Cooperation of Insulin and GLP-1 on Myocardial Glucose Uptake

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Indiana University

Status

Completed

Conditions

Type 2 Diabetes

Treatments

Drug: liraglutide plus insulin detemir
Drug: liraglutide
Drug: insulin detemir

Study type

Interventional

Funder types

Other
Industry

Identifiers

NCT01232946
1105005578

Details and patient eligibility

About

27 Type 2 diabetic subjects (HbA1c 7.5 - 9.5%) currently treated with diet and exercise alone or with oral antidiabetic agents will be randomly assigned to one of three treatment groups: insulin detemir, liraglutide, or liraglutide plus detemir (9 subjects per group), on a background of metformin 2000 mg per day. After 3 months' treatment, PET measurements of myocardial fuel selection will take place, under fasting conditions in the morning following that day's treatment injection(s).

Full description

The investigators will test the hypothesis that effects of liraglutide plus insulin detemir on myocardial fuel selection will be greater than the effects of either agent alone. 27 Type 2 diabetic subjects (HbA1c 7.5 - 9.5%) currently treated with diet and exercise alone or with oral antidiabetic agents will be randomly assigned to one of three treatment groups: insulin detemir, liraglutide, or liraglutide plus detemir (9 subjects per group). All subjects will undergo an initial standardization of background treatment to metformin 2000 mg per day, followed by randomized assignment to 3 months' treatment with liraglutide 1.8 mg/day (once daily each morning, tapering up according to label instructions) and/or detemir (administered twice daily, initially at 10 units per day then titrated to achieve fasting morning glucose readings below 130 mg/dL). PET measurements of myocardial fuel selection will take place at the end of this treatment period, under fasting conditions in the morning following that day's treatment injection(s).

Enrollment

30 patients

Sex

All

Ages

18 to 50 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Type 2 diabetic
  • 18-50 years
  • BMI > 25kg/m2
  • HbA1c 7.0-10.0%
  • Treated with up to 2 oral agents

Exclusion criteria

  • Chronic illness or infection (other than diabetes mellitus)
  • Known coronary artery disease, structural heart disease or abnormal ECG on screen.
  • Treatment with >2 antihypertensive agents or blood pressure >140/95 on two occasions during screening
  • History of claustrophobia, musculoskeletal or other factors which would result in an inability to comfortably remain within the PET scanner gantry for the duration of the imaging protocol.
  • Occupational, investigational or other known radiation exposure which together with the planned radiologic studies, will result in greater than 500 mrem total exposure in a 12 month period.
  • Current pregnancy
  • Treatment with GLP-1 agonist or DPP4 inhibitor within the past 6 months
  • Known intolerance to GLP-1 agonist
  • Personal history of pancreatitis, personal or family history of medullary thyroid carcinoma, or other contraindications to liraglutide treatment.
  • Recognized microvascular complications (neuropathy, nephropathy, retinopathy).

Trial design

30 participants in 3 patient groups

Iiraglutide
Experimental group
Description:
Type 2 diabetic subjects will be assigned to 3 months of treatment with 1.8mg liraglutide administered once daily in addition to background metformin 2000mg/day. PET measurements of myocardial glucose uptake will take place at the end of treatment.
Treatment:
Drug: liraglutide
insulin detemir
Experimental group
Description:
Type 2 diabetic subjects will be assigned to 3 months of treatment with insulin detemir administered twice daily in addition to background metformin 2000mg/day. PET measurements of myocardial glucose uptake will take place at the end of treatment.
Treatment:
Drug: insulin detemir
Liraglutide plus insulin detemir
Experimental group
Description:
Type 2 diabetic subjects will be assigned to 3 months of treatment with a combination of liraglutide and insulin detemir in addition to background metformin 2000mg/day. PET measurements of myocardial glucose uptake will take place at the end of treatment.
Treatment:
Drug: liraglutide plus insulin detemir

Trial documents
1

Trial contacts and locations

0

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Data sourced from clinicaltrials.gov

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