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The objective of this study is to explore the effects of two DPP-4 inhibitors(Sitagliptin, Saxagliptin) on β- and α-cell function, as well as the incretin effect.
The study is an open-label, randomized, three-way crossover and single-dose study.Subjects with newly onset T2DM are enrolled. They are assigned to take a single dose of sitagliptin (100 mg), saxagliptin (5 mg), or blank control in a randomized order separated by a washout period of 7-14 days.Then the two-step hyperglycemic clamp is initiated.
On each experimental day, the subject will take the given dose of Sitagliptin, Saxagliptin and nothing for blank control two hours before the clamp experiment starts.
The hyperglycaemic clamp will be performed after an overnight fast. Subjects will be placed in a recumbent position and cannula will be inserted in a dorsal hand vein. The hand will be placed in a heating box (50℃) throughout the experiment to allow frequent sampling of arterialized blood. A second cannula will be inserted in a contralateral cubital vein for glucose infusion.
At time zero (0 min), a 50% glucose bolus will be injected during 1 min to increase PG to 15mM. The glucose bolus will be calculated as:(15mM-FPG)×35 mg glucose × body weight (kg). PG will be measured bedside every 5 min and maintained at 15mM by an adjustable continuous 20% glucose infusion. After 90min, PG will be lowered down to 7mM for the islet cells to rest, then the subject will be instructed to consume 75g glucose solution orally in 5min. 40min after the oral glucose consumption, the 90min-hyperglycaemic clamp experiment wil be restarted. The oral period of hyperglycaemic clamp process is the same as what's done in fasting period. Blood samples will be collected in -2h, 0min, 10min, 90min in both hyperglycaemic clamp experimental process for the measurement of insulin, c-peptide, glucagon, active GLP-1 and other incretin hormones.
Thus we could evaluate the beta cell function represented by the first phase and the second phase of insulin secretion(C-peptide secretion) and alpha cell function represented by the change of glucagon concentration during the fasting period and oral period of hyperglycaemic clamp experiment and the change of active GLP-1.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sitagliptin | Experimental | Subjects are assigned to take one pill of sitagliptin(100mg po once) at 7am on experimental day,then the two-step hyperglycaemic clamp is initiated at 9am. |
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| Saxagliptin | Experimental | Subjects are assigned to take one pill of saxagliptin(5mg po once) at 7am on experimental day,then the two-step hyperglycaemic clamp is initiated at 9am. |
|
| Blank control | Experimental | Subjects take no medication for blank control at experimental day,then the two-step hyperglycaemic clamp is initiated at 9am. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sitagliptin | Drug | 100mg po once. |
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| Measure | Description | Time Frame |
|---|---|---|
| β-cell function (measurement of insulin and c-peptide during the clamp study) | The primary endpoints are the effects of DPP-4 inhibitors on β-cell function, with the measurement of insulin and c-peptide during the clamp study. | 15 months |
| Measure | Description | Time Frame |
|---|---|---|
| α-cell function (measurement of glucagon during the clamp study) | The secondary endpoints are the effects of DPP-4 inhibitors on α-cell function, with the measurement of glucagon during the clamp study. | 15 months |
| Incretin effect (measurement of active GLP-1 during the clamp study) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Guang Ning, MD. PHD | Contact | +86021-64370045 |
| Name | Affiliation | Role |
|---|---|---|
| Guang Ning, MD. PHD | Shanghai Jiao Tong University School of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shanghai Jiao Tong University School of Medicine | Recruiting | Shanghai | China |
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D000068900 | Sitagliptin Phosphate |
| C502994 | saxagliptin |
| C074807 | BaseLine dental cement |
| ID | Term |
|---|---|
| D014230 | Triazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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| Saxagliptin | Drug | 5mg po once. |
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| Blank control | Drug | No medication is taken. |
|
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The secondary endpoints are the effects of DPP-4 inhibitors on incretin effect, with the measurement of active GLP-1 during the clamp study. |
| 15 months |
| D004700 | Endocrine System Diseases |
| D011719 |
| Pyrazines |