GPR119 Agonist for Hypoglycemia in Type 1 Diabetes

NCT ID: NCT04432090

Last Updated: 2024-10-17

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

110 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-04-21

Study Completion Date

2023-08-12

Brief Summary

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The purpose of this study is to test if a specific research medication could increase the response to low blood glucose in people with type 1 diabetes. The response of the body to low blood sugar will be measured in healthy people as a reference point.

Detailed Description

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This is a placebo-controlled, double-blinded, within-subject, cross-over phase 2a study. In randomized order, (Latin square, randomly assigned to placebo-active and active-placebo periods) and in a double-blinded manner, the participants with T1D received 14 days of daily dosing with MBX-2982 (or placebo), taken at the same time each day after breakfast. The last dose of treatment/placebo was given when the glucose tracer infusion for the euglycemic/hypoglycemic-glucose clamp started. Participants with T1D underwent two euglycemic-hypoglycemic clamps (induction of controlled hypoglycemia by an insulin infusion), using a within-subject cross-over design, with the two clamps separated by approximately four weeks, that is, two weeks of drug washout followed by two weeks of treatment with the alternative therapy. Glucagon, hepatic glucose production and other counter-regulatory hormonal responses were assessed during hypoglycemia. After completion of the first clamp study, participants did not receive any study medication for two weeks (washout phase) and then begin 14 days of the other arm (placebo or MBX-2982) in a double-blinded manner, followed by a repeat euglycemic-hypoglycemic clamp study. During treatment on each arm and during wash out phase, a blinded CGM was used to assess daily and nocturnal patterns of glycemia. On the day preceding a clamp study, while admitted to the research unit, a standardized meal test was used to assess fasting and postprandial glucagon, GLP-1 and GIP secretion. A healthy normal volunteer cohort with no diabetes was enrolled in the study for 14 days for comparison of normal responses to insulin induced hypoglycemia.

Conditions

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Diabetes Mellitus, Type 1

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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MBX-2982 first then placebo- Volunteers with Type 1 diabetes

Participants with type 1 diabetes (T1D) will be randomized to either study medication or placebo group. In this arm, participants will receive a pill that contains the study medication (MBX-2982). This will be followed by a wash-out period and a cross over to the second study period in which they will receive a pill that does not contain the medication (placebo).

Group Type EXPERIMENTAL

Placebo

Intervention Type DRUG

Each group will receive either a pill that contains the study medication (MBX-2982) or a pill that does not contain the medication (placebo)

Study Medication (MBX-2982)

Intervention Type DRUG

Each group will receive either a pill that contains the study medication (MBX-2982) or a pill that does not contain the medication (placebo)

Healthy Volunteers

This group will not receive any medication. It will be studied to establish the norm of the measurement that will be performed to obtain the study outcomes.

Group Type ACTIVE_COMPARATOR

No medication for this group

Intervention Type OTHER

This group will be studied to establish the norm of the measurement that will be performed to obtain the study outcomes.

Placebo first then MBX-2982- Volunteers with Type 1 diabetes

Participants with type 1 diabetes (T1D) will be randomized to either study medication or placebo group. In this arm, participants will receive a pill that does not contain the medication (placebo). This will be followed by a wash-out period and a cross over to the second study period in which they will receive a pill that contains the study medication (MBX-2982).

Group Type EXPERIMENTAL

Placebo

Intervention Type DRUG

Each group will receive either a pill that contains the study medication (MBX-2982) or a pill that does not contain the medication (placebo)

Study Medication (MBX-2982)

Intervention Type DRUG

Each group will receive either a pill that contains the study medication (MBX-2982) or a pill that does not contain the medication (placebo)

Interventions

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Placebo

Each group will receive either a pill that contains the study medication (MBX-2982) or a pill that does not contain the medication (placebo)

Intervention Type DRUG

Study Medication (MBX-2982)

Each group will receive either a pill that contains the study medication (MBX-2982) or a pill that does not contain the medication (placebo)

Intervention Type DRUG

No medication for this group

This group will be studied to establish the norm of the measurement that will be performed to obtain the study outcomes.

Intervention Type OTHER

Other Intervention Names

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MBX-2982 MBX-2982

Eligibility Criteria

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Inclusion Criteria

Type 1 diabetes cohort:

1. Age 20-60 years
2. Diagnosis of T1DM according to American Diabetes Association (ADA) criteria continuously requiring insulin for survival
3. Diabetes diagnosis performed more than 5 years before enrollment
4. Fasting C-peptide levels \< 0.7 ng/mL with a concurrent plasma glucose concentration \> 90 mg/dL (Labs may need to be repeated if the Plasma glucose is \< 90 mg/dL)
5. For female participants: must be \> 6 months post-partum and not lactating and agrees not to become pregnant during the study and for at least 2 weeks after the last dose of the study medication. For male participants: agrees not to donate sperm or not to get a woman pregnant during the study and for at least 2 weeks after the last dose of the study medication.

