Role of Exenatide in Type 1 Diabetes
The Role of Exenatide in Type 1 Diabetes Mellitus
研究概览
详细说明
A large study in people with type 1 diabetes (T1DM) showed that lowering blood sugars stopped or delayed the occurrence of health problems. As a result of the study, treatment should try to control blood sugars as near to normal as safely possible.
In people without diabetes, the "after meal" blood sugar level is very carefully controlled. Insulin (the hormone that lowers blood sugar) and glucagon (hormone that raises blood sugar) play a key role in keeping this careful balance. It is now known that a substance made by the body called GLP-1 also helps with this careful balance. Glucagon like peptide-1 works in four ways. First, it helps to stimulate the cells in the pancreas to produce more insulin. Secondly, it helps to "dampen" the glucagon response (glucagon is released after a meal and causes the blood sugar to rise). Thirdly, Glucagon like peptide-1 delays the digestion of food in the stomach. Lastly, it seems to "dampen" the appetite, which causes a person to eat less.
Exenatide is a medication that works very similar to Glucagon like peptide-1. Exenatide is FDA approved for use in adults.
Study Design: Followed by a baseline study with insulin alone, subjects were randomized to two different doses of exenatide (1.25 and 2.5 µ,g), administered in a double-blinded randomized controlled manner, along with insulin as a single subcutaneous injection. Studies were at least 3 weeks apart.
Baseline: At 0800 h, the pre-breakfast insulin bolus was administered based on patient's usual insulin-to-carbohydrate ratio. Post-bolus, subjects drank 12 ounces of a standard liquid meal (Boost High Protein Drink, 360 calories, 50 g carbohydrates, and 12 g fat), enriched with 1 g of [13C] glucose within 10 min. Breath samples for 13CO2 analysis were collected in duplicates at 17 time points until 1300 h. Usual insulin basal rates or glargine were maintained during study.
On the days subjects received the study drug of 1.25 µ,g (~0.02 µ,g/kg) or 2.5 µ,g (~0.04 µ,g/kg) exenatide along with insulin, the prandial insulin was reduced by 20%.
Measurements: Plasma glucose was measured using a bedside YSI glucose analyzer (2300 Stat Plus; Yellow Springs Instruments, Yellow Springs, OH) throughout the study at regularly timed intervals. Delta plasma glucose area under the curve (AUC0 -120) was measured for the exenatide treated groups vs. insulin monotherapy.
研究类型
注册 (实际的)
阶段
- 阶段2
联系人和位置
学习地点
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Texas
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Houston、Texas、美国、77030
- Texas Children's Hospital/ Baylor College of Medicine
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
***Subjects must be patients of the Texas Children's Hospital Diabetes Care Center***.
All of the following criteria must be met:
- Between 12-21 years of age at the time of enrollment.
- Have been diagnosed with Type 1 diabetes for at least 1 year and in good control (HbA1C less than 8.5%).
- Subjects must be otherwise healthy except for the Type 1 Diabetes and treated hypothyroidism.
- Menstruating women must have a negative pregnancy test.
- Hemoglobin equal to or greater than 12 g/dL before each study.
- Weight greater than 44 kg.
- Tanner stage greater than 3
Exclusion Criteria:
- Any chronic disease: leukemia, asthma, inflammatory bowel disease, cystic fibrosis, juvenile rheumatoid arthritis etc or on treatment that might directly or indirectly affect glucose homeostasis, except for diabetes and hypothyroidism; stable on medications.
- Lack of a supportive family environment as detected by the clinicians and/or social workers.
- Positive pregnancy test in menstruating young women.
- BMI greater than 90th percentile for age or less than 10th percentile for age.
- Lactating and nursing mothers.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:交叉作业
- 屏蔽:双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:Exenatide 1.25 mcg + Insulin
In each intervention arm the participant receives a different dose of Exenatide along with Insulin as a single subcutaneous injection
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In each intervention arm the participant receives a different dose (1.25 or 2.5 mcg) of exenatide.
其他名称:
Each subject received a baseline study with insulin alone
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实验性的:Exenatide 2.5 mcg + Insulin
In each intervention arm the participant receives a different dose of Exenatide along with Insulin as a single subcutaneous injection
|
In each intervention arm the participant receives a different dose (1.25 or 2.5 mcg) of exenatide.
其他名称:
Each subject received a baseline study with insulin alone
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有源比较器:Insulin
Each subject received a baseline study with insulin alone
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Each subject received a baseline study with insulin alone
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Mean Plasma Glucose Area Under the Curve (AUC) for Blood Glucose Concentration in the Exenatide 1.25 mcg or Exenatide 2.5 mcg Treated Groups Along With Insulin, Compared to Insulin Alone
大体时间:0-120 minutes post-dose
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Post-prandial blood glucose concentration in terms of mean AUC (0-120 min) was determined in subjects treated with either Exenatide 1.25 mcg or Exenatide 2.5 along with insulin, compared to insulin alone, given as a single subcutaneous injection
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0-120 minutes post-dose
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合作者和调查者
调查人员
- 首席研究员:Rubina Heptulla, MD、Montefiore Medical Center
出版物和有用的链接
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
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