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Type 2 DiabetesPhase 1NCT02749032

Feed-Back Suppression of Meal-Induced Glucagon-like Peptide 1 (GLP-1) Secretion

A Phase 1 study testing Mixed meal test, Vildagliptin and Sitagliptin in people with Type 2 Diabetes, run by Michael A. Nauck at 1 site in Germany.

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

The present study is a phase I, single-centre, double-blind, randomized, cross-over (3 treatments, 3 treatment periods and 6 sequences), stratified (background medication: metformin vs. Read more about this study

Who is it for?
Ages 30 to 75 years
Conditions the study is for
Type 2 Diabetes
What is being tested?
Mixed meal test, Vildagliptin and Sitagliptin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
24 participants
Where
1 siteGermany
Study dates
Nov 2011to Mar 2014
Phase
Phase 1
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 30 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • diabetes mellitus type 2 for more than one year, as defined by the American Diabetes Association
  • body-mass-index between 20.0 and 40.0 kg/m² (inclusive),
  • glycohaemoglobin (HbA1c) ≤ 8.5%,
  • normal vital signs after 10 minutes resting in the supine position: systolic blood pressure 96 mmHg -159 mmHg; diastolic blood pressure 46 mmHg-99 mmHg; heart rate 46-99 bpm
  • laboratory parameters within the normal range, or abnormalities judged to be clinically irrelevant by the investigator (serum estimated glomerular filtration rate was enforced to be > 60 ml/min; hepatic enzymes and bilirubin (unless the subject has documented Gilbert syndrome) had to be > 3-fold the upper limit of normal)
  • women of childbearing potential (less than two years post-menopausal or not surgically sterile for more than 3 months), had to prove a negative serum β-human chorionic gonadotropin (HCG) pregnancy test at screening and a negative urine β-HCG pregnancy test at day 1 on each of the treatment periods, had to use a highly effective method of birth control (failure rate less than 1% per year)
  • normal or clinically irrelevant findings in medical history and physical examination

Who cannot join

  • any glucose-lowering drug therapy other than metformin during 3 months before the first treatment period
  • any history or presence of clinically relevant cardiovascular, pulmonary, gastro-intestinal, hepatic, renal, metabolic (apart from diabetes mellitus type 2), haematological, neurological, psychiatric, systemic, ocular, gynaecologic, or infectious disease; any acute infectious disease or signs of acute illness
  • symptoms of a clinically significant illness in the 3 months before the study, which, according to the investigator's opinion, could interfere with the purposes of the study
  • congestive heart failure of New York Heart Association (NYHA) functional class III-IV
  • Regular use of any medication other than metformin in the last month before study start with the exception of thyroid hormones, lipid-lowering and antihypertensive drugs, and, if female, with the exception of hormonal contraception or menopausal hormone replacement therapy
  • blood loss (>300 ml, any reason) within 3 months before inclusion, or a haemoglobin < 11.0 g/dl
Show all 10Show fewer
  • participation in a trial with any investigational drug during the past three months
  • presence or history of a drug allergy or clinically significant allergic disease according to the investigator's judgment including any known hypersensitivity to DPP-4 inhibitors
  • presence of drug or alcohol abuse (alcohol consumption > 40 grams / day)
  • if female, pregnancy (defined as positive β-HCG blood test), breast-feeding

Trial locations and contacts

1 site in 1 country.

Germany1 site
  • Diabeteszentrum Bad Lauterberg

    Bad Lauterberg im Harz, Lower Saxony, 37431

Other trials in Germany

About this study

Official title: Feed-Back Suppression of Meal-Induced GLP-1 Secretion Mediated Through Elevations in Intact GLP-1 Caused by Dipeptidyl Peptidase 4 (DPP-4) Inhibition: A Randomized, Prospective Comparison of Sitagliptin and Vildagliptin Treatment

The present study is a phase I, single-centre, double-blind, randomized, cross-over (3 treatments, 3 treatment periods and 6 sequences), stratified (background medication: metformin vs. diet-only), placebo-controlled study, comparing periods lasting 6-9 days on treatment with repeated doses of vildagliptin, sitagliptin, or placebo, with wash-out periods between treatment periods lasting 21 days minimum.

The study was designed to directly compare the effects of vildagliptin and sitagliptin on incretin hormone responses, glycaemia, and insulin as well as glucagon secretory responses in patients with type 2 diabetes.

