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PreDiabetesPhase 2NCT04742751

An Open-Label Pilot Intervention Trial to Prevent Diabetes in Prediabetic Adult Survivors of Childhood Cancer

A Phase 2 study testing Metformin and Digital Intervention in people with PreDiabetes and Adult Children, run by St. Jude Children's Research Hospital at 1 site in United States.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

This is a first-in survivor, single-arm pilot study with the goal of establishing evidence of feasibility and safety of a combined pharmacologic (metformin) and lifestyle intervention (using an existing digital platform) to prevent diabetes in prediabetic adult survivors of childhood cancer. Read more about this study

Who is it for?
Ages 18 to 44 years
Conditions the study is for
PreDiabetes, Adult Children
What is being tested?
Metformin and Digital Intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
96 participants
Where
1 siteUnited States
Study dates
2 Mar 2022to Mar 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 44 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Investigators will recruit to enroll 55 survivors who are at least 18 but <45 years of age who participate in the St. Jude Lifetime Cohort Study (SJLIFE) and have been identified to have prediabetes defined as hemoglobin A1c (HbA1c)
  • Participant in SJLIFE
  • ≥18 and <45 years of age
  • Prediabetic: fasting plasma glucose 105-125 mg/dL, hemoglobin A1c 5.7- 6.4% (either or both criteria may be present) According to institutional and NIH policy, the study will accession research participants regardless of sex and ethnic background. Institutional experience confirms broad representation in this regard.

Who cannot join

  • Absence of treatment related diabetes risk. Survivors will be excluded if their cancer treatment required observation only, surgery alone not involving the abdomen or brain, radiation alone not involving the chest (pancreatic risk), abdomen or brain (e.g. retinoblastoma treated with enucleation alone, melanoma of an extremity treated with excision alone, neuroblastoma in an infant requiring observation only)
  • Diabetes at baseline assessment: FPG ≥126 mg/dL, HbA1c ≥6.5% or previous diagnosis by a physician (except gestational diabetes that resolved post-partum)
  • BMI <19 kg/m2
  • Current metformin use (including for any period ≥30 days in the past 1yr)
  • Known allergy to metformin
  • Current use of other oral glucose lowering medications, non-insulin injectable diabetes medications or insulin (Appendix)
Show all 22Show fewer
  • Current participation in a lifestyle change program
  • Chronic kidney disease ≥ stage IIIb (eGFR < 45 mL/min)
  • Severe cardiovascular disease or recent intervention (NYHA class ≥2 or heart failure hospitalization in the past 6mo, Aortic stenosis, Heart block including LBBB or 3rd degree AV block, SBP >180 or DBP >105 mmHg, myocardial infarction or coronary revascularization in the past 1 month)
  • Severe hepatic dysfunction: cirrhosis or AST/ALT >3 times upper limit of normal
  • Pulmonary disease with dependence on oxygen or daily use of bronchodilators
  • Weight loss >10% in the past 6 months
  • Bariatric surgery in the past 2 years
  • Pregnant, within 3 months post-partum, nursing, or planning to become pregnant
  • Anemia: hematocrit <36% in males or <33% in females
  • Ongoing alcohol or substance abuse using criteria from the AUDIT and DAST questionnaires (Appendix)
  • Diagnosis of schizophrenia or other psychotic disorder
  • Vision impairment limiting ability to interface with the digital program
  • Unable to swallow medication
  • Non-English speaking
  • Cognitive impairment defined by IQ <80
  • Current active cancer or undergoing treatment for active cancer

Trial locations and contacts

1 site in 1 country.

United States1 site
  • St. Jude Children's Research Hospital

    Memphis, Tennessee, 38105

Other trials in United States

About this study

This is a first-in survivor, single-arm pilot study with the goal of establishing evidence of feasibility and safety of a combined pharmacologic (metformin) and lifestyle intervention (using an existing digital platform) to prevent diabetes in prediabetic adult survivors of childhood cancer.

