Meal-time Administration of Exenatide for Glycaemic Control in Type 1 Diabetic Cases (MAG1C)
Meal-time Administration of Exenatide for Glycaemic Control in Type 1 Diabetic Cases: A Randomised, Placebo-controlled Trial
Patients with type 1 diabetes (T1D) depend on insulin therapy as substitution for the lack of endocrine insulin production due to an autoimmune destruction of beta-cells in the pancreatic inslets. Insulin therapy is based on long lasting basal insulin for controlling fasting plasma glucose, and short lasting mealtime insulin for the postprandial plasma glucose. The long term efficacy of this treatment is measured in glycated haemoglobin A1c (HbA1c) of <7.0% as the treatment goal.
Intensive insulin therapy is associated with side effects such as hypoglycaemia, weight gain, and unwanted exaggerated excursions in PPG. This may ultimately affect treatment compliance.
The abovementioned problems associated with insulin treatment in T1D can also be seen in insulin-treated patients with type 2 diabetes (T2D). However, in T2D the combination of insulin with glucagon-like peptide-1 (GLP-1) receptor agonist (RA) has proven effective in reducing the weight gain and insulin dose in insulin-treated patients with T2D without exacerbating the risk of hypoglycaemia.
Exenatid is a short lasting GLP-1RA approved for treatment in T2D, and the investigators intend to evaluate it in a randomized, controlled trial as add-on therapy to standard insulin therapy for patients with T1D.
The investigators hypothesise that the add-on of exenatide to insulin therapy in patients with T1D will reduce insulin requirements, glycaemic excursions and body weight and improve glycaemic control without increasing the risk of hypoglycaemia.
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Studietype
Studietype
Registrering (Faktiske)
Registrering
Fase
Fase
- Fase 2
Kontakter og plasseringer
Studiesteder
-
-
Capital Region
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Gentofte, Capital Region, Danmark, 2820
- Steno Diabetes Center Copenhagen
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-
Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Beskrivelse
Inclusion Criteria:
- T1D according to WHO criteria with duration of ≥1 year
- Age ≥18 years
- BMI >22.0 kg/m2
- HbA1c >7.5% and <10.0% at visit 0 (screening)
- Able to count carbohydrates
Exclusion Criteria:
- Insulin pump treatment
- Hypoglycaemia unawareness (inability to register low blood glucose)
- Diabetic gastroparesis
- Compromised kidney function (eGFR <60 ml/min/1.73m2, dialysis or kidney transplantation)
- Liver disease with elevated plasma alanine aminotransferase (ALT) > three times the upper limit of normal (measured at visit 0 with the possibility of one repeat analysis within a week, and the last measured value as being conclusive)
- History of acute and/or chronic pancreatitis
- Subjects with personal or family history of medullary carcinoma or MEN syndrome
- Inflammatory bowel disease
- Cancer unless in complete remission for >5 years
- Proliferative retinopathy
- Other concomitant disease or treatment that according to the investigator's assessment makes the patient unsuitable for study participation
- Alcohol/drug abuse
- Fertile women not using chemical (tablet/pill, depot injection of progesterone, subdermal gestagen implantation, hormonal vaginal ring or transdermal hormonal patch) or mechanical (spirals) contraceptives
- Pregnant or nursing women
- Known or suspected hypersensitivity to trial product or related products
- Receipt of an investigational drug within 30 days prior to visit 0
- Simultaneous participation in any other clinical intervention trial
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Firemannsrom
Antall våpen
Våpen og intervensjoner
Deltakergruppe / ArmDeltakergruppe / Arm |
Intervensjon / BehandlingIntervensjon / Behandling |
|---|---|
|
Eksperimentell: Intervention
Exenatide 10 mikrogram, thrice daily, subcutaneous injection prior to main meals, 6 months.
