Effect of Short Course of Glucocorticoid in Patients With Diabetes Mellitus(DM) Type 2
NCT ID: NCT03661684
Last Updated: 2023-09-26
Study Results
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Basic Information
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COMPLETED
EARLY_PHASE1
10 participants
INTERVENTIONAL
2016-06-03
2017-07-01
Brief Summary
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Detailed Description
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On days 1 and 3 of the study period, participants will be checked into the clinic. A physical examination, including height, weight and waist circumference, and finger-stick glucose will be performed. A 75-g OGTT will be performed with venous samples for measurement of glucose, insulin and C-peptide levels obtained at 0, 30 and 60 minutes starting immediately after the ingestion of the 75 g glucose solution. After samples are collected on day 1, participants will be administered their first dose of steroid, prednisone 40 mg, and be given a packet of two additional doses for the rest of the study period. The investigators may only give 1 additional dose to them and have the participants take the last dose in clinic on day 3 two hours before the OGTT. Subjects will take prednisone 40 mg once daily for three days to be consumed around 8:00am on days 2 and 3. This dose was chosen as a typical high-dose glucocorticoid regimen. On the third day, the participants will again visit the clinic after an overnight fast of a minimum 8 hours and undergo a physical examination and OGTT just as on day 1.
Participants will be instructed to check pre-prandial (before breakfast, lunch and dinner), and bed time (around 10:00 pm) blood glucose (BG) levels and to record all values for a total of five days (three days while on prednisone and for two days after the second study visit). A member of the study staff will call each participant daily around 7:00 pm to obtain BG values. Compliance with the study protocol will be assessed at this time as well. Any subject not compliant with study medications will be excluded from the study.
Conditions
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Study Design
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NON_RANDOMIZED
SINGLE_GROUP
BASIC_SCIENCE
NONE
Study Groups
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Prednisone in subjects with Diabetes
Group of subjects with diabetes mellitus type 2 receiving prednisone 40 mg po q day for 3 days
Prednisone
40 mg po q day of Prednisone for 3 days
Prednisone in control subjects
Group of subjects without diabetes mellitus type 2 receiving prednisone 40 mg po q day for 3 days
Prednisone
40 mg po q day of Prednisone for 3 days
Interventions
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Prednisone
40 mg po q day of Prednisone for 3 days
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
2. Type 2 Diabetes for ≤ 1 year and only on metformin
3. BMI 24.0-35.0 kg/ m2
4. HBA1c ≤ 9.0%
1. Males or non-pregnant females between the ages of 18-50 years in good physical health as determined by medical history, physical examination, and screening blood tests
2. Normoglycemia defined by fasting plasma glucose \< 5.6 mmol/L (or 100 mg/dL) and 2h glucose \<7.8 mmol/L (or 140 mg/dL) after a 75 g OGTT
3. BMI: 22.0 - 28.0 kg/m2
Exclusion Criteria
2. Patients with impaired renal function (estimated Glomerular Filtration Rate (GFR) less than 60 ml/min based on results from Cerner).
3. Patient who have received glucocorticoid therapy within six months of study.
4. Patients who do shift work.
5. Blood glucose level ≥ 250 mg/dl on finger-stick at clinic visit.
6. Signs or symptoms of infection.
Control Group
1. Presence of any disease or use of any medication
2. Patients with a first-degree relative with Type 2 Diabetes
3. Patients who smoke
4. Patients with history of steroid use in previous 6 months.
5. Patients who do shift work
6. Signs or symptoms of infection.
7. Patients with recent changes in weight or physical activity
18 Years
50 Years
ALL
Yes
Sponsors
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Cook County Health
OTHER_GOV
Responsible Party
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Yannis Guerra
Endocrinology Attending
References
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Donihi AC, Raval D, Saul M, Korytkowski MT, DeVita MA. Prevalence and predictors of corticosteroid-related hyperglycemia in hospitalized patients. Endocr Pract. 2006 Jul-Aug;12(4):358-62. doi: 10.4158/EP.12.4.358.
Hwang JL, Weiss RE. Steroid-induced diabetes: a clinical and molecular approach to understanding and treatment. Diabetes Metab Res Rev. 2014 Feb;30(2):96-102. doi: 10.1002/dmrr.2486.
van Raalte DH, Brands M, van der Zijl NJ, Muskiet MH, Pouwels PJ, Ackermans MT, Sauerwein HP, Serlie MJ, Diamant M. Low-dose glucocorticoid treatment affects multiple aspects of intermediary metabolism in healthy humans: a randomised controlled trial. Diabetologia. 2011 Aug;54(8):2103-12. doi: 10.1007/s00125-011-2174-9. Epub 2011 May 12.
Shah M, Adel MM, Tahsin B, Guerra Y, Fogelfeld L. Effect of short-term prednisone on beta-cell function in subjects with type 2 diabetes mellitus and healthy subjects. PLoS One. 2020 May 5;15(5):e0231190. doi: 10.1371/journal.pone.0231190. eCollection 2020.
Other Identifiers
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16-035
Identifier Type: -
Identifier Source: org_study_id
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