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Type 1 Diabetes MellitusPhase 2NCT02408705

Investigating the Effect of Liraglutide on the Endogenous Glucose Production During in Tye 1 Diabetes Subjects

A Phase 2 study testing Liraglutide and Mixed Meal Tolerance Test with paracetamol in people with Type 1 Diabetes Mellitus, run by Medical University of Graz at 1 site in Austria.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Each subject will be allocated to 2 periods of 3 months of once daily dosing with either liraglutide (1.2 mg) or placebo treatment (in random sequence) as add on to usual intensive insulin treatment. Wash-out period between treatments will be 1 month. Read more about this study

Who is it for?
Ages 18 to 64 years
Conditions the study is for
Type 1 Diabetes Mellitus
What is being tested?
Liraglutide and Mixed Meal Tolerance Test with paracetamol
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
14 participants
Where
1 siteAustria
Study dates
Jan 2015to May 2016
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 64 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Informed consent obtained before any trial-related activities. Trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial
  • Type 1 diabetes mellitus as diagnosed (including I - III):
  • history of type 1 diabetes mellitus manifestation with acute hyperglycaemia and ketonuria II. positive results for at least one of four islet antibodies (glutamic acid decarboxylase, protein tyrosine phosphatase, zinc transporter 8, or islet cell antibodies) III. residual basal fasting C-peptide of ≥ 0.1 nmol/L
  • Male or female, aged 18 - 64 years (both inclusive)
  • Body mass index (BMI) 20.0 - 25.0 kg/m2 (both inclusive)
  • HbA1c 42 - 80 mmol/mol (6.0-9.5%)
  • Treated with daily insulin injections or continuous s.c. insulin infusion (CSII) ≥ 1 months. Stable insulin dose as judged by the investigator

Who cannot join

  • Known or suspected hypersensitivity to trial product(s) or related products
  • Use of liraglutide or exenatide within 3 months before screening
  • Severe hypoglycaemia within 1 month of screening
  • Hypoglycaemia unawareness as judged by the Investigator or hospitalisation for diabetic ketoacidosis during the previous 2 months
  • Clinically significant abnormal haematology, biochemistry, lipids, or urinalysis or coagulation screening tests, as judged by the investigator and any of the following laboratory safety results:
  • Aspartate transaminase(=AST), alanine aminotransferase (=ALT), lipase, alkaline phosphatase > 2.0 times upper limit of reference range (ULN)
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  • Haemoglobin < 8.0 mmol/L (male) or < 6.4 mmol/L (female), total leukocyte count <3.0 x 109/L, thrombocytes <100 x 109/L
  • Serum creatinine levels ≥ 126 μmol/L (male) or ≥ 111 μmol/L (female)
  • Amylase outside normal range
  • Screening calcitonin > 50 ng/L
  • Personal history of non-familial medullary thyroid carcinoma
  • History of chronic or idiopathic acute pancreatitis Suffer from or history of a life threatening disease (e.g. cancer except basal cell skin cancer or squamous cell skin cancer), or any clinically significant respiratory, metabolic, renal, hepatic, gastrointestinal, endocrinological (with the exception of diabetes mellitus and euthyroid struma), haematological, dermatological, venereal, neurological, psychiatric diseases or other major disorders as judged by the investigator.
  • Proliferative retinopathy or maculopathy and/or severe neuropathy, in particular autonomic neuropathy, as judged by the investigator.
  • Any disease or condition that, in the opinion of the investigator, would represent an unacceptable risk for the subject's safety.
  • Any condition that would interfere with trial participation or evaluation of results, as judged by the investigator.
  • Female of child-bearing potential who is pregnant, breast-feeding or intend to become pregnant or is not using adequate contraceptive methods (adequate contraceptive methods include sterilisation, hormonal intrauterine devices, oral contraceptives, sexual abstinence or vasectomised partner).
  • Severe acute and/or chronic diseases

Trial locations and contacts

1 site in 1 country.

Austria1 site
  • Medical University Graz

    Graz, 8036

Other trials in Austria

About this study

Official title: A Randomized, Double Blind, Two-period Cross-over Trial Investigating the Effect of Liraglutide as Add on to Intensive Insulin Treatment on the Endogenous Glucose Production in Subjects With C-peptide Positive Type 1 Diabetes Mellitus

Each subject will be allocated to 2 periods of 3 months of once daily dosing with either liraglutide (1.2 mg) or placebo treatment (in random sequence) as add on to usual intensive insulin treatment. Wash-out period between treatments will be 1 month.