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Andre navn:
|
|
Placebo komparator: Placebo
Placebo, thrice daily, subcutaneous injection prior to main meals, 6 months.
|
Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in HbA1c
Tidsramme: 6 months
|
Change in HbA1c from baseline to end of study (time 6 months)
|
6 months
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
adverse events (including hypoglycaemic episodes)
Tidsramme: 6 months
|
6 months
|
|
|
changes in insulin dosage
Tidsramme: 6 months
|
6 months
|
|
|
changes in body weight
Tidsramme: 6 months
|
6 months
|
|
|
changes in BMI
Tidsramme: 6 months
|
6 months
|
|
|
changes in body composition
Tidsramme: 6 months
|
DXA scan measuring bonemineral density
|
6 months
|
|
changes in body composition
Tidsramme: 6 months
|
DXA scan measuring lean mass
|
6 months
|
|
changes in body composition
Tidsramme: 6 months
|
DXA scan measuring fat mass
|
6 months
|
|
changes in fasting plasma glucose
Tidsramme: 6 months
|
6 months
|
|
|
changes in post prandial plasma glucose
Tidsramme: 6 months
|
6 months
|
|
|
changes in fasting plasma levels of C-peptide
Tidsramme: 6 months
|
6 months
|
|
|
Quality of life self reported
Tidsramme: 6 months
|
Quality of Life Questionaire
|
6 months
|
|
Treatment satisfaction
Tidsramme: 6 months
|
Diabetes treatment satisfactory questionnaire status version
|
6 months
|
|
Treatment satisfaction
Tidsramme: 6 months
|
Diabetes treatment satisfactory questionnaire change version
|
6 months
|
|
dietary patterns
Tidsramme: 6 months
|
Food frequency questionaire three times during the intervention
|
6 months
|
|
HDL (High Density Lipoprotein)
Tidsramme: 6 months
|
6 months
|
|
|
LDL (Low Density Lipoprotein)
Tidsramme: 6 months
|
6 months
|
|
|
VLDL (Very Low Density Lipoprotein)
Tidsramme: 6 months
|
6 months
|
|
|
totalt kolesterol
Tidsramme: 6 måneder
|
6 måneder
|
|
|
triglycerides
Tidsramme: 6 months
|
6 months
|
|
|
proBNP (Pro-Brain Natriuretic Peptide)
Tidsramme: 6 months
|
6 months
|
|
|
hsCRP (High-Sensitivity C-Reactive Protein)
Tidsramme: 6 months
|
6 months
|
Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Samarbeidspartnere
Samarbeidspartnere
Publikasjoner og nyttige lenker
Generelle publikasjoner
- Johansen NJ, Dejgaard TF, Lund A, Vilsboll T, Andersen HU, Knop FK. Protocol for Meal-time Administration of Exenatide for Glycaemic Control in Type 1 Diabetes Cases (The MAG1C trial): a randomised, double-blinded, placebo-controlled trial. BMJ Open. 2018 Jun 27;8(6):e021861. doi: 10.1136/bmjopen-2018-021861.
- Johansen NJ, Dejgaard TF, Lund A, Schluntz C, Frandsen CS, Forman JL, Wewer Albrechtsen NJ, Holst JJ, Pedersen-Bjergaard U, Madsbad S, Vilsboll T, Andersen HU, Knop FK. Efficacy and safety of meal-time administration of short-acting exenatide for glycaemic control in type 1 diabetes (MAG1C): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2020 Apr;8(4):313-324. doi: 10.1016/S2213-8587(20)30030-9. Epub 2020 Mar 2.
Studierekorddatoer
Studer hoveddatoer
Studiestart
Studiestart
Primær fullføring (Faktiske)
Primær fullføring
Studiet fullført (Faktiske)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
- Glukosemetabolismeforstyrrelser
- Metabolske sykdommer
- Sykdommer i immunsystemet
- Autoimmune sykdommer
- Sykdommer i det endokrine systemet
- Sukkersyke
- Diabetes mellitus, type 1
- Hypoglykemiske midler
- Fysiologiske effekter av legemidler
- Hormoner
- Hormoner, hormonsubstitutter og hormonantagonister
- Midler mot fedme
- Inkretiner
- Exenatid
Andre studie-ID-numre
Andre studie-ID-numre
- Eudract-nr.: 2016-001365-92
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