The Effect of Rapid and Slow Glucose Fall on the Subsequent Glucose Production in People With Type 1 Diabetes (RaSlo-19)
24 de junio de 2020 actualizado por: Steno Diabetes Center Copenhagen
In the effort of better understanding the glucose control in people with type 1 diabetes, in-depth insight into the physiology of hepatic glucose production and its influencing factors is essential.
Previously, a number of potential influencing factors of hepatic glucose production have been investigated, including insulin-on-board, low carbohydrate diet, preceding ethanol intake, exercise and multiple stimulations of hepatic glucose production.
Previous post-hoc analysis of dual-hormone closed-loop systems has indicated that the rate of fall in blood glucose influences the following stimulation of hepatic glucose response.
However, the rate of fall in blood glucose is highly related to insulin levels, which may explain those findings.
Thus, in this study the investigators want to examine whether the different rates of fall in blood glucose with similar insulin levels on board affect the hepatic glucose response in individuals with type 1 diabetes.
In the study, which will be conducted at Steno Diabetes Center Copenhagen, participants will complete two study visits.
On each visit, a hypoglycemic clamp technique will be used to lower the blood glucose levels of the participants (using either a rapid or slow decline rate), whereupon hepatic glucose production will be stimulated using low-dose glucagon.
The study days are divided into four phases: 1) preparation phase, 2) hyperinsulinemic euglycemic phase (stabilization of blood glucose), 3) hyperinsulinemic hypoglycemic phase (rapid or slow decline in blood glucose) and 4) post-glucagon administration phase.
This design will allow the investigators to examine whether differences in hepatic glucose response exist depending on preceding rate of fall in blood glucose.
We hypothesize that the rate of fall in blood glucose does not affect the hepatic glucose production.
Descripción general del estudio
Estado
Terminado
Intervención / Tratamiento
Tipo de estudio
Intervencionista
Inscripción (Actual)
10
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
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Gentofte, Dinamarca, 2820
- Steno Diabetes Center Copenhagen
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Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
18 años a 70 años (Adulto, Adulto Mayor)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- Age 18-70 years
- Duration of Type 1 Diabetes ≥ 3 years
- Insulin pump use > 6 months
Exclusion Criteria:
- Use of anti-diabetic medicine (other than insulin), corticosteroids or other drugs affecting glucose metabolism during the study period or within 30 days prior to study start
- Allergy or intolerance to lactose or GlucaGen (Novo Nordisk, Bagsværd, DK)
- Use of medications that are known to cause QT interval prolongation
- Females who are pregnant, breast-feeding or intend to become pregnant or are not using adequate contraceptive methods
- Females who have different basal insulin pattern depending on their menstrual cycle
- Inability to understand the individual information and to give informed consent
- Current participation in another clinical trial that, in the judgment of the principle investigator, will compromise the results of the study or the safety of the subject
- Other concomitant medical or psychological condition that according to the investigator's assessment makes the individual unsuitable for study participation
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Ciencia básica
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación cruzada
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
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Experimental: Rapid-Slow
This arm will begin with intervention "rapid" (rapid rate of fall in plasma glucose) for the first study visit and proceed to intervention "slow" (slow rate of fall in plasma glucose) for the second study visit.
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Rapid lowering of plasma glucose using hypoglycemic clamp technique
Slow lowering of plasma glucose using hypoglycemic clamp technique
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Experimental: Slow-Rapid
This arm will begin with intervention "slow" (slow rate of fall in plasma glucose) for the first study visit and proceed to intervention "rapid" (rapid rate of fall in plasma glucose) for the second study visit.
