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The purpose of this research is to help understand the relative importance of changes in insulin secretion (which lowers glucose) and changes in glucagon (which raises glucose) to regulate metabolism and the body's ability to make glucose.
Study A (Insulin 0.4mU/Kg/min): Subjects will be admitted to the CRTU at approximately 1700 on the day prior to study. They will then consume a standard 10kcal/kg meal (55% carbohydrate, 30% fat, 15% protein, caffeine free) and fast overnight. Blood will then be sampled for baseline enrichment and 2H20 (1.67g/kg of body water) will be given in 3 divided doses at 2200, 2400 and 0200. The following morning (approximately 0530), a forearm vein will be cannulated to allow infusions to be performed. In addition, a cannula will be inserted retrogradely into a vein of the contra-lateral dorsum of the hand. This will be placed in a heated Plexiglas box maintained at around 120oF to allow sampling of arterialized venous blood. At approximately 0600 (-180 min), a primed, (10microCi prime, 0.1microCi/min continuous) infusion containing trace amounts of glucose labeled with [3-3H] glucose will be started and continued till 0900 (0 min).
At 0900 (0 min), the infusion will be varied so as to mimic the anticipated pattern of fall of EGP. In addition, glucose also labeled with [3-3H] glucose will be infused so as to maintain glucose concentrations at ~ 95mg/dL. Peripheral venous glucose concentrations will be measured every 10 minutes to allow the infusion rate of glucose to be adjusted as necessary.
Simultaneously, an infusion of somatostatin (60ng/kg/min) will be started at time 0 to inhibit endogenous islet secretion and therefore ensure identical portal insulin concentrations on the two study days. Insulin will be infused at a constant rate known to produce ~ 50% suppression of EGP (0.4mU/Kg/min).
From 0900 (0 min) to 1030 (90 min) no glucagon will be infused. Subsequently, a glucagon infusion will commence (91 - 180 min) at 0.35 ng/Kg/min and then increase to 0.70 ng/Kg/min (181- 270 min), a rate which will be maintained till the end of the study (1330).
Study B (0.8mU/Kg/min): Approximately 1-2 weeks after the first study visit, subjects will be asked to return to the CRTU. This study visit will be similar to Study A. However, insulin will be infused at 0.8mU/Kg/min 0 to 270 minutes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 0.4mU Insulin | Other | During the euglycemic clamp insulin will be infused at 0.4mU/Kg/Min |
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| 0.8mU Insulin | Other | During the euglycemic clamp insulin will be infused at 0.8mU/Kg/Min |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 0.4mU Insulin followed by withdrawal period followed by 0.8mU study | Drug | Clamp study with insulin infused at 0.4 mU/Kg/min, followed by a 2 week withdrawal period followed by a clamp study with insulin infused at 0.8 mU/Kg/min |
| Measure | Description | Time Frame |
|---|---|---|
| Endogenous Glucose Production (EGP) | is calculated by tracer-based measurement and expressed per kg lean body mass | It will be quantified at 90, 180 and 270 minutes for the study with 0.4mU insulin infusion and compared to values obtained for the study with 0.8mU insulin infusion at the same timepoints |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Adrian Vella | Mayo Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mayo Clinic in Rochester | Rochester | Minnesota | 55905 | United States |
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| Label | URL |
|---|---|
| Mayo Clinic Clinical Trials | View source |
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The study is a cross-over study - subjects participated in both arms
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| ID | Title | Description |
|---|---|---|
| FG000 | 0.4 Then 0.8 | During the first euglycemic clamp insulin will be infused at 0.4mU/Kg/Min Subjects will undergo a 15 day 'withdrawal period' During the second euglycemic clamp insulin will be infused at 0.8mU/Kg/Min |
| FG001 | 0.8 Then 0.4 |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 13, 2021 |
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| 0.8mU Insulin followed by withdrawal period followed by 0.4mU study | Drug | Clamp study with insulin infused at 0.8 mU/Kg/min, followed by a 2 week withdrawal period followed by a clamp study with insulin infused at 0.4 mU/Kg/min |
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During the euglycemic clamp insulin will be infused at 0.8mU/Kg/Min Subjects will undergo a 15 day 'withdrawal period' During the second euglycemic clamp insulin will be infused at 0.4mU/Kg/Min |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | 0.4 Then 0.8 | Subjects will undergo the 0.4 clamp first during which insulin is infused at 0.4mU/Kg/Min following a suitable washout period, Subjects will undergo the 0.8 clamp second during which insulin is infused at 0.8mU/Kg/Min |
| BG001 | 0.8 Then 0.4 | Subjects will undergo the 0.8 clamp first during which insulin is infused at 0.8mU/Kg/Min following a suitable washout period, Subjects will undergo the 0.4 clamp second during which insulin is infused at 0.4mU/Kg/Min |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
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| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Analysis in people completing both arms | Count of Participants | Participants |
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| Age, Continuous | Analysis in people completing both arms | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||
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| Primary | Endogenous Glucose Production (EGP) | is calculated by tracer-based measurement and expressed per kg lean body mass | Posted | Mean | Standard Error | umol/kg/min | It will be quantified at 90, 180 and 270 minutes for the study with 0.4mU insulin infusion and compared to values obtained for the study with 0.8mU insulin infusion at the same timepoints |
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3 months
These young healthy participants were in the study for duration of time between screening, and the end of the last experiment. Each of the experiments was 270 minutes long but subjects were admitted the night before and monitored in house till the end of the experiment. After the first experiment there was a 15 day waiting period and then another experiment (with admission the night before).
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | 0.4 Events | Events occurring during the 0.4 euglycemic clamp when insulin was infused at 0.4mU/Kg/Min | 0 | 12 | 0 | 12 | 1 | 12 |
| EG001 | 0.8 Events | Events occurring during the 0.8 euglycemic clamp when insulin was infused at 0.8mU/Kg/Min | 0 | 12 | 0 | 12 | 2 | 12 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
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| Phlebitis | Blood and lymphatic system disorders | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | Systematic Assessment |
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The main caveat is that during the experiment insulin is kept constant - i.e. not quite like what happens in the postprandial situation
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Adrian Vella | Mayo Clinic | 507-255-6515 | vella.adrian@mayo.edu |
| Apr 5, 2022 |
| Prot_SAP_000.pdf |
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| Between 18 and 65 years |
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| >=65 years |
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| At 270 minutes |
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