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We want to investigate how lack of glucagon suppression during an oral glucose tolerance test in patients with type 2 diabetes contributes to patients postprandial hyperglycemia.
Patients with type 2 diabetes mellitus (T2DM) are not able to suppress their glucagon secretion after a meal or after ingestion of glucose. Previous studies have shown that gastrointestinal hormones might play a role in this phenomenon. However, it has not yet been possible to determine whether this lack of glucagon suppression postprandially results in an increased endogenous glucose secretion, and thus is a factor in the patients postprandial hyperglycemia.
We aim to perform oral glucose tolerance tests and isoglycemic intravenous glucose infusions with and without a continuous glucagon infusion in patients with T2DM and healthy control subjects. The glucagon infusion is aiming at copying the inappropriate "physiological" glucagon response observed in patients with T2DM.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients | Patients |
| |
| healthy controls | healthy controls |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| isoglycemic intravenous glucose infusion and Glucagon infusion, day C | Biological | Infusion of 0.8ng/kg/min glucagon from time 0-25min |
|
| Measure | Description | Time Frame |
|---|---|---|
| Differences in Endogenous glucose production during the three days measured as total Area under the curve (tAUC) | calculated based on infusions of stable isotope marked glucose | Endogenous glucose production will be calculated based on blood samples at time points: -30,-15,0,10,20,30,50,70,90,120,150,180 and 240 min on all days. |
| Measure | Description | Time Frame |
|---|---|---|
| Differences in glucagon during the three days measured as total Area under the curve (tAUC) | Glucagon will be measured at time points: -30,-15,0,10,20,30,50,70,90,120,150,180 and 240 min on all days. | |
| Differences in incretin hormone levels during the three days measured as total Area under the curve (tAUC) |
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Inclusion Criteria:
Patients with T2DM
Healthy Subjects
Exclusion Criteria:
Patients with T2DM
Healthy Subjects
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Patients with type 2 diabetes Healthy control subjects
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Diabetes Research Division, University Hospital Gentofte | Hellerup | 2900 | Denmark |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27533305 | Derived | Lund A, Bagger JI, Christensen M, Grondahl M, van Hall G, Holst JJ, Vilsboll T, Knop FK. Higher Endogenous Glucose Production During OGTT vs Isoglycemic Intravenous Glucose Infusion. J Clin Endocrinol Metab. 2016 Nov;101(11):4377-4384. doi: 10.1210/jc.2016-1948. Epub 2016 Aug 17. |
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hole blood, serum, white cells, urine
| Oral glucose tolerance test, day A | Biological |
|
| intravenous iv glucose infusion, day B | Biological |
|
GIP and GLP-1
| incretin hormone levels will be measured at time points: -30,-15,0,10,20,30,50,70,90,120,150,180, 240 min on all days. |
| Differences in gastrointestinal hormones during the three days measured as total Area under the curve (tAUC) | At the end of the study |
| differences in appetite, hunger, satiety between the three days | Will be measured with visual analogue scales (VAS) | Satiety, hunger and appetite will be measured at time points:0,30,60,90,120,150,180, 240 min during each day. |
| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| D003920 | Diabetes Mellitus |
| ID | Term |
|---|---|
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| D005951 | Glucose Tolerance Test |
| ID | Term |
|---|---|
| D001774 | Blood Chemical Analysis |
| D019963 | Clinical Chemistry Tests |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D003940 | Diagnostic Techniques, Endocrine |
| D008919 | Investigative Techniques |
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