker (for 1 year prior to entry)
- Healthy volunteers
- no known medical problems
- normal cardiovascular exam
- fasting glucose < 110 mg/dL
- non-smoker (for 1 year prior to entry)
Exclusion Criteria:
Type 2 Diabetics
- untreated hypertension (>140/90 mmHg)
- untreated hypercholesterolemia (LDL > 75th percentile for age)
- cigarette smoking within 1 year
- neuropathy requiring medication
- nephropathy (> 300mg/24 hour urinary albumin, or serum creatinine > 1.4 mg/dL
- abnormal cardiovascular exam
- treatment with thiazolidinedione within 1 year
- post-menopausal women taking hormone replacement therapy
(Note: subjects taking angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) must stop these medications for 2 weeks prior to taking study drug. If blood pressure rises to >140/90, subjects will be prescribed an alternative medication or be withdrawn from the study.
Healthy Volunteers
- abnormal cardiovascular exam
- use of prescription medications
- fasting glucose > 110mg/dL
- cigarette smoking within 1 year
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: 1
Acipimox treatment for 7 days
|
subjects will receive acipimox 250 mg orally every 6 hours (or matching placebo) for 7 days, including a dose at 6am on the morning of the study testing visit
Other Names:
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Placebo Comparator: 2
placebo treatment for 7 days
|
matching placebo
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Flow-mediated Dilation After Placebo or Acipimox Treatment Between Healthy Controls and Those With Metabolic Syndrome
Time Frame: 7 days
|
Flow mediated dilation is calculated as follows: A resting arterial diameter measurement is obtained using the average of 10 EKG-gated ultrasound images.
Next, an occlusive pressure is applied (using a blood pressure cuff inflated to a suprasystolic pressure)for a period of 5 minutes.
After 5 minutes, the cuff is rapidly deflated.
This produces a reactive hyperemic response which is captured via ultrasound at 1 minute post cuff deflation (also 10 EKG-gated images averaged).
The diameter of the artery following reactive hyperemia is calculated and compared to the resting diameter to obtain a percent dilation.
This is flow-mediated dilation.
|
7 days
|
Difference in Insulin-mediated Skeletal Muscle Glucose Utilization Between Test Agent and Placebo
Time Frame: baseline, 7 days
|
Insulin sensitivity (M) is measured by using a hyperinsulinaemic-euglycaemic clamp.
Insulin sensitivity (M) was calculated as the average glucose infusion rate (mg/kg of body weight per min) over the last 30 min of the clamp.
Higher values indicate better outcomes (more insulin sensitive), while lower values indicate more insulin resistance.
|
baseline, 7 days
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Mark Creager, M.D., Brigham and Women's Hospital
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2005P-000088
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.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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