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Pre-diabetesAPT-2DNCT02838693

Assessing Progression to Type-2 Diabetes (APT-2D): A Prospective Cohort Study Expanded From BRITE-SPOT (Bio-bank and Registry for StratIfication and Targeted intErventions in the Spectrum Of Type 2 Diabetes)

An observational study of Pre-diabetes and Diabetes, run by Medicine at 1 site in Singapore.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The Bio-bank and Registry for StratIfication and Targeted intErventions in the Spectrum Of Type 2 Diabetes (BRITE-SPOT) has been set up to prospectively collect clinical data and biologically relevant samples from individuals with, and at risk for type 2 diabetes (T2D), with the aim of delineating factors related to… Read more about this study

Who is it for?
Ages 30 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Pre-diabetes, Diabetes
What is being tested?
Not applicable. This is an observational study.
Type of treatment
Surgery or procedure
How many people
2,300 participants
Where
1 siteSingapore
Study dates
Mar 2016to Dec 2021
Phase
Observational
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 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Normoglycemic: 800 Pre-diabetics: 1,500

Who may be able to join

  • Ability to give informed consent
  • At least 30 years old, and not older than 65 years
  • Overtly healthy males or females, as determined by medical history, physical examination and laboratory results
  • Not on any regular medications. Subjects using traditional medicine concomitantly will also be excluded in this study

Who cannot join

  • History or presence of current cardiovascular, respiratory, hepatic, renal, gastrointestinal, endocrine, hematological, malignancy or neurological disorders capable of significantly altering the performance of the biomarker panel; or of interfering with the interpretation of data
  • Known or ongoing psychiatric disorders within 3 years
  • Regularly use known drugs of abuse within 3 years
  • Women who are pregnant or lactating
  • Have donated blood of more than 500 mL within 4 weeks of study enrollment.
  • Have an average weekly alcohol intake that exceeds 21 units per week (males) and 14 units per week (females) (1 unit = 12 oz or 360 mL of beer; 5 oz or 150 mL of wine; 1.5 oz or 45 mL of distilled spirits)
Show all 20Show fewer
  • Uncontrolled hypertension (blood pressure [BP] >160/100mmHg
  • Active infection requiring systemic antiviral or antimicrobial therapy that will not be completed prior to Study Day 1
  • Treatment with any investigational drug, or biological agent within one (1) month of screening or plans to enter into an investigational drug/ biological agent study during the duration of this study
  • Known allergy to insulin
  • History of bleeding diathesis or coagulopathy
  • Any of the following laboratory values at screening:
  • LDL > 190mg/dL (>4.9mmol/L)
  • TG > 500mg/dL (>5.6mmol/L)
  • Hba1C >= 6.5%
  • Fasting glucose >=126mg/dL(>=7mmol/L) or 2 hour post-prandial glucose >=200mg/dL (>=11.1mmol/L)
  • ALT > 3.0 x upper limit of normal
  • Estimated creatinine clearance <60 mL/min
  • Have any other conditions, which, in the opinion of the Investigator would make the subject unsuitable for inclusion, or could interfere with the subject participating in or completing the study
  • Significant change in weight (+/- 5%) during the past month

Trial locations and contacts

1 site in 1 country.

Sue-Anne Toh, MBBChir, MSc, MA contact

+65 67722195

mdcsates@nus.edu.sg

Singapore1 site, 1 recruiting
  • National University Hospital

    Singapore, 119074

    Sue-Anne Toh, MBBChir, MSc, MA, +65 67722195, mdcsates@nus.edu.sg

    Sue-Anne Toh, MBBChir, MSc, MA

    Recruiting

Other trials in Singapore

About this study

The Bio-bank and Registry for StratIfication and Targeted intErventions in the Spectrum Of Type 2 Diabetes (BRITE-SPOT) has been set up to prospectively collect clinical data and biologically relevant samples from individuals with, and at risk for type 2 diabetes (T2D), with the aim of delineating factors related to susceptibility, progression, complications and response to treatment. Expanded from BRITE-SPOT, Assessing the Progression to Type - 2 Diabetes (APT-2D) is a prospective cohort with a focus on non-diabetics (normoglycemic or prediabetic), to expand the sample size and depth of metabolic phenotyping in these upstream groups, with the more targeted aim of delineating factors related to insulin sensitivity versus secretion, that relate to progression to T2D.

Read the detailed description

This is a prospective open cohort study.

The study will comprise the following periods:

Screening

  • Complete screening checklist and informed consent form

Procedures.

