Type 1 Diabetes Clinical Trial
Official title:
Influence of Blockade of the Renin-angiotensin System for Preservation of Cognitive Function, Hormonal Counter-regulatory Response, Symptomatology and Cardiac Repolarisation During Hypoglycaemia in Patients With Type 1 Diabetes
Hypothesis: Treating patients with type 1 diabetes with a certain antihypertensive drug
preserve cerebral function during hypoglycaemia.
Background: Studies have found that certain genetic variations leaves a subject with type 1
diabetes more prone to hypoglycaemia. It it thought to be a decline in cognition during
hypoglycaemia that leaves them at risk of severe hypoglycaemia. The idea is tha when you
suppress the genetic phenotype with a well known antihypertensive drug an improvement in
cognition will occur and this will remove the patients tendency to severe hypoglycaemia.
Methods: The investigators want to explore whether the cerebral function is improved during
hypoglycaemia in subjects with type 1 diabetes and the above mentioned genetic variation
when treated with the antihypertensive drug Candesartan.
We will include 25 type 1 diabetic patients from our outpatient clinic. They are already
genotyped from another trial.
Each patient goes through two cycles with hyperinsulinemic glucose clamp induced
hypoglycemia. The study is double blinded, randomised and placebocontrolled so the patients
receive both Candesartan and placebo but in different cycles.
In each cycle patients will receive either Candesartan or placebo for 7 days. After 8 days
patients undergo a hypoglycaemic clamp during which primary and secondary endpoints will be
measured.
In the hyperinsulinemic hypoglycaemic clamp the patients will undergo an adjustment period
towards euglycaemia. A period of approximately 1 hour of euglycemia, an hour of hypoglycemia
and a period of recovery towards euglycemia. In each of these glycemic states primary and
secondary outcomes will be measured.
;
Allocation: Randomized, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention
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