Primary Objective

Read more

The primary aim of this proposal is to establish the feasibility and safety of a 24-week combined metformin + intensive lifestyle intervention among adult survivors with prediabetes (including a 12-week lifestyle alone run-in followed by 12-week combined intervention among survivors remaining prediabetic).

Primary endpoints of this trial will be adherence to 1) daily metformin administration and 2) completion of required core-curriculum of the lifestyle change intervention. Safety will be assessed using the Global Rating of Side Effects Burden

Secondary Objectives

The secondary aim is to assess preliminary evidence for efficacy of the combined metformin + intensive lifestyle intervention on glycemic control and insulin resistance. Glycemic control will be measured by fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) and insulin resistance measured by the homeostatic model assessment (HOMA-IR) and IGF- binding protein 1 (IGF-BP1; a measure of insulin sensitivity strongly correlated with euglycemic insulin clamp testing).

Exploratory Objectives

To assess preliminary evidence for efficacy of the combined metformin + intensive lifestyle intervention on weight, other anthropometric measures, blood pressure and lipid profile, physical activity (self-reported and as measured by accelerometer), frailty measures, and health-related quality of life (HRQOL). We will also assess diabetes development at future SJLIFE visits.

To assess measures of participation in the lifestyle change program as well as barriers to participation and medication adherence.

Read the detailed description

Eligible subjects who meet inclusion criteria will be enrolled in a 12 week run-in period of the digital lifestyle intervention program. At the 12 week study visit, those who remain prediabetic will received metformin extended release daily, first at lower dose (500 mg/day) to minimize gastrointestinal side effects (diarrhea, nausea, flatulence, bloating), then escalated to a maximum dose of 1000 mg/day at week 14. The digitally delivered lifestyle change program will include a core curriculum focused on diet quality, food types, exercise and behavioral strategies for goal setting, and self- monitoring.

Being tested
Metformin, Digital Intervention
Medical subject headings
Prediabetic State

What participants receive

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

  • MetforminDrug

    Also called D-Care DM2, Fortamet, Glucophage, Glucophage XR

    To begin week 12 for participants who remain prediabetic after 12 week lifestyle run-in. Dosage and Route of Administration: 500 mg dose/ day to be taken orally, increased to 1000 mg dose/ day at week 14 through week 24. The dose should be taken immediately following the evening meal and at approximately the same time daily

  • Digital InterventionBehavioural

    Also called Lifestyle Change Digital Intervention

    Lifestyle Change Digital Intervention - This is a digital platform that will include a core curriculum focused on diet, exercise, and behavioral strategies for goal setting and self-monitoring to improve diet including a weight loss On Day 1, participants will begin their digital lifestyle intervention using their smart-phone application with their lifestyle coach and peer group.

    On day 14, participants will be contacted by phone (+/- 4 days, day 10 to 18) and adherence assessed using virtual pill counts via phone calls.

    At weeks 4, 8, 16 and 20 a phone-based pill count for adherence and adverse event symptom log will be completed and study medication dispensed.

    At week 12 (interim assessment) and 24 (study-end), the participant will return to St. Jude Children's Research Hospital (SJCRH) for an in-person assessment.

    The digital lifestyle change program will complete at week 24.

Study groups in NCT04742751
Study groupRoleWhat they receive
TreatmentExperimentalMetformin is an antihyperglycemic agent which improves glucose tolerance in patients with type 2 diabetes mellitus, lowering both basal and postprandial plasma glucose. Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. With Metformin therapy, insulin secretion remains unchanged while fasting insulin levels and day-long plasma insulin response may decrease.
Receives: Drug: Metformin; Behavioral: Digital Intervention

What is being measured

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

  1. Adherence for feasibility

    Adherence to the intervention with 80% adherence to prescribed metformin and completion of 60% of the digitally-delivered core education curriculum through the lifestyle change platform.

