The Effect of Insulin-induced Hypoglycaemia on Gut-derived Glucagon Secretion (Px-Hypo)

NCT ID: NCT04064203

Last Updated: 2019-08-21

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

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-07-05

Study Completion Date

2018-09-20

Brief Summary

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The overall objective of this study is to investigate whether hypoglycaemia (the most potent stimulus of pancreatic glucagon secretion) affects the secretion of gut-derived glucagon in totally pancreatectomized patients.

Detailed Description

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The investigators want to assess the plasma glucagon response to insulin-induced hypoglycaemia in totally pancreatectomised patients and at the same time evaluate whether hypoglycaemia affects a range of other products from endocrine cells in the gastrointestinal tract including ghrelin, gastrin, cholecystokinin (CCK), glucose-dependent insulinotropic polypeptide (GIP), GLP-1, glucagon-like peptide-2 (GLP-2), oxyntomodulin and peptide YY (PYY). Furthermore the investigators will evaluate how hypoglycaemia in these patients affects other counter-regulatory mechanisms including plasma responses of the hormones adrenaline, noradrenaline, growth hormone and cortisol as well as the rate of gastric emptying rate (which under normal circumstances accelerates during hypoglycaemia) during an oral glucose tolerance test (OGTT).

Conditions

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Diabetes After Total Pancreatectomy

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

12 totally pancreatectomized patients and 12 healthy control subjects
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Totally pancreatectomized patients

Oral glucose tolerance test + insulin-induced hypoglycaemic clamp followed by an oral glucose tolerance test

Group Type EXPERIMENTAL

Oral glucose tolerance test

Intervention Type OTHER

50 grams OGTT

Clamp experiment

Intervention Type OTHER

insulin-induced hypoglycaemic clamp followed by an 50 grams OGTT

Healthy controls

Oral glucose tolerance test + insulin-induced hypoglycaemic clamp followed by an oral glucose tolerance test

Group Type EXPERIMENTAL

Oral glucose tolerance test

Intervention Type OTHER

50 grams OGTT

Clamp experiment

Intervention Type OTHER

insulin-induced hypoglycaemic clamp followed by an 50 grams OGTT

Interventions

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Oral glucose tolerance test

50 grams OGTT

Intervention Type OTHER

Clamp experiment

insulin-induced hypoglycaemic clamp followed by an 50 grams OGTT

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Pancreatectomised patients

* Caucasian above 30 years of age who have undergone total pancreatectomy
* Blood haemoglobin \>7.0 mmol/l for males and \>6.5 mmol/l for females Non-diabetic control subjects
* Normal fasting plasma glucose and normal HbA1c (according to the World Health Organization (WHO) criteria)
* Normal blood haemoglobin
* Caucasian above 30 years of age
* BMI (body mass index) 17-30
* Informed consent

Exclusion Criteria

Pancreatectomised patients

* Pancreatectomy within the last 3 months
* Ongoing chemotherapy or chemotherapy within the last 3 months
* Previous or ongoing treatment with GLP-1 receptor agonists or dipeptidyl peptidase 4 (DPP-4) inhibitors
* Inflammatory bowel disease
* Gastrointestinal resection (other than the gastro-duodenectomy performed in connection with total pancreatectomy) and/or ostomy
* Nephropathy (eGFR\<60 and/or albuminuria)
* Known liver disease (excluding non-alcoholic fatty liver disease) and/or serum alanine aminotransferase (ALAT) and/or serum aspartate aminotransferase (ASAT) \>3 × normal values)
* Severe lung disease
* Pregnancy and/or breastfeeding
* Age above 85 years
* Uncontrolled hypertension and/or significant cardiovascular disease
* Any condition that the investigator feels would interfere with trial participation Non-diabetic control subjects
* Diabetes or prediabetes (according to WHO criteria)
* First-degree relatives with diabetes
* Inflammatory bowel disease
* Gastrointestinal resection and/or ostomy
* Nephropathy (serum creatinine \>150 µmol/l and/or albuminuria)
* Known liver disease (excluding non-alcoholic fatty liver disease) and/or serum ALAT and/or serum ASAT \>3 × normal values)
* Severe lung disease
* Pregnancy and/or breastfeeding
* Age above 85 years
* Uncontrolled hypertension and/or significant cardiovascular disease
* Any condition that the investigator feels would interfere with trial participation
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Copenhagen

OTHER

Sponsor Role collaborator

University Hospital, Gentofte, Copenhagen

OTHER

Sponsor Role lead

Responsible Party

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Filip Krag Knop

Consultant endocrinologist, Professor of

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Center for Clinical Metabolic Research

Hellerup, Capital Region, Denmark

Site Status

Countries

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Denmark

Other Identifiers

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H-17014216

Identifier Type: -

Identifier Source: org_study_id

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