- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01786707
Autologous Stem Cell and Hyperbaric Oxygen Therapy in Type 2 Diabetes Mellitus (HOT)
Phase 2 Study of Autologous Stem Cell and Hyperbaric Oxygen Therapy in Type 2 Diabetes Mellitus
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a phase I/II, prospective, randomized case controlled study in patients with Type 2 Diabetes Mellitus (T2DM) that seeks to investigate whether the combination of intrapancreatic Autologous Stem Cell infusion (ASC) and Hyperbaric Oxygen treatment (HBO) can improve glycemic control and pancreatic function in T2DM patients compared to controls receiving standard medical treatment (SMT) with metformin and insulin alone.
New therapies that lead to stopping ß-cell damage and possible ß-cell regeneration may decrease the incidence and progression of T2DM chronic complications and together with achievable life style changes may improve general health and quality of life of T2DM patients. Preliminary data from a pilot study involving 25 subjects with T2DM that underwent a combined treatment using ASC+HBO showed a significant progressive and consistent reduction in plasma glucose and HbA1c with an increase in C-peptide in conjunction with a decrease in the number and dose of oral agents and/or insulin. These encouraging preliminary results require confirmation in a controlled, randomized prospective trial.
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
Florida
-
Miami, Florida, United States, 33136
- Diabetes Research Institute, University of Miami Miller School of Medicine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Male and female patients age 45 to 65 years of age.
- Ability to provide written informed consent.
- Mentally stable and able to comply with the procedures of the study protocol.
- Clinical history compatible with type 2 diabetes as defined by the Expert Committee on the Diagnosis and classification of Diabetes Mellitus.
- Onset of Type 2 DM disease at 40 years of age.
- T2DM duration: 2-15 years at the time of enrollment.
- Basal C-peptide: 0.3 ng/mL
- HbA1c of 7.5-12.5% before standard medical therapy. Patients must have been treated with SMT for minimum of 4 months prior to randomization. Insulin and metformin doses should be stable over the 3 months prior to randomization.
- HbA1c: 7.5-9.5% at time of randomization.
- Total insulin daily dose at baseline and at randomization <100 units/day.
Exclusion Criteria:
- BMI >40 kg/m2.
- Insulin requirements of >100 U/day, and HbA1c >9.5%
- C-reactive protein >10.00
- Uncontrolled blood pressure: Systolic Blood Pressure >140 mmHg or Diastolic Blood Pressure >80 mmHg Evidence of renal dysfunction, serum creatinine > 1.5 mg/dl (males) and 1.4 mg/dl (females)
- Proteinuria >300 mg/day
- History or EKG evidence of myocardial infarction or any degree of heart failure
- Female participants: Positive pregnancy test, presently breast-feeding, or unwillingness to use effective contraceptive measures for the duration of the study. Male participants: intent to procreate 3 months before or after the intervention or unwillingness to use effective measures of contraception.
- Active infection including hepatitis B, hepatitis C, HIV, or Tuberculosis. Positive tests are acceptable only if associated with a history of previous vaccination in the absence of any sign of active infection.
- Known active alcohol or substance abuse including cigarette/cigar smoking
- Baseline Hgb below the lower limits of normal at the local laboratory; lymphopenia (<1,000/L), neutropenia (<1,500/L), or thrombocytopenia (platelets <100,000/L).
- A history of Factor V deficiency or other coagulopathy defined by International normalized ratio (INR) >1.5, Partial thromboplastin time (PTT) >40, Prothrombin time (PT) >15.
- Acute or chronic pancreatitis.
- Symptomatic peptic ulcer disease.
- Hyperlipidemia despite medical therapy
- Receiving treatment for a medical condition requiring chronic use of systemic corticosteroids in the past six months.
- Symptomatic cholecystolithiasis.
- Use of any investigational agents within 4 weeks of enrollment.
- Admission to hospital for any reason in the 14 days prior to enrollment.
- History or presence of active proliferative diabetic retinopathy or macular edema.
- Any malignancy.
- Hepatic enzyme levels upper normal limits.