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Rapid lowering of plasma glucose using hypoglycemic clamp technique
Slow lowering of plasma glucose using hypoglycemic clamp technique
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
|---|---|
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Positive incremental area under the glucose curve (PI-AUC) (using the plasma glucose concentration before glucagon administration as basal level)
Periodo de tiempo: from 0-120 minutes after glucagon administration
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from 0-120 minutes after glucagon administration
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Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
|---|---|
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Total area under the glucose curve (AUC)
Periodo de tiempo: from 0-120 minutes after glucagon administration
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from 0-120 minutes after glucagon administration
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Peak plasma glucose
Periodo de tiempo: from 0-120 minutes after glucagon administration
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from 0-120 minutes after glucagon administration
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Incremental plasma glucose peak
Periodo de tiempo: from 0-120 minutes after glucagon administration
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from 0-120 minutes after glucagon administration
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Time-to-peak plasma glucose
Periodo de tiempo: from 0-120 minutes after glucagon administration
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from 0-120 minutes after glucagon administration
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Plasma glucose level
Periodo de tiempo: 120 minutes after glucagon administration
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120 minutes after glucagon administration
|
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Duration of plasma glucose above 4.0 mmol/l
Periodo de tiempo: from 0-120 minutes after glucagon administration
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from 0-120 minutes after glucagon administration
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Duration of plasma glucose above baseline
Periodo de tiempo: from 0-120 minutes after glucagon administration
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from 0-120 minutes after glucagon administration
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Number of subjects who, after reaching a plasma glucose value > 3.9 mmol/l following glucagon administration, maintain a plasma glucose level in the range of 3.9-10 mmol/l
Periodo de tiempo: throughout phase 4 (until 120 minutes after glucagon administration)
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throughout phase 4 (until 120 minutes after glucagon administration)
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Number of subjects who, after reaching a PG > 3.9 mmol/l following glucagon administration, maintain a plasma glucose level in the range of 3.9-7.8 mmol/l
Periodo de tiempo: throughout phase 4 (until 120 minutes after glucagon administration)
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throughout phase 4 (until 120 minutes after glucagon administration)
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Time from glucagon administration to reaching a plasma glucose level > 3,9 mmol/l
Periodo de tiempo: from 0-120 minutes after glucagon administration
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from 0-120 minutes after glucagon administration
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Duration of a plasma glucose level in the range of 3.9-10 mmol/l
Periodo de tiempo: from 0-120 minutes after glucagon administration
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from 0-120 minutes after glucagon administration
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Duration of a plasma glucose level in the range of 3.9-7.8 mmol/l
Periodo de tiempo: from 0-120 minutes after glucagon administration
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from 0-120 minutes after glucagon administration
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Change in insulin levels (measured as area under the curve)
Periodo de tiempo: 0-120 minutes after glucagon administration
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0-120 minutes after glucagon administration
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Change in insulin levels (measured as peak change)
Periodo de tiempo: from baseline to 120 minutes after glucagon administration
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from baseline to 120 minutes after glucagon administration
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Change in glucagon levels (measured as area under the curve)
Periodo de tiempo: 0-120 minutes after glucagon administration
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0-120 minutes after glucagon administration
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Change in glucagon levels (measured as peak change)
Periodo de tiempo: 0-120 minutes after glucagon administration
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0-120 minutes after glucagon administration
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Average changes in Edinburgh Hypoglycemia Scale
Periodo de tiempo: measured at baseline, 5 minutes prior to the end of phase 2, 5 minutes prior to the end of phase 3 and 30 and 115 minutes after glucagon administration
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measured at baseline, 5 minutes prior to the end of phase 2, 5 minutes prior to the end of phase 3 and 30 and 115 minutes after glucagon administration
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Average change in visual analogue scale score for nausea, headache, stomach ache and palpitations
Periodo de tiempo: measured at baseline, 5 minutes prior to the end of phase 2, 5 minutes prior to the end of phase 3 and 30 and 115 minutes after glucagon administration
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measured at baseline, 5 minutes prior to the end of phase 2, 5 minutes prior to the end of phase 3 and 30 and 115 minutes after glucagon administration
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Number of subjects experiencing vomiting
Periodo de tiempo: from 0-120 minutes after glucagon administration
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from 0-120 minutes after glucagon administration
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Patrocinador
Colaboradores
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Actual)
12 de septiembre de 2019
Finalización primaria (Actual)
15 de enero de 2020
Finalización del estudio (Actual)
15 de enero de 2020
Fechas de registro del estudio
Enviado por primera vez
11 de septiembre de 2019
Primero enviado que cumplió con los criterios de control de calidad
20 de septiembre de 2019
Publicado por primera vez (Actual)
23 de septiembre de 2019
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
25 de junio de 2020
Última actualización enviada que cumplió con los criterios de control de calidad
24 de junio de 2020
Última verificación
1 de junio de 2020
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- H-19034585
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Sí
Tipo de información de apoyo para compartir IPD
- Protocolo de estudio
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
No
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
No
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