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Type 2 DiabetesPhase 4NCT06461377

The Ameliorative Effects of GLP-1RA on Diabetic Cardiac Autonomatic Neuropathy

A Phase 4 study testing Glucagon-like peptide-1 receptor agonist:Semaglutide in people with Type 2 Diabetes and Diabetes With Diabetic Autonomic Neuropathy (Diagnosis), run by The First Affiliated Hospital with Nanjing Medical University at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Diabetic cardiac autonomic neuropathy (DCAN) is a common chronic complication that reduces survival in patients with diabetes. Epidemiological surveys have shown that the prevalence of DCAN is 25-75% in people with type 2 diabetes. The onset of DCAN is insidious and easy to be ignored in the early stage. Read more about this study

Who is it for?
Ages 18 to 70 years
What is being tested?
Glucagon-like peptide-1 receptor agonist:Semaglutide
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
1 siteChina
Study dates
13 Jun 2024to 31 Dec 2027
Phase
Phase 4
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 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients aged 18-70 years
  • Patients with T2DM who meet the diagnostic guidelines
  • The patient signed the relevant informed consent form
  • Being overweight or obese

Who cannot join

  • <18 years old
  • Pregnant or lactating women
  • Acute and chronic pancreatitis
  • Recent acute complications of diabetes
  • Arrhythmia or taking drugs that affect heart rate
  • Thyroid disease
  • Severe organ dysfunction
  • Denial of informed consen

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

jianbo Li, MD/PhD contact

13951750648

ljbzjlx18@aliyun.com

China1 site, 1 recruiting
  • the First Affiliated Hospital of Nanjing Medical University

    Nanjing, Jiangsu, 210029

    li wang, 15061040299, wangli08010923@163.com

    Recruiting

Other trials in China

About this study

Diabetic cardiac autonomic neuropathy (DCAN) is a common chronic complication that reduces survival in patients with diabetes. Epidemiological surveys have shown that the prevalence of DCAN is 25-75% in people with type 2 diabetes. The onset of DCAN is insidious and easy to be ignored in the early stage. With the progression of the disease, the following clinical symptoms gradually appear, including reduced heart rate variability, exercise intolerance, resting tachycardia, orthostatic hypotension, painless myocardial infarction and even sudden death, which seriously endanger the life and health of type 2 diabetes patients. Existing literature has shown that glucagon-like peptide-1 receptor agonist (GLP-1RA) can improve diabetic peripheral neuropathy and diabetic cognitive dysfunction, but there are few studies on improving diabetic autonomic neuropathy. Insulin resistance is an important risk factor for DCAN. Patients with type 2 diabetes are characterized by insulin resistance, and GLP-1RA is recognized as a drug to improve insulin resistance and control blood sugar in patients with diabetes. In this study, GLP-1RA was used to intervene patients with type 2 diabetes, and the changes in blood sugar control and insulin resistance status of patients were followed up. Special attention was paid to the improvement of autonomic neuropathy in diabetic patients.

Being tested
Glucagon-like peptide-1 receptor agonist:Semaglutide
Keywords
T2DM,DCAN,HRV, CART,insulin resistance
Medical subject headings
Diabetes Mellitus, Type 2, Disease

What participants receive

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

  • Glucagon-like peptide-1 receptor agonist:SemaglutideDrug

    Also called Semaglutide

    The GLP-1RA intervention group was given subcutaneous injection of GLP-1RA for 3 months, while the control group was not given GLP-1RA intervention

Study groups in NCT06461377
Study groupRoleWhat they receive
controlNo interventionIn the control group, no other intervention was used except the basic drugs for diabetes treatment
GLP-1RA intervention groupExperimentalSubcutaneous injection of semaglutide 0.5-1mg (dosage depends on individual body weight)once a week (not off-label use),lasting 12 weeks
Receives: Drug: Glucagon-like peptide-1 receptor agonist:Semaglutide

What is being measured

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

  1. heart rate variability(HRV)

    All participants were given ambulatory electrocardiogram.The time domain analysis and frequency domain analysis of heart rate variability are included in the holter ECG report.