  • Following the screening visit, subjects are required to return to undergo the following:
  • Oral Glucose Tolerance Test (OGTT) to assess glucose tolerance and beta cell function
  • Frequently-Sampled Intravenous Glucose Tolerance test (FSIVGTT) to assess acute insulin response to glucose
  • Euglycemic Hyperinsulinemic Clamp (EHC) to obtain the insulin sensitivity index and assess insulin action
  • The Disposition index (DI) that quantifies the relationship between insulin sensitivity and insulin secretion, will be determined through the results obtained during FSIVGTT and EHC to determine subject's risk for Type 2 diabetes.
  • OGTT will be repeated every 6 months to assess for conversion to Type 2 Diabetes. Plasma C-peptide, and glucose will be measured at 7 time points during the OGTT for minimal model assessment of beta cell function
  • FSIVGTT and EHC will be repeated within 3 months of conversion to Type 2 Diabetes, or at 3 years from recruitment, whichever comes sooner.

Normoglycemic Subjects: 800 Pre-Diabetic Subjects: 1500

Being tested
Not applicable. This is an observational study.
Medical subject headings
Glucose Intolerance, Diabetes Mellitus

What participants receive

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

  • Not applicable. This is an observational study.Procedure or surgery

    Not applicable. This is an observational study.

Study groups in NCT02838693
Study groupRoleWhat they receive
APT-2D (Normoglycemic)800 Normoglycemic
Receives: Procedure: Not applicable. This is an observational study.
APT-2D (Pre-Diabetic)1,500 Pre-Diabetic
Receives: Procedure: Not applicable. This is an observational study.

What is being measured

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

  1. Changes in beta-cell function in Asian populations with normal glucose tolerance and prediabetes over 3 years.

    Glucose \& c-peptide laboratory results, from OGTT, will be used to assess glucose tolerance and beta cell function

    Measured: Data for each participant will be analysed upon completion all their OGTT visits

  2. Changes in insulin sensitivity in Asian populations with normal glucose tolerance and prediabetes over 3 years. Data will be presented at the end of 5.5years.

    Disposition index assessed via glucose and insulin results from FSIVGTT and EHC.

    Measured: Data for each participant will be analysed upon completion of both of the FSIVGTT and EHC visits

Secondary outcomes (1)
  1. To discover and/or validate biomarkers that predict which subjects will progress from NGT to prediabetes and/or from prediabetes to diabetes. Data will be presented at the end of 5.5years.

    Biomarker panel will be conducted through testing of plasma and serum samples.

    Measured: All samples collected during the study will be consolidated at the end of 5.5years or upon study completion, whichever that comes first, and analysed in one single batch to ensure consistency of the data

Timeline

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

  1. First posted20 Jul 2016 (estimated)
  2. Study startMar 2016
  3. Primary completionSep 2021 (estimated)
  4. Study completionDec 2021 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
2,300 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02838693
Sponsor's protocol ID
28431754DIA4019
Acronym
APT-2D
Status last verified
Jul 2016
First submitted
21 Jun 2016
Last updated
22 Jul 2016
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Yes

Publications

  • Tai ES, Goh SY, Lee JJ, Wong MS, Heng D, Hughes K, Chew SK, Cutter J, Chew W, Gu K, Chia KS, Tan CE. Lowering the criterion for impaired fasting glucose: impact on disease prevalence and associated risk of diabetes and ischemic heart disease. Diabetes Care. 2004 Jul;27(7):1728-34. doi: 10.2337/diacare.27.7.1728.

    PubMed 15220254
  • Bergman RN, Phillips LS, Cobelli C. Physiologic evaluation of factors controlling glucose tolerance in man: measurement of insulin sensitivity and beta-cell glucose sensitivity from the response to intravenous glucose. J Clin Invest. 1981 Dec;68(6):1456-67. doi: 10.1172/jci110398.

    PubMed 7033284
  • Kahn SE, Prigeon RL, McCulloch DK, Boyko EJ, Bergman RN, Schwartz MW, Neifing JL, Ward WK, Beard JC, Palmer JP, et al. Quantification of the relationship between insulin sensitivity and beta-cell function in human subjects. Evidence for a hyperbolic function. Diabetes. 1993 Nov;42(11):1663-72. doi: 10.2337/diab.42.11.1663.

    PubMed 8405710
  • Chen M, Porte D Jr. The effect of rate and dose of glucose infusion on the acute insulin response in man. J Clin Endocrinol Metab. 1976 Jun;42(6):1168-75. doi: 10.1210/jcem-42-6-1168.