    Measured: 2 years

  2. Digitally-delivered core education curriculum through the lifestyle change platform

    Adherence will be monitored by completion logs of lessons

    Measured: At end of Week 24

  3. Safety and Adverse Events (Symptom Log including monitoring for AEs)

    An Adverse Event Monitoring Log with Global Rating of Side Effects Burden

    Measured: Week 4

  4. Safety and Adverse Events (Symptom Log including monitoring for AEs)

    An Adverse Event Monitoring Log with Global Rating of Side Effects Burden

    Measured: Week 8

  5. Safety and Adverse Events (Symptom Log including monitoring for AEs)

    An Adverse Event Monitoring Log with Global Rating of Side Effects Burden

    Measured: Week 12

  6. Safety and Adverse Events (Symptom Log including monitoring for AEs)

    An Adverse Event Monitoring Log with Global Rating of Side Effects Burden

    Measured: Week 14

  7. Safety and Adverse Events (Symptom Log including monitoring for AEs)

    An Adverse Event Monitoring Log with Global Rating of Side Effects Burden

    Measured: Week 16

  8. Safety and Adverse Events (Symptom Log including monitoring for AEs)

    An Adverse Event Monitoring Log with Global Rating of Side Effects Burden

    Measured: Week 20

  9. Safety and Adverse Events (Symptom Log including monitoring for AEs)

    An Adverse Event Monitoring Log with Global Rating of Side Effects Burden

    Measured: Week 24

  10. Drug adherence/Pill Counts

    Adherence will be monitored by pill counts showing participant taking study drug, metformin ER, 80% of the time.

    Measured: Week 2

  11. Drug adherence/Pill Counts

    Adherence will be monitored by pill counts showing participant taking study drug, metformin ER, 80% of the time.

    Measured: Week 4

  12. Drug adherence/Pill Counts

    Adherence will be monitored by pill counts showing participant taking study drug, metformin ER, 80% of the time.

    Measured: Week 8

  13. Drug adherence/Pill Counts

    Adherence will be monitored by pill counts showing participant taking study drug, metformin ER, 80% of the time.

    Measured: Week 12

  14. Drug adherence/Pill Counts

    Adherence will be monitored by pill counts showing participant taking study drug, metformin ER, 80% of the time.

    Measured: Week 16

  15. Drug adherence/Pill Counts

    Adherence will be monitored by pill counts showing participant taking study drug, metformin ER, 80% of the time.

    Measured: Week 20

  16. Drug adherence/Pill Counts

    Adherence will be monitored by pill counts showing participant taking study drug, metformin ER, 80% of the time.

    Measured: Week 24

Secondary outcomes (2)
  1. Glycemic Control

    Glycemic Control will be measured by Change in Hemoglobin A1c

    Measured: Baseline to Week 24 (on campus labs at Baseline, Week 12 and 24)

  2. Glycemic Control

    Glycemic Control will be measure by Change in Fasting Plasma Glucose

    Measured: Baseline to Week 24 (on campus labs at Baseline, Week 12 and 24

Timeline

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

  1. First posted8 Feb 2021
  2. Study start2 Mar 2022
  3. Primary completion16 Jan 2026
  4. Study completionMar 2027 (estimated)

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
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
96 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04742751
Sponsor's protocol ID
PREDM
Other IDs
R21CA261713
Status last verified
Apr 2026
First submitted
6 Jan 2021
Last updated
30 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Individual participant de-identified datasets containing the variables analyzed in the published article will be made available (related to the study primary or secondary objectives contained in the publication). Supporting documents such as the protocol, statistical analyses plan, and informed consent are available through the CTG website for the specific study. Data used to generate the published article will be made available at the time of article publication. Investigators who seek access to individual level de-identified data will contact the computing team in the Department of Biostatistics (ClinTrialDataRequest@stjude.org) who will respond to the data request.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Metformin and Digital Intervention in people with PreDiabetes and Adult Children, run by St. Jude Children's Research Hospital at 1 site in United States.

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 22 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: under way, not looking for participants, as of the sponsor's last update on 30 Apr 2026. 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 United States. 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.

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?

This study is still under way. Results are not available in the source record yet.

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?

Adherence for feasibility (time frame: 2 years). The study lists 16 primary outcomes in all. 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 30 Apr 2026.

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