- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05501483
Adipose Tissue Heterogeneity and Its Link to Type 2 Diabetes (DiaSpax)
October 2, 2023 updated by: Mikael Ryden, Karolinska Institutet
Adipose Tissue Heterogeneity and Its Link to Type 2 Diabetes: A Randomized Open Intervention Study That Compares Empagliflozin, Pioglitazone and Semaglutide
People with newly diagnosed type 2 diabetes treated with metformin that have not reached their HbA1c target (49-64 mmol/mol) will be recruited to the study.
If they fulfill the inclusion and none of the exclusion criteria, they will be, after signing informed consent, randomized to a six-month intervention with either pioglitazone, empagliflozin or semaglutide.
Fat biopsies are obtained from the subcutaneous abdominal area before and after a hyperinsulinemic-euglycemic clamp at baseline and after six months.
Participants are regularly followed during this the intervention.
The overall goal is to determine how antidiabetic-drugs affect white adipose tissue cellularity and whether adipose heterogeneity impacts on drug response.
The primary outcome measure is the change in fat tissue lipolysis (glycerol release in isolated fat cells after hormone stimulation) before and after treatment.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
A detailed description of the protocol has been approved by the Swedish Medical Products Agency and the study is registered as EudraCT: 2021-002367-21.
Study Type
Interventional
Enrollment (Estimated)
60
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Mikael Ryden, MD, PhD
- Phone Number: +46736995215
- Email: mikael.ryden@ki.se
Study Contact Backup
- Name: Jesper Bäckdahl, MD, PhD
- Phone Number: +46702297237
- Email: jesper.backdahl@ki.se
Study Locations
-
-
-
Stockholm, Sweden, 14186
- Recruiting
- Karolinska University Hospital
-
Contact:
- Jesper Bäckdahl, MD, PhD
- Phone Number: +46702297237
- Email: jesper.backdahl@ki.se
-
Contact:
- Mikael Rydén, MD, PhD
- Phone Number: 0736995215
- Email: mikael.ryden@ki.se
-
Sub-Investigator:
- Niklas Mejhert, PhD
-
Sub-Investigator:
- Daniel P Andersson, MD, PhD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
30 years to 65 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Signed informed consent
- BMI 27-35 kg/m2
- HbA1c 48 mmol/mol or higher
- For fertile women, effective contraception
Exclusion Criteria:
- HbA1c 65 mmol/mol or higher
- Established cardiovascular disease and/or heart failure
- Severe psychiatric condition
- Active alcoholism
- Insulin treatment
- Anticoagulant therapy (vitamin K antagonists or equivalent)
- Pregnancy, lactation
- Positive GAD or IA2 antibodies
- Low C-peptide/glucose ratio (less than 2 measured as pmol/mg per dL)
- NT-proBNP above the upper normal reference value
- Kidney disease
- Liver disease or hepatic values over twice the upper reference value
- Severe concomitant disease including ongoing cancer
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Pioglitazone
Pioglitazone is known to affect fat cells and is used as an active comparator.
It reduces HbA1c but increase fat mass slightly.
We hypothesize that pioglitazone may have particular benefits in individuals with a specific adipose cellularity.
|
Starts with 45 mg
|
Experimental: Empagliflozin
Empagliflozin reduces HbA1c and increase lipolysis possibly due to increased glucagon secretion.
It also reduces fat mass weight to a minor degree.
|
Starts with 25 mg
|
Experimental: Semaglutide
Semaglutide reduces body weight, including fat mass, to a more significant degree than empagliflozin but has no known direct effects on adipose tissue.
|
Starts with 3 mg daily for the first 2 weeks
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in fat cell lipolysis after 6 months of treatment
Time Frame: Baseline and after six months intervention
|
Change in isoprenaline-induced (over basal) lipolysis in isolated fat cells
|
Baseline and after six months intervention
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in fat cell heterogeneity after 6 months of treatment
Time Frame: Baseline and after six months intervention
|
Changes in the adiponectin/leptin mRNA expression ratio in adipose tissue measured by quantitative PCR
|
Baseline and after six months intervention
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in tissue cellularity after 6 months of treatment (explorative outcome)
Time Frame: Baseline and after six months intervention
|
Changes in adipose tissue cellularity measured by single-cell transcriptomic analyses of fat tissue biopsies
|
Baseline and after six months intervention
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 8, 2023
Primary Completion (Estimated)
September 1, 2024
Study Completion (Estimated)
December 31, 2032
Study Registration Dates
First Submitted
August 10, 2022
First Submitted That Met QC Criteria
August 11, 2022
First Posted (Actual)
August 15, 2022
Study Record Updates
Last Update Posted (Actual)
October 3, 2023
Last Update Submitted That Met QC Criteria
October 2, 2023
Last Verified
October 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Karolinska University Hospital
- 2021-002367-21 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
IPD Plan Description
According to the ethical approval, we are not allowed to share participant data that can allow identification of the individual participants.
We will present data at a group level and anonymized data in the publications that are planned to result from this study.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
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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