The trial can be divided into the following periods:

Read more
  • Screening
  • Treatment period 1
  • Washout period
  • Treatment period 2
  • Follow up Visit

Mixed Meal Tolerance Test (MMTT) enriched with paracetamol:

At the beginning and end of each period a MMTT (Fortimel complete) enriched with paracetamol will be performed to assess the remaining beta-cell function via obtained maximal plasma C-peptide levels as well as the gastric emptying.

Experimental / Hypoglycaemic clamp :

At the end of each period (Visit 8, 15) a hypoglycaemic clamp will be performed. After the subject completed the MMTT on day 1, the subject will stay in the clinical unit to prepare for the hypoglycaemic clamp with an variable insulin infusion intravenously in order to obtain a steady state of a plasma glucose (PG) level of 5.5 mmol/L overnight until approximately 08:00. At 05:00 hours 10%-[6,6-2H2] glucose solution will be given i.v. as a primed (9.6mg/kg/min) for one minute and a constant (0.08 mg/kg/min) infusion until the last blood sampling of the plateau 4.0 mmol/L will be performed.

At 08:00 hours in the morning at day 2, insulin infusion will be increased to 1.5 mU/kg/min for each subject and the PG will be kept at a plateau of 5.5 mmol/L by a controlled variable intravenous infusion of glucose (10% glucose enriched with 4mg [6,6-2H2] glucose /ml) for one hour. Afterwards, PG is allowed to fall to a plateau of 3.5 mmol/L, then to a nadir of 2.5 mmol/L, then to a blood glucose of 4.0 mmol/L and finally back to a level of 5.5 mmol/L for safety reasons. Blood sampling for measurement of [6,6-2H2] glucose, glucagon, insulin, counterregulatory hormones, lactate, free fatty acids, glycerol, vital signs, hypoglycaemic symptoms questionnaire and hypoglycaemic awareness will be performed at each PG plateau.

Being tested
Liraglutide, Placebo, Mixed Meal Tolerance Test with paracetamol
Keywords
Endogenous Glucose Production, Hypoglycemic clamp, Tracer to Tracee Technique, Type 1 diabetes mellitus
Medical subject headings
Diabetes Mellitus, Type 1

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • LiraglutideDrug

    Also called Victoza

    They are receiving liraglutide for 3 months. Dose escalation: 0.3 mg - 0.6mg - 0.9mg - 1.2mg (over 4 weeks)

  • PlaceboDrug

    They are receiving placebo for 3 months. Dose escalation: 0.3 mg - 0.6mg - 0.9mg - 1.2mg (over 4 weeks)

  • Mixed Meal Tolerance Test with paracetamolDrug

    Also called MMTT

    At the beginning and end of each period (Visit 2a, 8, 9a, 15) a Mixed Meal Tolerance Test enriched paracetamol will be performed.

Study groups in NCT02408705
Study groupRoleWhat they receive
LiraglutideActive comparator3-month treatment of liraglutide
Receives: Drug: Liraglutide; Drug: Mixed Meal Tolerance Test with paracetamol
PlaceboPlacebo comparator3-month treatment of placebo
Receives: Drug: Placebo; Drug: Mixed Meal Tolerance Test with paracetamol

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Area under the curve of the endogenous glucose production from (=EGP) from begin of the hypoglycaemic clamp 5.5 mmol/L period until the end of recovery period (4.0 mmol/L), calculated from stable isotope labelled plasma glucose

    Measured: After 12 weeks and 2 days of treatment in each treatment period (day 86 and day 198)

Secondary outcomes (16)
  1. Area under the curve of peripheral glucose uptake (=PGU), calculated from labelled PG from begin of the hypoglycaemic clamp period 5.5mmol/L until end of recovery period (4.0 mmol/L)

    Measured: After 12 weeks and 2 days of treatment in each treatment period (day 86 and day 198)

  2. Area under the glucose infusion rate curve from begin of the hypoglycaemic clamp period 5.5mmol/L until end of recovery period (4.0 mmol/L)

    Measured: After 12 weeks and 2 days of treatment in each treatment period (day 86 and day 198)

  3. Change in mean plasma glucagon concentrations from begin of the hypoglycaemic clamp period 5.5 mmol/L to 3.5 mmol/L to nadir and to recovery phase

    Measured: After 12 weeks and 2 days of treatment in each treatment period (day 86 and day 198)

  4. Change in mean values of adrenaline from begin of the hypoglycaemic clamp period 5.5 mmol/L to 3.5 mmol/L to nadir and to recovery phase

    Measured: After 12 weeks and 2 days of treatment in each treatment period (day 86 and day 198)