    Measured: baseline and 12 weeks later

Secondary outcomes (19)
  1. E/I difference

    Take an average of 6 deep breaths per minute, record the difference between the maximum heart rate and the minimum heart rate during deep breathing

    Measured: basline and 12 weeks later

  2. 30/15 ratio

    The heart rate in lying position was measured, and the R-R interval in more than 30 beats was measured after standing, and the ratio between the longest R-R interval in the 25-35 beats and the shortest R-R interval in the 10-15 beats after standing was calculated

    Measured: basline and 12 weeks later

  3. Valsalva action

    After deep inhalation, hold your breath as much as possible, and then blow air into the modified sphygmomanometer to keep the pressure of the sphygmomanometer at 40mmHg, continue for 10-15s, and then relax for 1 minute, a total of 3 minutes. At the same time, ECG was recorded to record the ratio of maximum heart rate to minimum heart rate

    Measured: basline and 12 weeks later

  4. the difference between lying and Orthostatic blood pressure

    Blood pressure was measured in the supine position. The patient was asked to stand immediately, and blood pressure was measured at the first and fifth minutes

    Measured: basline and 12 weeks later

  5. grip strength tests

    First, the basic blood pressure and the maximum grip strength were measured, and the blood pressure was measured after 5 minutes of continuous hard clenching with the grip apparatus (the force used was 30% of the maximum grip strength measured), and the blood pressure difference was calculated

    Measured: basline and 12 weeks later

  6. BMI

    It is calculated by dividing a person's weight in kg by their height in meters squared

    Measured: basline and 12 weeks later

  7. FBG

    Fasting glucose

    Measured: basline and 12 weeks later

  8. Fins

    Fasting insulin

    Measured: basline and 12 weeks later

  9. Fc-peptide

    Fasting c-peptide

    Measured: basline and 12 weeks later

  10. HOMA-IR

    calculated by HOMA Calculator v2.2.3

    Measured: basline and 12 weeks later

  11. HbA1c

    Reflect the average blood sugar of 3 months

    Measured: basline and 12 weeks later

  12. Total cholesterol

    one of serum biochemical index

    Measured: basline and 12 weeks later

  13. triglyceride

    one of serum biochemical index

    Measured: basline and 12 weeks later

  14. HDL

    high-density lipoprotein,one of serum biochemical index

    Measured: basline and 12 weeks later

  15. LDL

    low density lipoprotein,one of serum biochemical index

    Measured: basline and 12 weeks later

  16. UA

    Uric Acid,one of serum biochemical index

    Measured: basline and 12 weeks later

  17. creatinine

    one of serum biochemical index

    Measured: basline and 12 weeks later

  18. eGFR

    Estimated glomerular filtration rate,one of serum biochemical index

    Measured: basline and 12 weeks later

  19. Urinary trace albumin/urinary creatinine

    urine protein test urine protein urine protein test

    Measured: basline and 12 weeks later

Timeline

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

  1. First posted17 Jun 2024
  2. Study start13 Jun 2024
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06461377
Sponsor's protocol ID
2023-SR-611
Status last verified
Jun 2024
First submitted
1 Mar 2024
Last updated
21 Jun 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Maser RE, Lenhard MJ. Cardiovascular autonomic neuropathy due to diabetes mellitus: clinical manifestations, consequences, and treatment. J Clin Endocrinol Metab. 2005 Oct;90(10):5896-903. doi: 10.1210/jc.2005-0754. Epub 2005 Jul 12.

    PubMed 16014401
  • Balcioglu AS, Muderrisoglu H. Diabetes and cardiac autonomic neuropathy: Clinical manifestations, cardiovascular consequences, diagnosis and treatment. World J Diabetes. 2015 Feb 15;6(1):80-91. doi: 10.4239/wjd.v6.i1.80.

    PubMed 25685280
  • Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003 May;26(5):1553-79. doi: 10.2337/diacare.26.5.1553.

    PubMed 12716821
  • Goh JK, Koh L. Evaluating treatment options for cardiovascular autonomic neuropathy in patients with diabetes mellitus: a systematic review. Diabetol Int. 2023 Apr 25;14(3):224-242. doi: 10.1007/s13340-023-00629-x. eCollection 2023 Jul.

    PubMed 37397902
  • Kaze AD, Yuyun MF, Fonarow GC, Echouffo-Tcheugui JB. Cardiac autonomic dysfunction and risk of incident stroke among adults with type 2 diabetes. Eur Stroke J. 2023 Mar;8(1):275-282. doi: 10.1177/23969873221127108. Epub 2022 Nov 1.

