Defining the Decline in Endogenous Insulin Secretion in Type 1 Diabetes Diagnosed After 30 Years of Age. (DROPLeT)
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ClinicalTrials.gov Identifier: NCT04682457 |
Recruitment Status :
Recruiting
First Posted : December 23, 2020
Last Update Posted : December 23, 2020
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The study aims is to find out if people with type 1 diabetes diagnosed in later life (after age 30) have the same rapid loss of insulin secretion (measured using C-peptide) that occurs in younger adults with type 1 diabetes. The investigators will recruit 135 participants aged over 30 years with a clinical diagnosis of type 1 diabetes and diabetes duration ≤100 days. The investigators will also recruit a comparison group of 61 participants aged 18-30 with a clinical diagnosis of type 1 diabetes and diabetes duration ≤100 days. C-peptide will be measured during mixed meal tolerance tests (MMTT) performed at baseline, 6 months and a year.
This study also aims to test a new more practical way of monitoring insulin secretion at home using a finger prick 'blood spot' rather than time consuming tests in a hospital. Finger-prick C-peptide samples will be collected after the MMTT and by the participants at home throughout the year.
Condition or disease |
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Diabetes Mellitus, Type 1 Progression |
The study aims to evaluate progression of type 1 diabetes. Primary analysis will be conducted on those with >=1 diabetes autoantibody positive (GAD, IA2 ZNT8). Sensitivity analysis will be performed by repeating all analysis defining T1D as a) double antibody positivity and b) single antibody positivity combined with a high genetic risk score for T1D (T1DGRS>5th centile of a control population).
Further aims will be to evaluate the utility of dried blood spot testing to detect change in C-peptide and the utility of home test results as a marker of hypoglycaemia and glucose variability.
Study Type : | Observational |
Estimated Enrollment : | 196 participants |
Observational Model: | Case-Control |
Time Perspective: | Prospective |
Official Title: | Defining the Decline in Endogenous Insulin Secretion in Type 1 Diabetes Diagnosed After 30 Years of Age. |
Actual Study Start Date : | November 1, 2019 |
Estimated Primary Completion Date : | December 2021 |
Estimated Study Completion Date : | December 2022 |

Group/Cohort |
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Late Onset
Participants diagnosed with Type 1 diabetes at over 30 years of age.
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18 to 30
Participants diagnosed with Type 1 diabetes between 18 and 30 years of age
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- C-peptide value at a year [ Time Frame: 12 months ]12 month (Mixed Meal Tolerance Test) MMTT area under the curve (AUC) C-peptide.
- Change in C-peptide over a year [ Time Frame: 12 months ]Rate of change of MMTT AUC C-peptide over 12 months assessed at regular study visits
- C-peptide value at 12 months [ Time Frame: 12 months ]Mean C-peptide at 12 months assessed using MMTT and home blood samples
- Glucose variability & hypoglycemia [ Time Frame: 12 months ]Glucose variability & hypoglycemia as measured by continuous glucose monitoring (CGM)
- Change in dried blood spot C-peptide [ Time Frame: 12 months ]Rate of change in home dried blood spot C-peptide over 12 months
Biospecimen Retention: Samples With DNA

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
- Adults with a clinical diagnosis of Type 1 diabetes within the previous 100 days.
- Aged >30 at the time of Type 1 diabetes diagnosis OR (additional early onset Type 1 diabetes cohort) aged ≥18 and ≤30 at the time of Type 1 diabetes diagnosis.
- Insulin treated at the time of recruitment
- Able and willing to provide informed consent.
Exclusion criteria
- Pregnancy
- Known monogenic diabetes
- Known secondary diabetes (diabetes considered likely due to medication, cystic fibrosis, pancreatitis, pancreatic cancer, pancreatic surgery, hemochromatosis or Cushing's syndrome).

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04682457
Contact: Anita Hill | 01392408184 | Anita.Hill2@nhs.net | |
Contact: Peter Tippett | 01392408184 | rde-tr.DiabetesResearch@nhs.net |
United Kingdom | |
Royal Devon & Exeter NHS Foundation Trust | Recruiting |
Exeter, Devon, United Kingdom, EX2 5DW | |
Contact: Nicholas Thomas, MRCP n.thomas3@exeter.ac.uk | |
Contact: Anita Hill +44 (0) 1392 408184 Anita.Hill2@nhs.net | |
Principal Investigator: Angus G Jones, MRCP | |
Sub-Investigator: Nicholas Thomas, MRCP |
Study Director: | Angus Jones, MBBS MRCP | NIHR Exeter Clinical Research Facility | |
Principal Investigator: | Nicholas Thomas, MRCP | NIHR Exeter Clinical Research Facility |
Responsible Party: | Royal Devon and Exeter NHS Foundation Trust |
ClinicalTrials.gov Identifier: | NCT04682457 |
Other Study ID Numbers: |
2003962 |
First Posted: | December 23, 2020 Key Record Dates |
Last Update Posted: | December 23, 2020 |
Last Verified: | December 2020 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Undecided |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Diabetes Mellitus Diabetes Mellitus, Type 1 Glucose Metabolism Disorders Metabolic Diseases |
Endocrine System Diseases Autoimmune Diseases Immune System Diseases |