- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05581043
Pre-meals of 3-hydroxybutyrate in Type 2 Diabetes (PreKetone)
January 15, 2024 updated by: University of Aarhus
Pre-meals of 3-hydroxybutyrate for People With Type 2 Diabetes
Hyperglycemia following meals in patients with type 2 diabetes mellitus (T2DM) is a common problem.
Recently, our group found that oral consumption of the ketone metabolite, 3-hydroxybutyrate (3-OHB), effectively stimulates insulin secretion and delays gastric emptying.The aim of this study is to investigate the dose/response relationship between 3-OHB servings of 0, 10, 20 and 40 grams 30 minutes before an OGTT and, ii) investigate the role of timing by serving 20 grams of 3-OHB at different timepoints ahead of an OGTT (0, 30 and 60 minutes)
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Hyperglycemia following meals in patients with type 2 diabetes mellitus (T2DM) is a common problem, which can cause discomfort and fatigue but may also lead to diabetic complications.
Small servings of macronutrients, especially protein-rich products, before a main meal (= pre-meals) has been shown to significantly lower postprandial glucose excursions in both healthy individuals and patients with T2DM.
The reductions are primarily attributed the fact that protein stimulates insulin secretion and delays gastric emptying.
The timing and dose of a premeal are essential for the glycemic reductions following a meal 4. Unfortunately, it often requires a rather large amount of protein (> 50 g) to facilitate clinically relevant reductions in postprandial glucose levels and a large protein intake may be unwanted for some patients (i.e., chronic kidney disease).
Recently, our group found that oral consumption of the ketone metabolite, 3- hydroxybutyrate (3-OHB), effectively stimulates insulin secretion and delays gastricemptying.
We have also shown that 3-OHB inhibits gluconeogenesis 6, which may further contribute to glucose-lowering effects.
Two other clinical studies have shown that serving 3- OHB before an oral glucose tolerance test (OGTT) lowered glucose excursions in healthy volunteers and persons with impaired glucose tolerance.
There are no current data available about the effect of 3-OHB premeals in T2DM patients, but we have preliminary data from an ongoing trial showing that 30 g of 3-OHB served 40 min before a mixed meal test effectively lowers postprandial glucose levels (around 3 mM) in patients with T2DM.
The optimal dose and timing of 3-OHB pre-meals is unknown but important before initiating long-term clinical trials.
We hypothesize that pre-melas of 3-OHB will affect postprandialglucose excursions in a time-dependent matter and servings 30 minutes before an OGTT is Deleted: 4 optimal in order to lower postprandial glucose excursions.
The aim of this study is therefore to i) investigate the dose/response relationship between 3-OHB servings of 0, 10, 20 and 40 grams 30 minutes before an OGTT and, ii) investigate the role of timing by serving 20 grams of 3-OHB at different timepoints ahead of an OGTT (0, 30 and 60 minutes).
The primary endpoint is glucose trajectories following the OGTT.
This study will give important insight into the optimal dose and timing for potential future clinical long-term studies in patients with metabolic diseases (i.e., T2DM, obesity)
Study Type
Interventional
Enrollment (Actual)
10
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: Mads Bisgaard Bengtsen, MD, PhD
- Phone Number: 004529277453
- Email: madsbengtsen@clin.au.dk
Study Contact Backup
- Name: Nikolaj Rittig, MD, PhD
Study Locations
-
-
-
Aarhus, Denmark, 8200
- Department of Endocrinology and Internal Medicine
-
-
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
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Older than 18 years of age
- Type 2 diabetes diagnosis
- No antiglycemic treatment or monotherapy with metformin
Exclusion Criteria:
- Hba1c > 70
- Severe liver disease (Child-Pugh score >10) or kidney disease (eGFR< 40 ml/min)
- Anemia (Hgb < 6.5 mM)
- History with pancreatitis
- Practicing ketogenic diets (i.e., low-carb diet, fasting regime)
- Inability to understand Danish or English
- Ongoing cancer or other acute/chronic serious diseases (PI will determine)
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: Crossover Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: 0 gram 3-OHB 30 minutes before an OGTT
|
The aim of this study was therefore to i) investigate the dose/response relationship between 3-OHB servings of 0, 10, 20 and 40 grams 30 minutes before an OGTT and, ii) investigate the role of timing by serving 25 grams of 3-OHB at different timepoints ahead of an OGTT (0, 30 and 60 minutes).
|
Experimental: 10 gram 3-OHB 30 minutes before an OGTT
|
The aim of this study was therefore to i) investigate the dose/response relationship between 3-OHB servings of 0, 10, 20 and 40 grams 30 minutes before an OGTT and, ii) investigate the role of timing by serving 25 grams of 3-OHB at different timepoints ahead of an OGTT (0, 30 and 60 minutes).
|
Experimental: 20 gram 3-OHB 30 minutes before an OGTT
|
The aim of this study was therefore to i) investigate the dose/response relationship between 3-OHB servings of 0, 10, 20 and 40 grams 30 minutes before an OGTT and, ii) investigate the role of timing by serving 25 grams of 3-OHB at different timepoints ahead of an OGTT (0, 30 and 60 minutes).