    PubMed 37021204
  • Williams SM, Eleftheriadou A, Alam U, Cuthbertson DJ, Wilding JPH. Cardiac Autonomic Neuropathy in Obesity, the Metabolic Syndrome and Prediabetes: A Narrative Review. Diabetes Ther. 2019 Dec;10(6):1995-2021. doi: 10.1007/s13300-019-00693-0. Epub 2019 Sep 24.

    PubMed 31552598
  • Dimitropoulos G, Tahrani AA, Stevens MJ. Cardiac autonomic neuropathy in patients with diabetes mellitus. World J Diabetes. 2014 Feb 15;5(1):17-39. doi: 10.4239/wjd.v5.i1.17.

    PubMed 24567799
  • Wink J, van Delft R, Notenboom RGE, Wouters PF, DeRuiter MC, Plevier JWM, Jongbloed MRM. Human adult cardiac autonomic innervation: Controversies in anatomical knowledge and relevance for cardiac neuromodulation. Auton Neurosci. 2020 Sep;227:102674. doi: 10.1016/j.autneu.2020.102674. Epub 2020 May 16.

    PubMed 32497872
  • Kapa S, DeSimone CV, Asirvatham SJ. Innervation of the heart: An invisible grid within a black box. Trends Cardiovasc Med. 2016 Apr;26(3):245-57. doi: 10.1016/j.tcm.2015.07.001. Epub 2015 Jul 9.

    PubMed 26254961
  • Aksu T, Gupta D, Pauza DH. Anatomy and Physiology of Intrinsic Cardiac Autonomic Nervous System: Da Vinci Anatomy Card #2. JACC Case Rep. 2021 Apr 21;3(4):625-629. doi: 10.1016/j.jaccas.2021.02.018. eCollection 2021 Apr.

    PubMed 34317590
  • Kikel-Coury NL, Brandt JP, Correia IA, O'Dea MR, DeSantis DF, Sterling F, Vaughan K, Ozcebe G, Zorlutuna P, Smith CJ. Identification of astroglia-like cardiac nexus glia that are critical regulators of cardiac development and function. PLoS Biol. 2021 Nov 18;19(11):e3001444. doi: 10.1371/journal.pbio.3001444. eCollection 2021 Nov.

    PubMed 34793438
  • Jorgensen JR, Thompson L, Fjord-Larsen L, Krabbe C, Torp M, Kalkkinen N, Hansen C, Wahlberg L. Characterization of Meteorin--an evolutionary conserved neurotrophic factor. J Mol Neurosci. 2009 Sep;39(1-2):104-16. doi: 10.1007/s12031-009-9189-4. Epub 2009 Mar 4.

    PubMed 19259827
  • Lee HS, Han J, Lee SH, Park JA, Kim KW. Meteorin promotes the formation of GFAP-positive glia via activation of the Jak-STAT3 pathway. J Cell Sci. 2010 Jun 1;123(Pt 11):1959-68. doi: 10.1242/jcs.063784. Epub 2010 May 11.

    PubMed 20460434
  • Mehta K, Behl T, Kumar A, Uddin MS, Zengin G, Arora S. Deciphering the Neuroprotective Role of Glucagon-like Peptide-1 Agonists in Diabetic Neuropathy: Current Perspective and Future Directions. Curr Protein Pept Sci. 2021;22(1):4-18. doi: 10.2174/1389203721999201208195901.

    PubMed 33292149
  • Takaku S, Tsukamoto M, Niimi N, Yako H, Sango K. Exendin-4 Promotes Schwann Cell Survival/Migration and Myelination In Vitro. Int J Mol Sci. 2021 Mar 15;22(6):2971. doi: 10.3390/ijms22062971.

    PubMed 33804063

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Glucagon-like peptide-1 receptor agonist:Semaglutide in people with Type 2 Diabetes and Diabetes With Diabetic Autonomic Neuropathy (Diagnosis), run by The First Affiliated Hospital with Nanjing Medical University at 1 site in China.

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 8 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: looking for participants now, as of the sponsor's last update on 21 Jun 2024. 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 China. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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?

Contact jianbo Li, MD/PhD (13951750648, ljbzjlx18@aliyun.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

heart rate variability(HRV) (time frame: baseline and 12 weeks later). 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 NCT06461377, which also lists 15 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 21 Jun 2024.

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