Read the detailed description

Design. The present study is a phase I, single-centre, double-blind, randomized, cross-over (3 treatments, 3 treatment periods and 6 sequences), stratified (background medication: metformin vs. diet-only), placebo-controlled study, comparing periods lasting 6-9 days on treatment with repeated doses of vildagliptin, sitagliptin, or placebo, with wash-out periods between treatment periods lasting 21 days minimum.

Experimental procedures. Meal tests were performed in the morning after an overnight fast. The standardized mixed meal was composed of 2 eggs (100 g), 1 slice (50 g) of whole grain rye bread, 1 slice (50 g) of rye flour bread, 10 g of fat-reduced margarine, 20 g of boiled ham, and 25 g of diet jam, amounting to 450 kcal, 50 % carbohydrate, 20 % protein, and 30 % fat (based on calorie count). Patients were allowed to drink tea (black or fruit-based) or de-caffeinated coffee ad libitum.

Blood sampling. Plasma glucose was determined in capillary samples taken from hyperaemic ear lobes. Venous blood was collected from indwelling venous cannulas placed in a distal forearm vein, for the determination of insulin, C-peptide, glucagon, GLP-1 (total), GLP-1 (intact), glucose-dependent insulinotropic polypeptide (GIP) (total), GIP (intact), and free fatty acids. After drawing basal blood specimens at -15 and 0 min, blood was taken at 15, 30, 45, 60, 90, 120, 180, and 240 min.

Laboratory determinations. Glucose, insulin, C-peptide, total GLP-1 (C-terminally directed assay), intact GLP-1 (sandwich ELISA), total GIP (C-terminally directed assay), intact GIP (N-terminally directed assay) and glucagon were determined.

Conditions
Type 2 Diabetes
Being tested
Mixed meal test, Vildagliptin, Sitagliptin, Placebo, Metformin
Medical subject headings
Diabetes Mellitus, Type 2

What participants receive

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

  • Mixed meal testOther

    Mixed meal test were performed in the morning after an overnight fast. The standardized mixed meal was composed of 2 eggs (100 g), 1 slice (50 g) of whole grain rye bread, 1 slice (50 g) of rye flour bread, 10 g of fat-reduced margarine, 20 g of boiled ham, and 25 g of diet jam, amounting to 450 kcal, 50 % carbohydrate, 20 % protein, and 30 % fat (based on calorie count). Patients were allowed to drink tea (black or fruit-based) or de-caffeinated coffee ad libitum.

  • VildagliptinDrug

    Vildagliptin (50 mg per tablet) was administered orally twice daily (15 minutes prior to breakfast or test meal, on the last day of treatment period) and without a defined temporal relation to dinner in the evening, irrespective of the stratum defined by the background diabetes treatment.

  • SitagliptinDrug

    The dosage of sitagliptin depended on the stratum defined by the background diabetes medication. In patients treated with diet and exercise (no other glucose-.lowering medication), sitagliptin was given as one 100 mg in the morning (15 minutes prior to breakfast or the test meal, on the last day of the treatment period), and a corresponding placebo tablet was administered in the evening (no temporal relation to dinner required).

  • PlaceboDrug

    Placebo was administered orally twice daily: 15 minutes prior to breakfast or the test meal on the last day of treatment period) and one dose in the evening (no temporal relation to dinner required).

  • MetforminDrug

    For patients continuing with pre-existing metformin treatment, 1000 mg film coated tablets from commercial sources. In half of the patients (stratum: metformin as background medication), metformin was administered orally twice daily at 1000 mg of active compound during of after breakfast and dinner.