  5. Change in mean values of noradrenaline from begin the hypoglycaemic clamp period 5.5 mmol/L to 3.5 mmol/L to nadir and to recovery phase

    Measured: After 12 weeks and 2 days of treatment in each treatment period (day 86 and day 198)

  6. Change in mean values of cortisol from begin the hypoglycaemic clamp period 5.5 mmol/L to 3.5 mmol/L to nadir and to recovery phase

    Measured: After 12 weeks and 2 days of treatment in each treatment period (day 86 and day 198)

  7. Change in mean values of growth hormone from begin the hypoglycaemic clamp period 5.5 mmol/L to 3.5 mmol/L to nadir and to recovery phase

    Measured: After 12 weeks and 2 days of treatment in each treatment period (day 86 and day 198)

  8. Change in number of regulatory T-cells detected by blood (fasting) and measured by a laboratory

    Measured: After 12 weeks and 2 days of treatment just before the hypoglycaemic clamp in each treatment period (day 86 and day 198)

  9. Change in function of regulatory T-cells detected by blood (fasting) and measured by a laboratory

    Measured: After 12 weeks and 2 days of treatment just before the hypoglycaemic clamp in each treatment period (day 86 and day 198)

  10. Area under the glucose curve during the Mixed Meal Tolerance Test

    Measured: Period 1: Visit 2a (Day 1) versus Visit 8 (Day 85) ; Period 2: Visit 9a (Day 113) versus Visit 15 (Day 197)

  11. Area under the c-peptid concentration curve during the Mixed Meal Tolerance Test

    Measured: Period 1: Visit 2a (Day 1) versus Visit 8 (Day 85) ; Period 2: Visit 9a (Day 113) versus Visit 15 (Day 197)

  12. Area under the paracetamol concentration curve to calculate gastric emptying during the Mixed Meal Tolerance Test

    Measured: Period 1: Visit 2a (Day 1) versus Visit 8 (Day 85) ; Period 2: Visit 9a (Day 113) versus Visit 15 (Day 197)

  13. Area under the insulin curve during the Mixed Meal Tolerance Test

    Measured: Period 1: Visit 2a (Day 1) versus Visit 8 (Day 85) ; Period 2: Visit 9a (Day 113) versus Visit 15 (Day 197)

  14. Area under the glucagon curve during the Mixed Meal Tolerance Test

    Measured: Period 1: Visit 2a (Day 1) versus Visit 8 (Day 85) ; Period 2: Visit 9a (Day 113) versus Visit 15 (Day 197)

  15. Change in HbA1c during each period detected by blood (fasting) at the begin of the visits and measured by a laboratory (tube: K3 EDTA Plasma)

    Measured: Period 1: Visit 2a (Day 1) versus at Visit 8 (Day 85) ; Period 2: Visit 9a (Day 113) versus Visit 15 (Day 197)

  16. Change in fasting plasma glucose during each period detected by blood at the begin of the visits and measured by a laboratory (tube: lithium heparin plasma)

    Measured: Period 1: Visit 2a (Day 1) versus Visit 8 (Day 85) ; Period 2: Visit 9a (Day 113) versus Visit 15 (Day 197)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Apr 2015 (estimated)
  2. Study startJan 2015
  3. Primary completionMay 2016
  4. Study completionMay 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Crossover
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
14 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02408705
Sponsor's protocol ID
LG_T1_EGP
Status last verified
Sep 2016
First submitted
28 Jan 2015
Last updated
12 Sep 2016
Results posted
No
Data monitoring committee
Yes

Publications

  • Zenz S, Regittnig W, Boulgaropoulos B, Augustin T, Brunner M, Korsatko S, Munzker J, Narath SH, Raml R, Magnes C, Pieber TR. Effect of Liraglutide Treatment on Whole-body Glucose Fluxes in C-peptide-Positive Type 1 Diabetes During Hypoglycemia. J Clin Endocrinol Metab. 2022 Aug 18;107(9):e3583-e3593. doi: 10.1210/clinem/dgac369.

    PubMed 35833597

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Liraglutide and Mixed Meal Tolerance Test with paracetamol in people with Type 1 Diabetes Mellitus, run by Medical University of Graz at 1 site in Austria.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Sep 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Austria. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Area under the curve of the endogenous glucose production from (=EGP) from begin of the hypoglycaemic clamp 5.5 mmol/L period until the end of recovery period (4.0 mmol/L), calculated from stable isotope labelled plasma glucose (time frame: After 12 weeks and 2 days of treatment in each treatment period (day 86 and day 198)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02408705, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Sep 2016.

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