    PubMed 932179
  • Dalla Man C, Campioni M, Polonsky KS, Basu R, Rizza RA, Toffolo G, Cobelli C. Two-hour seven-sample oral glucose tolerance test and meal protocol: minimal model assessment of beta-cell responsivity and insulin sensitivity in nondiabetic individuals. Diabetes. 2005 Nov;54(11):3265-73. doi: 10.2337/diabetes.54.11.3265.

    PubMed 16249454
  • Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004 May;27(5):1047-53. doi: 10.2337/diacare.27.5.1047.

    PubMed 15111519
  • Tan CE, Emmanuel SC, Tan BY, Jacob E. Prevalence of diabetes and ethnic differences in cardiovascular risk factors. The 1992 Singapore National Health Survey. Diabetes Care. 1999 Feb;22(2):241-7. doi: 10.2337/diacare.22.2.241.

    PubMed 10333940
  • Jin W, Patti ME. Genetic determinants and molecular pathways in the pathogenesis of Type 2 diabetes. Clin Sci (Lond). 2009 Jan;116(2):99-111. doi: 10.1042/CS20080090.

    PubMed 19076063
  • Levy J, Atkinson AB, Bell PM, McCance DR, Hadden DR. Beta-cell deterioration determines the onset and rate of progression of secondary dietary failure in type 2 diabetes mellitus: the 10-year follow-up of the Belfast Diet Study. Diabet Med. 1998 Apr;15(4):290-6. doi: 10.1002/(SICI)1096-9136(199804)15:43.0.CO;2-M.

    PubMed 9585393
  • Bagust A, Beale S. Deteriorating beta-cell function in type 2 diabetes: a long-term model. QJM. 2003 Apr;96(4):281-8. doi: 10.1093/qjmed/hcg040.

    PubMed 12651972
  • Turner R, Stratton I, Horton V, Manley S, Zimmet P, Mackay IR, Shattock M, Bottazzo GF, Holman R. UKPDS 25: autoantibodies to islet-cell cytoplasm and glutamic acid decarboxylase for prediction of insulin requirement in type 2 diabetes. UK Prospective Diabetes Study Group. Lancet. 1997 Nov 1;350(9087):1288-93. doi: 10.1016/s0140-6736(97)03062-6.

    PubMed 9357409
  • Matthews DR, Cull CA, Stratton IM, Holman RR, Turner RC. UKPDS 26: Sulphonylurea failure in non-insulin-dependent diabetic patients over six years. UK Prospective Diabetes Study (UKPDS) Group. Diabet Med. 1998 Apr;15(4):297-303. doi: 10.1002/(SICI)1096-9136(199804)15:43.0.CO;2-W.

    PubMed 9585394
  • Donnan PT, MacDonald TM, Morris AD. Adherence to prescribed oral hypoglycaemic medication in a population of patients with Type 2 diabetes: a retrospective cohort study. Diabet Med. 2002 Apr;19(4):279-84. doi: 10.1046/j.1464-5491.2002.00689.x.

    PubMed 11942998
  • Ringborg A, Lindgren P, Yin DD, Martinell M, Stalhammar J. Time to insulin treatment and factors associated with insulin prescription in Swedish patients with type 2 diabetes. Diabetes Metab. 2010 Jun;36(3):198-203. doi: 10.1016/j.diabet.2009.11.006. Epub 2010 Mar 28.

    PubMed 20347376
  • Cook MN, Girman CJ, Stein PP, Alexander CM, Holman RR. Glycemic control continues to deteriorate after sulfonylureas are added to metformin among patients with type 2 diabetes. Diabetes Care. 2005 May;28(5):995-1000. doi: 10.2337/diacare.28.5.995.

    PubMed 15855556

Questions about this trial

What is this clinical trial studying?

An observational study of Pre-diabetes and Diabetes, run by Medicine at 1 site in Singapore.

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 4 inclusion and 20 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: status not confirmed, as of the sponsor's last update on 22 Jul 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 Singapore. 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. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

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

Contact Sue-Anne Toh, MBBChir, MSc, MA (+65 67722195, mdcsates@nus.edu.sg), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in beta-cell function in Asian populations with normal glucose tolerance and prediabetes over 3 years. (time frame: Data for each participant will be analysed upon completion all their OGTT visits). The study lists 2 primary outcomes in all. 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 NCT02838693, which also lists 20 linked publications.

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 Jul 2016.

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