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Metabolic Adaptation to Diabetes

This study has been completed.
VA Office of Research and Development
Juvenile Diabetes Research Foundation
Information provided by (Responsible Party):
Steve Davis, Vanderbilt University Identifier:
First received: August 8, 2008
Last updated: December 10, 2014
Last verified: December 2014
Hypoglycemia or low blood sugar is a very serious complication that diabetics experience. This is of great concern because there is a lack of available information of how Non Insulin Dependent Diabetic Mellitus patients (NIDDM) defend themselves against a low blood sugar. This is particularly disturbing since NIDDM patients are likely to require intensive treatment, and as a result, the risks of severe hypoglycemia to the NIDDM patient increase. The current proposal aims to provide information on how NIDDM patients can defend themselves against hypoglycemia, thus decreasing their risks for this severe complication.

Condition Intervention
Type 2 Diabetes Procedure: glucose clamp

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Metabolic Adaptation to Diabetes

Further study details as provided by Steve Davis, Vanderbilt University:

Primary Outcome Measures:
  • HbA1c [ Time Frame: 6 months ]

Secondary Outcome Measures:
  • Catecholamines [ Time Frame: 6 months ]

Enrollment: 15
Study Start Date: February 1998
Study Completion Date: December 2008
Primary Completion Date: March 2000 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
Baseline clamp study before treatment phase.
Procedure: glucose clamp
Hyperinsulinemic Hypoglycemic clamp
Active Comparator: 2
Final clamp experiment after 6 months intensive therapy.
Procedure: glucose clamp
Hyperinsulinemic Hypoglycemic clamp

Detailed Description:
There is very little data available on the neuroendocrine response to hypoglycemia in intensively treated (sulfonylurea or insulin) NIDDM patients. The data that are available on the neuroendocrine response to hypoglycemia in NIDDM patients were obtained under conditions following a single IV bolus of insulin or single SQ regular insulin injection. The neuroendocrine response following a large IV bolus of insulin differs greatly from the clinical paradigm of a slow progression into hypoglycemia. Therefore, clinically relevant data cannot be obtained from short experiments involving rapid changes in plasma glucose levels and insulinemia. Furthermore, a comparison between neuroendocrine responses to hypoglycemia in NIDDM and normal man is not available due to the fact that glycemia has never been equally controlled. In short, virtually nothing is known about the neuroendocrine response to hypoglycemia in these subjects. This is of great concern as following the positive outcome of the Kumamato study, large numbers of NIDDM subjects are going to receive intensive therapy with all its altendent risks of severe hypoglycemia. The Kumamato study was a trial in NIDDM patients to determine if intensive therapy reduces tissue complications of diabetes. Similar to the results of the Diabetes control and complications trial in IDDM patients the Kumamato study proved that intensive therapy in NIDDM patients also prevents diabetic tissue complications. Therefore, the goals of this study are 1) to define in greater detail how the body defends itself against hypoglycemia in NIDDM patients and 2) to determine if differing levels of insulin affect hypoglycemic counterregulation in NIDDM patients.

Ages Eligible for Study:   30 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • Healthy male and female subjects aged 30-65 years
  • Male and female non-insulin-dependent diabetic patients, sulfonylurea and/or Metformin aged 30-65 years

Exclusion Criteria:

  • Prior or current history of poor health
  • Abnormal results following screening tests
  • Pregnancy
  Contacts and Locations
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Please refer to this study by its identifier: NCT00732862

Sponsors and Collaborators
Vanderbilt University
VA Office of Research and Development
Juvenile Diabetes Research Foundation
Principal Investigator: Stephen N Davis, MD Vanderbilt University
  More Information

Responsible Party: Steve Davis, Chairman of Medicine, University of Maryland, Baltimore, Vanderbilt University Identifier: NCT00732862     History of Changes
Other Study ID Numbers: IRB#8842-NIDDM
Study First Received: August 8, 2008
Last Updated: December 10, 2014

Keywords provided by Steve Davis, Vanderbilt University:
Type 2 diabetes
intensive therapy

Additional relevant MeSH terms:
Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucose Metabolism Disorders
Metabolic Diseases
Endocrine System Diseases processed this record on June 23, 2017