Effect of Angiotensin Receptor Blockade on Insulin Resistance and Adipose Tissue Cytokines in Type 2 Diabetes

NCT ID: NCT01011062

Last Updated: 2013-10-18

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

23 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-01-31

Study Completion Date

2009-08-31

Brief Summary

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The study aims to investigate the effect of acute angiotensin receptor blockade on insulin action/insulin resistance and expressions of selected adipocytokines in subcutaneous adipose tissue in insulin-resistant subjects with type 2 diabetes and healthy controls.

Hypothesis: Changes in adipocytokine concentrations and/or expressions and different reactions to acute in vivo induced hyperinsulinemia and angiotensin receptor blockade will be found in patients with type 2 diabetes compared to healthy subjects. A significant relationships between insulin sensitivity and selected adipokines and intracellular fat content and high energy phosphates in soleus muscle will be documented in healthy individuals, while no significant relation will be found in patients with type 2 diabetes.

Detailed Description

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10-15 patients with type 2 diabetes and 10-15 healthy control subjects will be examined on an outpatient basis. The following examination will be carried out in each subject after 12 hrs fasting:

* Oral glucose tolerance test (75 g of glucose) (in healthy subjects to confirm the normal tolerance of glucose).
* Evaluation of insulin secretion after 1 mg of glucagon i.v.
* Hyperinsulinaemic (75 milly-international unit(mIU)/l) euglycemic clamp study lasting 4 hours combined with indirect calorimetry and biopsy of subcutaneous adipose tissue.
* Hyperinsulinemic (75 mIU/l) euglycemic clamp study lasting 4 hours combined with indirect calorimetry after losartan 100 mg given in the evening and in the morning before the study.
* Proton and phosphorus magnetic resonance spectroscopy.

Before (0 min), at 30 min and in the end of studies c) and d) the blood samples will be taken and biopsies of subcutaneous abdominal adipose tissue will be done.

Conditions

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Insulin Resistance Type 2 Diabetes

Keywords

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Adipose tissue Adipokines

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Hyperinsulinaemia

Hyperinsulinaemic (1 mIU/kg/min) euglycaemic (5 mmol/l) clamp

Group Type EXPERIMENTAL

Hyperinsulinaemia

Intervention Type PROCEDURE

Hyperinsulinaemic (1 mIU/kg/min) euglycaemic (5 mmol/l) clamp

Losartan + hyperinsulinaemia

Group Type EXPERIMENTAL

Hyperinsulinaemia

Intervention Type PROCEDURE

Hyperinsulinaemic (1 mIU/kg/min) euglycaemic (5 mmol/l) clamp

Losartan

Intervention Type DRUG

Acute administration of losartan 200mg total prior to clamp

Saline

Infusion of Saline as a volume control intervention

Group Type PLACEBO_COMPARATOR

Saline

Intervention Type DRUG

Infusion of Saline as a volume control intervention

Interventions

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Hyperinsulinaemia

Hyperinsulinaemic (1 mIU/kg/min) euglycaemic (5 mmol/l) clamp

Intervention Type PROCEDURE

Losartan

Acute administration of losartan 200mg total prior to clamp

Intervention Type DRUG

Saline

Infusion of Saline as a volume control intervention

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Type 2 Diabetes treated with oral agents and/or diet
2. Healthy volunteers age- and sex-matched to type 2 diabetes, without any concomitant disease

Exclusion Criteria

1. Type 2 Diabetes

* treated with insulin
* clinical evidence of atherosclerotic complications
* advanced long-term diabetic complications (manifest nephropathy, proliferative retinopathy)
* other internal disease
* weight change \>10% 3 months prior to study
2. Healthy volunteers

* fulfilling the criteria of metabolic syndrome
* weight change \>10% 3 months prior to study
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

Yes

Sponsors

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Ministry of Health, Czech Republic

OTHER_GOV

Sponsor Role collaborator

Institute for Clinical and Experimental Medicine

OTHER_GOV

Sponsor Role lead

Responsible Party

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Diabetes Center, Institute for Clinical and Experimental Medicine

Principal Investigators

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Terezie Pelikanova, Prof., MD

Role: PRINCIPAL_INVESTIGATOR

Diabetes Center, Institute of Clinical and Experimental Medicine

Locations

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Diabetes Center, Institute of Clinical and Experimental Medicine

Prague, , Czechia

Site Status

Countries

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Czechia

Other Identifiers

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CDS01

Identifier Type: -

Identifier Source: org_study_id