Hyperinsulinemic Euglycemic Clamp Protocol

Inclusion Criteria:

• Subjects will be considered eligible for entry in the study if they meet all of the following criteria.

  1. Adult male
  2. Age range 30-65 years at screening
  3. Caucasian or Indian ethnicity
  4. Waist circumference ≥ 102 cm for Caucasians and ≥ 90 cm for Indians at screening.
  5. Fasting Serum Insulin ≥ 10 mU/ml at screening
  6. Blood Pressure ≥ 130/85 mmHg at screening (or patients taking medication for hypertension)
  7. Stable weight during 3 months prior to the study (assessed through medical history of the patient)
  8. Drug naive diabetic patients* or patients with impaired fasting glucose i.e > 100 mg/dl or 5.5 mmol/l and < 200 mg/dl or 11.0 mmol/l Diabetic patients who were taking metformin and have undergone washout for at least 4 weeks before Day 0 and are currently on life style modification as a treatment for diabetes will also be allowed in the study

  9. Willingness to give written informed consent (prior to any study-related procedures being performed) and ability to adhere to the study restrictions and assessments schedule.

     • Diabetic patient is defined as a patient with a documented history of type II DM or a documented history of a fasting glucose > 200mg/dl or 11.0 mmol/l or 2x fasting glucose > 126 mg/dl or 6.9 mmol/l (2x =recorded twice).

Exclusion Criteria:

• Subjects will not be considered eligible for entry in the study if they meet one or more of the following criteria.

  1. Medical history, physical examination, vital signs, clinical laboratory tests, 12-lead ECG and Chest X ray (to exclude tuberculosis in India only) with any significant abnormalities, in the opinion of the investigator.
  2. Subjects with any known somatic illness, including neoplasm, endocrine disorder such as cushing's disease, PCOD and uncontrolled hypothyroidism, neurologic disorder, active infection, or recent surgical procedure within 3 months of the study initiation.
  3. Subject currently using medication, which can influence glucose or FFA metabolism such as fibrates, niacin, ACE inhibitors, PPAR agonists, omega 3 fatty acids.
  4. eGFR < 60 mL/min/1.73m2 at screening as evaluated by Modification of Diet in Renal Disease (MDRD) method.
  5. History of angina, Myocardial Infarction (MI) or stroke since last 6 months.
  6. Hypertension with SBP/DBP ≥160/100 mmHg at screening.
  7. ALT or AST ≥ ULN*3 at screening
  8. History or presence of malignancy.
  9. History of recreational drug use within the last 30 days, or regular consumption of greater than 2 units of alcohol/day.
  10. History of allergy to the test drug or any drug chemically similar to the drug under investigation.
  11. Seropositive for Hepatitis B, Hepatitis C or HIV.
  12. Subjects suffering from any psychiatric (acute or chronic) illness.
  13. Intake of any medication except those permitted in this study (see Section 6.6).
  14. Intake of any investigational drug in the period within 3 months prior to the first dose of study drug.
  15. History of significant blood loss due to any reason, including blood donation, in the 12 weeks prior to the first dose of study drug; or the total blood loss in the last 3 months, including for this study, exceeds 450 mL.
  16. History of any bleeding disorder.
  17. Existence of any surgical or medical condition which, in the judgment of the principal investigator, might interfere with the absorption, distribution, metabolism or excretion of the study drug or might be likely to compromise the safety of the subject.
  18. Inability to communicate or co-operate with the investigator because of language problems, poor mental development or impaired cerebral function.
  19. Inability to comply with study requirements.
  20. Positive drugs of abuse test (at screening) and alcohol breath test.
  21. Heavy smokers (who are smoking >15 cigarettes or equivalent per day).