|
Experimental: 40 gram 3-OHB 30 minutes before an OGTT
|
The aim of this study was therefore to i) investigate the dose/response relationship between 3-OHB servings of 0, 10, 20 and 40 grams 30 minutes before an OGTT and, ii) investigate the role of timing by serving 25 grams of 3-OHB at different timepoints ahead of an OGTT (0, 30 and 60 minutes).
|
Experimental: 20 gram 3-OHB 0 minutes before an OGTT
|
The aim of this study was therefore to i) investigate the dose/response relationship between 3-OHB servings of 0, 10, 20 and 40 grams 30 minutes before an OGTT and, ii) investigate the role of timing by serving 25 grams of 3-OHB at different timepoints ahead of an OGTT (0, 30 and 60 minutes).
|
Experimental: 20 gram 3-OHB 60 minutes before an OGTT
|
The aim of this study was therefore to i) investigate the dose/response relationship between 3-OHB servings of 0, 10, 20 and 40 grams 30 minutes before an OGTT and, ii) investigate the role of timing by serving 25 grams of 3-OHB at different timepoints ahead of an OGTT (0, 30 and 60 minutes).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Blood glucose following the OGTT
Time Frame: Blood samples will be obtained -60, -30, -15, 0, 15, 30, 45, 60, 90, 120, 150, 180 minutes from the OGTT
|
Change in blood glucose following the OGTT and compared between the different visits.
Incremental change (delta) from baseline to peak.
Measured with laboratory kits.
|
Blood samples will be obtained -60, -30, -15, 0, 15, 30, 45, 60, 90, 120, 150, 180 minutes from the OGTT
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Plasma concentrations of 3-OHB, insulin, C-peptide, glucagon like peptide-1 (GLP-1), cholecystokinin (CCK), acetaminophen, free fatty acids along others.
Time Frame: Blood samples will be obtained -60, -30, -15, 0, 15, 30, 45, 60, 90, 120, 150, 180 minutes from the OGTT
|
Incremental change (delta) from baseline to peak in plasma concentrations of 3-OHB, insulin, C-peptide, glucagon like peptide-1 (GLP-1) following the OGGT and compared between the different visits.
Measured with laboratory kits.
|
Blood samples will be obtained -60, -30, -15, 0, 15, 30, 45, 60, 90, 120, 150, 180 minutes from the OGTT
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Study Director: Niels Møller, Professor, professor
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)
January 12, 2023
Primary Completion (Actual)
January 1, 2024
Study Completion (Actual)
January 1, 2024
Study Registration Dates
First Submitted
October 4, 2022
First Submitted That Met QC Criteria
October 11, 2022
First Posted (Actual)
October 14, 2022
Study Record Updates
Last Update Posted (Actual)
January 17, 2024
Last Update Submitted That Met QC Criteria
January 15, 2024
Last Verified
October 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- V4_03052022
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Ketosis
-
University of Alabama at BirminghamCompletedExogenous KetosisUnited States
-
University Health Network, TorontoRecruiting
-
University of OxfordRecruiting
-
Instituto Nacional de Ciencias Medicas y Nutricion...American Ketone LLCRecruitingEvaluation of the Safety and Tolerability of Exogenous Ketosis Induced by Free Beta-hydroxybutyrate.Exogenous KetosisMexico
-
University of AarhusCompleted
-
Montefiore Medical CenterGlenn Foundation for Medical ResearchWithdrawnFasting | Aging Well | Autophagy | Ketosis, MetabolicUnited States
-
Baylor College of MedicineCompleted
-
Nova BiomedicalOcean Wellness CenterCompletedDiabetes Mellitus | Ketosis, DiabeticUnited States, Germany
-
Insel Gruppe AG, University Hospital BernWithdrawn
-
Bournemouth UniversityDorset HealthCare University NHS Foundation TrustCompletedMetabolic Ketosis | Cognitive Impairments, MildUnited Kingdom
Clinical Trials on 3-hydroxybutyrate (3-OHB)
-
University of AarhusCompletedHeart Failure, Systolic | KetonemiaDenmark
-
University of AarhusCompleted
-
University of AarhusAarhus University HospitalCompletedType 1 Diabetes Mellitus | Diabetic KetoacidosisDenmark
-
University of AarhusAarhus University HospitalCompletedType 2 Diabetes | Ketoses, MetabolicDenmark
-
University of AarhusCompletedHealthy | Incretin Effect | KetosisDenmark
-
University of British ColumbiaStanford UniversityCompleted
-
University of AarhusAarhus University HospitalCompleted
-
University of MichiganFarmer Family FoundationTerminatedParkinson Disease | Lewy Body Dementia | Parkinson Disease DementiaUnited States
-
University of AarhusCompleted
-
Universitair Ziekenhuis BrusselNot yet recruiting