Healthy subject cohort:

1. Age 20-60 years
2. General good health
3. Creatinine clearance \>80 mL/min based on CKD-EPI equation
4. Fasting blood glucose (FBG) \>70 mg/dL and \<100 mg/dL
5. No history of diabetes
6. For female participants: must be \> 6 months post-partum and not lactating and agrees not to become pregnant during the study

Exclusion Criteria

1. BMI \>35 kg/m2 and \<18.5 kg/m2 for females and BMI \>35 kg/m2 and \<20 kg/m2 for males.
2. Increase or decrease body weight greater than 3kg in the 3 months before enrollment.
3. Evidence by history, ECG or exams of clinically significant cardiovascular disease (unstable angina, myocardial infarction or coronary revascularization within 6 months, clinically significant abnormalities on ECG, presence of cardiac pacemaker, implanted cardiac defibrillator)
4. Evidence of autonomic neuropathy
5. Liver disease (AST or ALT \>2.5 times the upper limit of normal)
6. Kidney disease (creatinine \>1.6 mg/dl or estimated GFR \<60 ml/min).
7. Dyslipidemia, including triglycerides \>500 mg/dl, LDL \>200 mg/dl or unstable hyperlipidemia. Treatment with a single lipid lowering agents is allowed if stable within the previous 3 months.
8. Anemia (hemoglobin \<12 g/dl in men, \<11 g/dl in women)
9. Thyroid dysfunction (suppressed TSH, elevated TSH \<10 µIU/ml if symptomatic or elevated TSH \>10 µIU/ml if asymptomatic)
10. Uncontrolled hypertension (BP \>160 mmHg systolic or \>100 mmHg diastolic) or treatment with more than 2 antihypertensive medications.
11. Current use of beta-adrenergic blocking agents or their use was stopped less than one month before recruitment
12. History of cancer within the last 5 years (skin cancers, with the exception of melanoma, may be acceptable)
13. History of organ transplant
14. History of HIV, active Hepatitis B or C, or Tuberculosis
15. Pregnancy, lactation or 6 months postpartum from the scheduled date of screening lab collection
16. Females of childbearing potential (any female except those with tubal ligation, hysterectomy, or absence of menses \>2 years) unwilling to use an approved method of contraception (one medically accepted method of contraception with ≥99% effectiveness when used consistently and correctly). Male participants: he or he and his partner unwilling to use an approved method of contraception with ≥99% effectiveness when used consistently and correctly
17. History of Major Depression in the last 5 years
18. History of an eating disorder
19. History of bariatric surgery
20. History of drug or alcohol abuse (\> 3 drinks per day) within the last 5 years
21. Self-report of marijuana use ≥3 days/week in any form
22. Psychiatric disease prohibiting adherence to study protocol
23. Current use of oral or injectable anti-hyperglycemic agents: metformin, sulfonylureas, DPP IV inhibitors, SGLT-2 inhibitors, thiazolidinediones, acarbose, GLP-1 analogs
24. Initiation or change in hormone replacement therapy within the past 3 months (including, but not limited to thyroid hormone or estrogen replacement therapy). Hormone based contraception is acceptable.
25. Use of any medications known to influence glucose, fat and/or energy metabolism (e.g., growth hormone therapy, glucocorticoids \[steroids\], prescribed medications for weight loss, etc.). Patients on medications with acute effects on glucose metabolism used for other indications (certain antidepressants, ADHD and antiepileptic medications) may be enrolled if they have been on chronic, stable doses (≥6 months)
26. Uncontrolled seizure disorder
27. Current night shift worker
28. Presence of any condition that, in the opinion of the Investigator, compromises participant safety or data integrity or the participant's ability to complete study visits
29. Unwilling and/or unable to follow and comply with scheduled visits and protocol requirements


1. HbA1c \>9%
2. Insulin dose less than 0.3 U/kg or low carbohydrate diet
3. History of T2DM or any form of diabetes other than T1DM
4. Hypoglycemia unawareness as assessed using the GOLD score
5. Using a predictive low blood glucose suspend mode on an insulin pump or a hybrid closed loop algorithm for insulin delivery. For those applying these strategies for everyday management of blood glucose and willing to participate, the algorithm will be stopped at enrollment.
6. Two or more episodes of severe hypoglycemia (Hypoglycemia requiring help from a third party) per month in the past six months
7. One or more DKA episodes in the past 3 months
8. QTcF \>450 msec for males and \>470 msec for females
9. Using non-insulin agents to control blood glucose levels
10. History or evidence of moderate or severe end-organ diabetic complications of retinopathy, nephropathy or neuropathy. Proliferative diabetic retinopathy. Non-proliferative retinopathy and microalbuminuria will be allowed.


1\. Insulin treatment
Minimum Eligible Age

20 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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AdventHealth Translational Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Richard Pratley, MD

Role: PRINCIPAL_INVESTIGATOR

Study Principal Investigator

Locations

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AdventHealth Translational Research Institute

Orlando, Florida, United States

Site Status

Countries

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United States

References

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Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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1552172

Identifier Type: -

Identifier Source: org_study_id