Validation of a 13C Glucose Breath Test Compared With the Euglycaemic Clamp Test

NCT ID: NCT04623320

Last Updated: 2022-03-18

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

UNKNOWN

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-10-27

Study Completion Date

2023-03-31

Brief Summary

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Insulin resistance can be assessed by the euglycaemic clamp technique. To date, this is the golden standard, but it is not suited for clinical practice. A 13C glucose breath test will be tested as a valid alternative. The curve of the exhaled 13C CO2 as a function of glucose metabolism can be correlated to the curve of the glucose disposal rate obtained via the clamp technique.

Detailed Description

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The hyperinsulinemic-euglycemic clamp technique is the golden standard to assess insulin resistance in type 1 diabetes subjects. The plasma insulin concentration is acutely raised and maintained at 100 μU/ml by a continuous infusion of insulin. Meanwhile, the plasma glucose concentration is held constant at basal levels by a variable glucose infusion. When the steady-state is achieved, the glucose infusion rate equals glucose uptake by all the tissues in the body and is therefore a measure of tissue insulin sensitivity.

These data will be compared with the results of a 13C glucose breath test. Breath tests using 13C substrates are based on the principle that 13C CO2 in the exhaled breath can be measured as a metabolic tracer.

Breath testing has a major advantage over the clamp test in that it can be performed non-invasively and repeatedly without necessary supervision by medical staff.

Conditions

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Insulin Resistance Type 1 Diabetes

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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NAFLD+T1DM+

Subjects with type 1 diabetes and ultrasound-defined NAFLD

euglycaemic clamp test

Intervention Type DIAGNOSTIC_TEST

clamp test (golden standard) to determine insulin resistance

13C glucose breath test

Intervention Type DIAGNOSTIC_TEST

13C glucose breath test to compare with the golden standard

NAFLD-T1DM+

Subjects with type 1 diabetes without ultrasound-defined NAFLD

euglycaemic clamp test

Intervention Type DIAGNOSTIC_TEST

clamp test (golden standard) to determine insulin resistance

13C glucose breath test

Intervention Type DIAGNOSTIC_TEST

13C glucose breath test to compare with the golden standard

Interventions

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euglycaemic clamp test

clamp test (golden standard) to determine insulin resistance

Intervention Type DIAGNOSTIC_TEST

13C glucose breath test

13C glucose breath test to compare with the golden standard

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Adult type 1 diabetes patients
* 25/50 subjects with confirmed NAFLD (using ultrasound criteria)

Exclusion Criteria

* pregnancy
* gastric bypass surgery
* cirrhosis
* secondary cause of liver steatosis present
* any cause which makes a 4-hour clamp impossible
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Antwerp

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Christophe De Block, Prof.

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Antwerp

Locations

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Antwerp University Hospital

Antwerp, , Belgium

Site Status RECRUITING

Countries

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Belgium

Central Contacts

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Jonathan Mertens, M.D.

Role: CONTACT

+32 821 74 03

Maria Braspenning, nurse

Role: CONTACT

+32 821 40 02

References

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Hussain M, Jangorbhani M, Schuette S, Considine RV, Chisholm RL, Mather KJ. [13C]glucose breath testing provides a noninvasive measure of insulin resistance: calibration analyses against clamp studies. Diabetes Technol Ther. 2014 Feb;16(2):102-12. doi: 10.1089/dia.2013.0151. Epub 2013 Oct 11.

Reference Type BACKGROUND
PMID: 24116833 (View on PubMed)

Maldonado-Hernandez J, Martinez-Basila A, Salas-Fernandez A, Navarro-Betancourt JR, Pina-Aguero MI, Bernabe-Garcia M. The 13C-Glucose Breath Test for Insulin Resistance Assessment in Adolescents: Comparison with Fasting and Post-Glucose Stimulus Surrogate Markers of Insulin Resistance. J Clin Res Pediatr Endocrinol. 2016 Dec 1;8(4):419-424. doi: 10.4274/jcrpe.3260. Epub 2016 Jun 29.

Reference Type BACKGROUND
PMID: 27354200 (View on PubMed)

Lewanczuk RZ, Paty BW, Toth EL. Comparison of the [13C]glucose breath test to the hyperinsulinemic-euglycemic clamp when determining insulin resistance. Diabetes Care. 2004 Feb;27(2):441-7. doi: 10.2337/diacare.27.2.441.

Reference Type RESULT
PMID: 14747226 (View on PubMed)

Mertens J, Roosens L, Braspenning R, Vandebeeck J, Francque S, De Block C. The 13C Glucose Breath Test Accurately Identifies Insulin Resistance in People With Type 1 Diabetes. J Clin Endocrinol Metab. 2025 Jan 21;110(2):e432-e442. doi: 10.1210/clinem/dgae175.

Reference Type DERIVED
PMID: 38487831 (View on PubMed)

Clinck I, Mertens J, Wouters K, Dirinck E, De Block C. Insulin Resistance and CGM-Derived Parameters in People With Type 1 Diabetes: Are They Associated? J Clin Endocrinol Metab. 2024 Oct 15;109(11):e2131-e2140. doi: 10.1210/clinem/dgae015.

Reference Type DERIVED
PMID: 38198792 (View on PubMed)

Other Identifiers

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20/40/515

Identifier Type: -

Identifier Source: org_study_id

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