Type 2 Diabetes Clinical Trial
— PREVAILOfficial title:
Preserving Beta-cell Function in Type 2 Diabetes With Exenatide and Insulin (PREVAIL)
Verified date | April 2022 |
Source | Mount Sinai Hospital, Canada |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Type 2 diabetes mellitus is a chronic metabolic disorder characterized by progressive deterioration in the function of the pancreatic beta-cells, which are the cells that produce and secrete insulin (the hormone primarily responsible for the handling of glucose in the body). The investigators propose a randomized controlled trial to determine whether combining basal insulin with a new medication called exenatide is a therapeutic strategy that can preserve beta-cell function early in the course of type 2 diabetes.
Status | Completed |
Enrollment | 105 |
Est. completion date | February 2022 |
Est. primary completion date | December 2021 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 30 Years to 80 Years |
Eligibility | Inclusion Criteria: 1. Men and women between the ages of 30 and 80 years inclusive 2. T2DM diagnosed by a physician =7 years prior to enrolment 3. On 0-2 anti-diabetic medications, with no change in dose/regimen in the preceding 4 weeks 4. A1c at screening between 5.5% and 9.0% inclusive if on anti-diabetic medications, or between 6.0% and 9.5% inclusive if on no oral anti-diabetic medication 5. BMI = 23 kg/m2 6. Negative pregnancy test at recruitment for all women with childbearing potential Exclusion Criteria: 1. Current anti-diabetic treatment with insulin or a glucagon-like peptide-1 (GLP-1) agonist 2. Type 1 diabetes or secondary forms of diabetes 3. History of hypoglycemia unawareness or severe hypoglycemia requiring assistance 4. Hypersensitivity to insulin, exenatide, or the formulations of these products 5. Renal dysfunction as evidenced by estimated glomerular filtration rate (eGFR)<30 ml/min by Modification of Diet in Renal Disease (MDRD) formula 6. History of pancreatitis 7. Family or personal history of Multiple Endocrine Neoplasia type 2 (MEN-2) or familial medullary thyroid carcinoma (MTC) 8. Personal history of non-familial medullary thyroid carcinoma (MTC) 9. Malignant neoplasm requiring chemotherapy, surgery, radiation or palliative therapy within the previous 5 years (with the exception of basal cell skin cancer) 10. Unwillingness to perform capillary glucose monitoring at least 4 times a day during treatment 11. Pregnancy or unwillingness to use reliable contraception. Women should not be planning pregnancy for the duration of the study or the first 3 months after the study. Reliable contraception includes birth control pill, intra-uterine device, abstinence, tubal ligation, partner vasectomy, or condoms with spermicide. 12. Any factor likely to limit adherence to the protocol, in the opinion of investigator |
Country | Name | City | State |
---|---|---|---|
Canada | Mount Sinai Hospital | Toronto | Ontario |
Lead Sponsor | Collaborator |
---|---|
Mount Sinai Hospital, Canada | Canadian Institutes of Health Research (CIHR), University of Toronto |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Baseline-adjusted insulin sensitivity at 8 weeks | Baseline-adjusted insulin sensitivity at 8 weeks will be measured by Matsuda index | 8 weeks | |
Other | Baseline-adjusted insulin sensitivity at 20 weeks | Baseline-adjusted insulin sensitivity at 20 weeks will be measured by Matsuda index | 20 weeks | |
Primary | Mean beta-cell function over the 8-week treatment period, measured using the Insulin Secretion-Sensitivity Index-2 (ISSI-2) | ISSI-2 is an established measure of beta-cell function. ISSI-2 is defined as the product of (i) insulin secretion measured by the ratio of the area-under-the-insulin-curve to the area-under-the-glucose curve and (ii) insulin sensitivity measured by the Matsuda index. The primary outcome comparison is between the glargine/exenatide and glargine only arms. | 8 weeks | |
Secondary | Baseline-adjusted beta-cell function at 20 weeks | The secondary outcome of baseline-adjusted beta-cell function at 20 weeks will be measured with the Insulin Secretion-Sensitivity Index-2 (ISSI-2) | 20 weeks | |
Secondary | Baseline-adjusted glycemic control at 20 weeks | The secondary outcome of baseline-adjusted glycemic control at 20 weeks will be assessed by A1c (glycated hemoglobin) | 20 weeks | |
Secondary | Endothelial function at 8 weeks | Endothelial function will be assessed as the digital endothelial vasomotor function in response to reactive hyperemia using pulse amplitude tonometry, which will be measured by the pulse amplitude response to hyperemia (PAT ratio) | 8 weeks | |
Secondary | Baseline-adjusted glycemic control at 8 weeks | Baseline-adjusted glycemic control at 8 weeks will be measured by A1c | 8 weeks |
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