  • Diet and exerciseOther

    Patients treated their diabetes mellitus type 2 with diet/exercise only

Study groups in NCT02749032
Study groupRoleWhat they receive
Vildagliptin - stratum diet/exerciseActive comparatorVildagliptin (50 mg per tablet) was administered orally twice daily (15 minutes prior to breakfast or test meal, on the last day of treatment period) and without a defined temporal relation to dinner in the evening, irrespective of the stratum defined by the background diabetes treatment. Mixed meal test were performed in the morning after an overnight fast.
Receives: Other: Mixed meal test; Drug: Vildagliptin; Other: Diet and exercise
Vildagliptin - stratum metforminActive comparatorVildagliptin (50 mg per tablet) was administered orally twice daily (15 minutes prior to breakfast or test meal, on the last day of treatment period) and without a defined temporal relation to dinner in the evening, irrespective of the stratum defined by the background diabetes treatment. Mixed meal test were performed in the morning after an overnight fast.
Receives: Other: Mixed meal test; Drug: Vildagliptin; Drug: Metformin
Sitagliptin - stratum diet/exerciseActive comparatorThe dosage of sitagliptin depended on the stratum defined by the background diabetes medication. In patients treated with diet and exercise (no other glucose-.lowering medication), sitagliptin was given as one 100 mg in the morning (15 minutes prior to breakfast or the test meal, on the last day of the treatment period), and a corresponding placebo tablet was administered in the evening (no temporal relation to dinner required). Mixed meal test were performed in the morning after an overnight fast.
Receives: Other: Mixed meal test; Drug: Sitagliptin; Other: Diet and exercise
Sitagliptin - stratum metforminActive comparatorIn patients treated with metformin, sitagliptin (50 mg per tablet) was administered orally twice daily (15 minutes prior to breakfast or test meal, on the last day of treatment period) and without a defined temporal relation to dinner in the evening. Mixed meal test were performed in the morning after an overnight fast.
Receives: Other: Mixed meal test; Drug: Sitagliptin; Drug: Metformin
Placebo - stratum diet/exercisePlacebo comparatorPlacebo was administered orally twice daily: 15 minutes prior to breakfast or the test meal on the last day of treatment period) and one dose in the evening (no temporal relation to dinner required). Mixed meal test were performed in the morning after an overnight fast.
Receives: Other: Mixed meal test; Drug: Placebo; Other: Diet and exercise
Placebo - stratum metforminPlacebo comparatorPlacebo was administered orally twice daily: 15 minutes prior to breakfast or the test meal on the last day of treatment period) and one dose in the evening (no temporal relation to dinner required). Mixed meal test were performed in the morning after an overnight fast.
Receives: Other: Mixed meal test; Drug: Placebo; Drug: Metformin

What is being measured

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

  1. GLP-1 feedback inhibition

    Comparison of the percentage reduction or its reciprocal value (times 100) in total GLP-1 (secretion, incremental values above baseline, 0-240 min following meal ingestion) between vildagliptin and sitagliptin treatment relative to placebo treatment.

    Measured: 0-240 min following meal ingestion

Secondary outcomes (6)
  1. Relationship of the GLP-1 feedback inhibition [%]

    Relationship of the GLP-1 feedback inhibition [%] by DPP-4 inhibition to meal-related plasma responses of "total" and "intact" incretin hormone concentrations

    Measured: 0-240 min following meal ingestion

  2. Differences in glucagon secretion [pmol/l]

    Differences in glucagon secretion [pmol/l] between vildagliptin and sitagliptin treatment relative to placebo treatment during mixed meal tests

    Measured: 0-240 min following meal ingestion

  3. Differences in insulin secretory responses - Insulin [pmol/l]

    Differences in insulin secretory responses due to insulin concentration between vildagliptin and sitagliptin treatment relative to placebo [pmol/l] treatment during mixed meal tests

    Measured: 0-240 min following meal ingestion

  4. Differences in insulin secretory responses - c-peptide [pmol/l]

    Differences in insulin secretory responses due to c-peptide [pmol/l] concentration between vildagliptin and sitagliptin treatment relative to placebo treatment during mixed meal tests

    Measured: 0-240 min following meal ingestion

  5. Differences in glucose concentrations [mmol/l]

    Differences in glucose concentrations [mmol/l] between vildagliptin and sitagliptin treatment relative to placebo treatment during mixed meal tests

    Measured: 0-240 min following meal ingestion

  6. Incidence of Treatment-Emergent Adverse Events - Safety and tolerability

    Safety and tolerability of treatments were assessed for A) period between screening visit and first treatment period (3 to 28 days),B) Three treatment periods 7 to 9 days each (21 - 28 days),C) 2 wash-out periods between 21 - 40 days (42 - 80 days), and D) Period between last treatment visit and end of study visit (1 day). In total that are 67 - 136 days (2.2 - 4.7 month). Patients were ask for any adverse events. Incidence of Treatment-Emergent Adverse Events were analysed.

    Measured: From date of screening until the end of study date, assessed for up to 4.7 months

Timeline

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

  1. First posted22 Apr 2016 (estimated)
  2. Study startNov 2011
  3. Primary completionMar 2014

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 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
24 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02749032
Sponsor's protocol ID
DZBL-2010-1
Status last verified
Apr 2016
First submitted
8 Apr 2016
Last updated
22 Apr 2016
Results posted
No
Data monitoring committee
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Mixed meal test, Vildagliptin and Sitagliptin in people with Type 2 Diabetes, run by Michael A. Nauck at 1 site in Germany.

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 10 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 22 Apr 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 Germany. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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?

GLP-1 feedback inhibition (time frame: 0-240 min following meal ingestion). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 22 Apr 2016.

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