The Prospective Evaluation of Pancreatic Function in Pancreas Transplant Recipients

NCT ID: NCT00571818

Last Updated: 2023-10-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

31 participants

Study Classification

INTERVENTIONAL

Study Start Date

2000-11-01

Study Completion Date

2010-06-01

Brief Summary

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The purpose of this study is to understand how the pancreas functions after transplantation and particularly why high blood sugar levels develop. It will also analyze the effect of the medicines used to prevent rejection on blood sugar levels.

The hypothesis to be tested is that hyperglycemia more than six months after successful pancreas transplant results from a defect in insulin secretion, insulin resistance, or both.

Detailed Description

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Type I diabetes mellitus (DM1) is an autoimmune disease characterized by destruction of the insulin-secreting beta cells. Insulin replacement has been the cornerstone of therapy for patients with DM1. However, pancreas transplantation, utilizing the whole pancreas as a means to replace the destroyed beta cells, has become a therapeutic alternative. The goal of pancreas transplantation is the establishment of long-term euglycemia, thereby preventing or allowing for the repair of end-organ complications.

Maintenance of the pancreas allograft over many years remains the goal in following pancreas transplant recipients over time. The onset of hyperglycemia less than one year after transplant is usually due to issues of surgical technique or acute rejection. However, the onset of hyperglycemia after one year of pancreas transplant is more problematic because the underlying causes are less clear and have been less well characterized. Currently, there is no protocol for definitively identifying the causes of hyperglycemia in pancreas transplant recipients over one year. This project will systematically characterize beta cell function and peripheral tissue response to insulin in patients who have received an earlier successful pancreas transplant who have developed hyperglycemia.

Conditions

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Transplant Diabetes

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Euglycemic pancreas transplant recipients

Participants receiving a pancreas transplant who have blood glucose level is within the normal range

Group Type ACTIVE_COMPARATOR

Oral glucose tolerance test

Intervention Type PROCEDURE

test done over 2 hours

IV Glucose Tolerance Test

Intervention Type PROCEDURE

Done over 4 hours

Hyperglycemic pancreas transplant recipients

Participants receiving a pancreas transplant who have high blood glucose (blood sugar)

Group Type ACTIVE_COMPARATOR

Oral glucose tolerance test

Intervention Type PROCEDURE

test done over 2 hours

IV Glucose Tolerance Test

Intervention Type PROCEDURE

Done over 4 hours

Euglycemic Kidney Transplant Recipients

Participants receiving a kidney transplant who have blood glucose level is within the normal range

Group Type ACTIVE_COMPARATOR

Oral glucose tolerance test

Intervention Type PROCEDURE

test done over 2 hours

IV Glucose Tolerance Test

Intervention Type PROCEDURE

Done over 4 hours

Euglycemic Healthy Control Participants

Participants who do not receive either a pancreas or kidney transplant who have blood glucose level is within the normal range

Group Type ACTIVE_COMPARATOR

Oral glucose tolerance test

Intervention Type PROCEDURE

test done over 2 hours

IV Glucose Tolerance Test

Intervention Type PROCEDURE

Done over 4 hours

Interventions

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Oral glucose tolerance test

test done over 2 hours

Intervention Type PROCEDURE

IV Glucose Tolerance Test

Done over 4 hours

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Hyperglycemic pancreas transplant recipients:

* ages 19-65
* received a pancreas transplant ≥ 9 months previously
* fasting glucose levels ≥ 126 mg/dl
* hemoglobin A1C \> 1% above normal
* Euglycemic pancreas transplant recipients:

* ages 19-65
* received a pancreas transplant ≥ 9 months previously
* fasting glucose levels are \< 126 mg/dl
* normal HbA1C without taking any medications for the treatment of high blood sugars.
* Euglycemic Kidney Transplant Recipients:

* ages 19-65
* no prior diagnosis of diabetes
* received a kidney transplant ≥ 9 months previously
* showing continued function
* Euglycemic Healthy Control Subjects:

* ages 19-65
* no diabetes or renal disease

Exclusion Criteria

* Hyperglycemic pancreas transplant recipients:

* chronic illnesses that would decrease insulin sensitivity (
* terminal illness
* BMI \> 30 kg/m2
* serum creatinine \> 2 mg/dl
* hemoglobin \< 10 g/dl
* an episode of acute rejection with the preceding 3 months of entry.
* Euglycemic pancreas transplant recipients:

* no diagnosis of type 2 diabetes.
* Euglycemic Kidney Transplant Recipients:

* Euglycemic Healthy Control Subjects:

* chronic illnesses
* medications known to affect glucose metabolism
* a history of smoking
* serum creatinine ≥ 1.5 mg/dl
* BMI \> 30 kg/m2.
Minimum Eligible Age

19 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Nebraska

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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James T Lane, MD

Role: PRINCIPAL_INVESTIGATOR

University of Nebraska

Locations

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University of Nebraska Medical Center

Omaha, Nebraska, United States

Site Status

Countries

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United States

Other Identifiers

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0114-00-FB

Identifier Type: -

Identifier Source: org_study_id

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