- Total bilirubin upper normal limits unless secondary to known benign condition.
- Abdominal aortic aneurysm.
- History of cerebro-vascular accident.
- Any patient with acute or subacute decompensation from diabetes.
- Any acute or chronic infectious condition that in the criteria of the investigator would be a risk for the patient.
- Hypoproteinemia, cachexia or terminal states; history of anorexia/bulimia; respiratory insufficiency; history of chronic sinusitis (sinusitis lasting more than 8 weeks in the past year) or recurrent acute sinusitis (sinusitis lasting more than 4 weeks more than four times in the past year.
- Any contraindication to hyperbaric oxygen treatment.
- Subjects treated with any medication that could interfere with the outcome of the study.
- Subjects positive for auto-antibodies
- History of Cushing syndrome (endogenous or iatrogenic).
- History of allergy to iodine or iodinated materials.
- Abnormal thyroid function
- Any medical condition that, in the opinion of the investigator, will interfere with the safe completion of the trial.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Autologous SC and HOT
Autologous stem cells and hyperbaric oxygen therapy
|
Pancreatic artery infusion of Autologous Stem cells.
Insulin dose as per clinical management
Metformin dose as tolerated
|
Active Comparator: Control group
Patients in a control group will continue with standard medical treatment (Insulin and Metformin)
|
Insulin dose as per clinical management
Metformin dose as tolerated
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Number of Participants With a Reduction of HbA1c of >0.5%
Time Frame: 1 year
|
1 year
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The Number of Subjects With a Reduction of >1% in HbA1c
Time Frame: at 1 year
|
at 1 year
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Rodolfo Alejandro, MD, Diabetes Research Institute, University of Miami Miller School of Medicine
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 20070881
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
Clinical Trials on Type 2 Diabetes Mellitus
-
SanofiCompletedType 1 Diabetes Mellitus-Type 2 Diabetes MellitusHungary, Russian Federation, Germany, Poland, Japan, United States, Finland
-
Mannkind CorporationTerminatedType 2 Diabetes Mellitus | Type 1 Diabetes MellitusUnited States
-
RWTH Aachen UniversityBoehringer IngelheimCompletedDiabetes Mellitus Type 2 (T2DM)Germany
-
Griffin HospitalCalifornia Walnut CommissionCompletedDIABETES MELLITUS TYPE 2United States
-
University Hospital Inselspital, BerneCompletedType 2 Diabetes MellitusSwitzerland
-
India Diabetes Research Foundation & Dr. A. Ramachandran...CompletedTYpe 2 Diabetes MellitusIndia
-
Scripps Whittier Diabetes InstituteSan Diego State UniversityCompletedType 2 Diabetes Mellitus (T2DM)United States
-
AstraZenecaRecruiting
-
Daewoong Pharmaceutical Co. LTD.Not yet recruitingT2DM (Type 2 Diabetes Mellitus)
-
Zhongda HospitalRecruitingType 2 Diabetes Mellitus (T2DM)China
Clinical Trials on Autologous stem cells
-
Hospital Universitario Dr. Jose E. GonzalezCompleted
-
University College, LondonUnknownTendinopathy | Achilles Tendinitis | Achilles Degeneration | Achilles Tendinitis, Right Leg | Achilles Tendon Thickening | Achilles Tendinitis, Left LegUnited Kingdom
-
Losordo, Douglas, M.D.WithdrawnMyocardial Ischemia | Cardiovascular Disease | Congestive Heart FailureUnited States
-
Mayo ClinicNational Institute of Neurological Disorders and Stroke (NINDS); Food and Drug...Active, not recruiting
-
Mashhad University of Medical SciencesCompleted
-
University of JordanCompletedOsteoarthritis, Knee | Articular Cartilage Disorder of KneeJordan
-
Clínica Las Condes. LIT INNOVA CORFOUnknownSpinal Cord InjuryChile
-
Mayo ClinicCompletedAmyotrophic Lateral SclerosisUnited States
-
Karolinska InstitutetCompleted
-
Imperial College LondonCompletedType 1 Diabetes | Type 2 DiabetesUnited Kingdom