Glucagon Responses During Oral- and iv Glucose in Patients With Type 1 Diabetes
Recruitment status was Active, not recruiting
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Purpose
In order to evaluate the potential role of the gastrointestinal (GI) tract in the postprandial hyperglucagonemia, which characterizes type 1 diabetes mellitus (T1DM) (as well as type 2 diabetes mellitus (T2DM)), we wish to investigate the secretion of glucagon in patients with T1DM without residual beta-cell function during 50-g oral glucose tolerance test (OGTT) and during isoglycemic iv glucose infusion. By evaluating C-peptide negative patients with T1DM we aim to describe the glucagon response to glucose (+/-stimulation of the GI tract) independently of the potentially very important regulation of glucagon secretion by endogenous insulin secretion. A more detailed understanding of the inappropriate glucagon secretion in T1DM is highly needed in order to establish new intervention strategies in the future treatment of the growing numbers of T1DM patients.
| Condition | Intervention |
|---|---|
|
Hyperglucagonemia Hyperglycemia Diabetes Mellitus |
Other: Oral glucose tolerance test Other: Isoglycemic iv glucose infusion |
| Study Type: | Observational |
| Study Design: | Observational Model: Case Control |
| Official Title: | Glucagon Responses Following Oral Glucose and Isoglycemic iv Glucose in Patients With Type 1 Diabetes - a Role for the Gastrointestinal Tract in Diabetic Hyperglucagonemia? |
- Glucagon responses (as assessed by area under curve (AUC)) during 50-g oral glucose tolerance test (OGTT) and isoglycemic iv glucose infusion, respectively. [ Time Frame: months ] [ Designated as safety issue: No ]
- Responses of glucagon-like peptide-1 (GLP-1), glucagon-like peptide-2 (GLP-2) and glucose-dependent insulinotropic polypeptide (GIP) as assessed by AUC during 50-g OGTT and isoglycemic iv glucose infusion, respectively. [ Time Frame: months ] [ Designated as safety issue: No ]
- GI-mediated glucose tolerance as assessed by the amount of glucose ingested as compared to the amount of glucose needed to mimic the OGTT curve during the iv glucose infusion. [ Time Frame: Months ] [ Designated as safety issue: No ]
Biospecimen Retention: Samples Without DNA
Plasma
| Enrollment: | 20 |
| Study Start Date: | June 2008 |
| Estimated Study Completion Date: | October 2009 |
| Estimated Primary Completion Date: | March 2009 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
1
Patients with type 1 diabetes mellitus
|
Other: Oral glucose tolerance test
50 g of waterfree glucose dissolved in 300 ml water is ingested over 5 minutes following a 10-h fast including liquids and medication (if any).
Other Names:
Other: Isoglycemic iv glucose infusion
The plasma glucose curve obtained during a 50 g-OGTT (performed on a separate day) is copied using an adjustable iv glucose infusion (20% w/v) performed following a 10-h fast including liquids and medication (if any). The iv catheter is inserted into a peripheral vein in the hand/forearm.
Other Name: Isoglycemic IVGTT
|
|
2
Healthy control subjects matched for body mass index (BMI), age and gender.
|
Other: Oral glucose tolerance test
50 g of waterfree glucose dissolved in 300 ml water is ingested over 5 minutes following a 10-h fast including liquids and medication (if any).
Other Names:
Other: Isoglycemic iv glucose infusion
The plasma glucose curve obtained during a 50 g-OGTT (performed on a separate day) is copied using an adjustable iv glucose infusion (20% w/v) performed following a 10-h fast including liquids and medication (if any). The iv catheter is inserted into a peripheral vein in the hand/forearm.
Other Name: Isoglycemic IVGTT
|
Eligibility| Ages Eligible for Study: | 18 Years to 60 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Non-Probability Sample |
Patients with type 1 diabetes mellitus and no residual beta-cell function (C-peptide negative)
Inclusion Criteria:
- Caucasian over 18 years with T1DM (diagnosed according to WHO's criteria) treated with long-acting insulin
- No residual beta-cell function (arginine test without increment in plasma C-peptide - see below)
- BMI <30 kg/m2
- Normal haemoglobin
- Informed consent
Exclusion Criteria:
- Residual beta-cell function (increment in plasma C-peptide during arginine test - see below)
- Known liver disease or affected liver enzymes (ALAT/ASAT > 2 x upper normal limit)
- Diabetic nephropathy (se-creatinin > 130 µM and/or albuminuria)
- Proliferative diabetic retinopathy (anamnestic)
- Treatment with medication that cannot be discontinued for 14 hours
Contacts and Locations| Denmark | |
| Gentofte University Hospital | |
| Hellerup, Denmark, 2900 | |
| Principal Investigator: | Filip K Knop, MD PhD | University Hospital, Gentofte, Copenhagen |
More Information
No publications provided
| Responsible Party: | Kristine Juul Hare/MD, Gentofte University Hospital, Copenhagen |
| ClinicalTrials.gov Identifier: | NCT00704795 History of Changes |
| Other Study ID Numbers: | H-D-2008-037 |
| Study First Received: | June 24, 2008 |
| Last Updated: | June 25, 2008 |
| Health Authority: | Denmark: Ethics Committee |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 1 Hyperglycemia Glucose Metabolism Disorders Metabolic Diseases Endocrine System Diseases Autoimmune Diseases Immune System Diseases |
Glucagon Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions Gastrointestinal Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on June 13, 2013