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Gluconeogenesis in Very Low Birth Weight Infants Who Are Receiving Nutrition By Intravenous Infusion

This study is currently recruiting participants.
Verified by National Center for Research Resources (NCRR), December 2003

Sponsors and Collaborators: National Center for Research Resources (NCRR)
Baylor College of Medicine
Information provided by: National Center for Research Resources (NCRR)
ClinicalTrials.gov Identifier: NCT00005889
  Purpose

RATIONALE: Very low birth weight infants have problems maintaining normal blood sugar levels. Gluconeogenesis is the production of sugar from amino acids and fats. The best combination of amino acids, fat, and sugar to help very low birth weigh infants maintain normal blood sugar levels is not yet known.

PURPOSE: Clinical trial to study how very low birth weight infants break down amino acids, fat, and sugar given by intravenous infusion, and the effect of different combinations of nutrients on the infants' ability to maintain normal blood sugar levels.


Condition Intervention
Infant, Low Birth Weight
Hyperglycemia
Drug: alanine
Drug: amino acids
Drug: glucagon
Drug: glucose
Drug: glutamine
Drug: glycerol
Drug: insulin
Drug: leucine
Drug: lipids
Drug: urea

Drug Information available for:   Insulin    Dextrose    Glucagon    Glycerol    Amino acids, branched-chain    Lipids    Glutamine    Leucine    Alanine   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Treatment
Official Title:   Study of Gluconeogenesis in Very Low Birth Weight Infants Receiving Total Parenteral Nutrition

Further study details as provided by National Center for Research Resources (NCRR):

Estimated Enrollment:   96
Study Start Date:   October 1999

Detailed Description:

PROTOCOL OUTLINE: Patients are assigned to one of 6 study groups.

Patients receive infusions of stable isotope tracers: [15N]urea IV beginning at -12 hours and continuing over 22 hours to measure protein oxidation; [U-13C]glucose IV beginning at zero hour and continuing over 10 hours to measure glucose appearance rate and gluconeogenesis; [2-13C]glycerol IV over 10 hours to measure lipolysis; and [1-C]leucine IV over 10 hours to measure proteolysis. Blood samples are obtained before the start of the urea tracer infusion; before the start of the glucose, glycerol, and leucine tracer infusions; and at study hours 4, 4.5, 5, 9, 9.5, and 10. Blood glucose is measured hourly, and patients receive glucose IV if blood glucose falls below 40 mg/dL.

Group I: Patients are randomized to one of two study arms. Arm I: Patients receive standard total parenteral nutrition (TPN), except the [U-13C]glucose is substituted for a portion of the glucose. Arm II: The infusions of lipids (Intralipid) and amino acids (TrophAmine) are discontinued at study hour zero. The infusion rate of natural glucose will be reduced during the first hour, and thereafter discontinued.

Group II: Patients are randomized to receive either TrophAmine or Intralipid IV over the last 5 hours of the study.

Group III: Patients are randomized to receive one of two different doses of glycerol IV over the last 5 hours of the study.

Group IV: Patients are randomized to receive either glutamine or alanine IV over the last 5 hours of the study.

Group V: Patients receive glucagon IV for 24 hours prior to study. Patients are then randomized to receive glucagon IV with either IV glucose alone or with Intralipid and TrophAmine IV.

Group VI: Patients who are hyperglycemic receive TPN and [U-13C]glucose as in group I, arm I, over 14 hours, and regular insulin IV at 10 hours, followed by an IV infusion of carbohydrate. Blood samples obtained between hours 4 and 5 are omitted, and are drawn instead between hours 13 and 14.

  Eligibility
Ages Eligible for Study:   up to 6 Days
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria
  • Clinically stable, very low birth weight infants (750-1,500 grams)
  • Normal blood glucose values OR Blood glucose greater than 175 mg/dL
  • No prior insulin
  • No sepsis Oxygen supply less than 30% Normal acid base status
  • No malformation
  • No discernible diseases
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00005889

Locations
United States, Texas
Baylor College of Medicine     Recruiting
      Houston, Texas, United States, 77030
      Contact: Agneta L. Sunehag     713-798-6725     asunehag@bcm.tmc.edu    

Sponsors and Collaborators

Investigators
Study Chair:     Agneta L. Sunehag     Baylor College of Medicine    
  More Information


Study ID Numbers:   NCRR-M01RR00188-0667, BCM-H7213, BCM-GCRC-0667
First Received:   June 2, 2000
Last Updated:   June 23, 2005
ClinicalTrials.gov Identifier:   NCT00005889
Health Authority:   United States: Federal Government

Keywords provided by National Center for Research Resources (NCRR):
endocrine disorders  
hyperglycemia  
low birth weight  
neonatal disorders  
rare disease  

Study placed in the following topic categories:
Birth Weight
Metabolic Diseases
Glucagon
Rare Diseases
Endocrine System Diseases
Insulin
Body Weight
Signs and Symptoms
Glycerol
Hyperglycemia
Infant, Newborn, Diseases
Endocrinopathy
Glucose Metabolism Disorders
Metabolic disorder

ClinicalTrials.gov processed this record on November 20, 2008




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