Diabetes Mellitus Clinical Trial
Official title:
Effect of a DPP-IV Inhibitor Treatment on the Secretion of Glucagon in Patients Presenting With Type 1 Diabetes Mellitus With or Without Autonomic Neuropathy
The purpose of this study is to compare the effect of a single administration of a DPP-IV inhibitor (vildagliptin: Galvus ®) versus no treatment over two populations of diabetic patients: without diabetic autonomic neuropathy (NA, i.e. the control group) and with diabetic autonomic neuropathy (i.e. the neuropathy group). The investigators hypothesize that the therapeutic efficacy of DPP-IV inhibitors is partly mediated by the autonomic nervous system. This hypothesis will be validated if a lower glycemic response to DPP-IV inhibitor treatment is observed for the neuropathy group compared to control.
Recently published work has demonstrated in animals that the control of pancreatic hormone
secretion is due, at least in part, to the action of GLP-1 on the via the autonomic nervous
system. Therefore, rhe investigators hypothesized that altered autonomic nervous system
could explain, at least in part, the altered therapeutic efficacy of DPP-IV inhibitors
observed in some patients. Our aim is to validate this concept in humans.
The objective of this physiopathological, monocentric, comparative, open, parallel study is
to compare the effect of a single administration of a DPP-IV (vildagliptin: Galvus ®) over
two populations of type 1 diabetic patients: a control group of 12 patients without diabetic
autonomic neuropathy (NA) and a group of 12 patients with NA.
This proof of concept study will enrol type 1 diabetic patients to avoid confounding factors
related to endogen insulin secretion and frequent polymedication of type 2 diabetic
patients. The response will be evaluated for each patient by the relative difference between
pre-and post-glucagon concentrations following a test meal, measured in the absence and
presence of treatment with DPP4 inhibitor. Expected results: the DPP-4 inhibitor should lead
to a reduction of about 20 to 30% of the glucagon level in patients without NA and a smaller
or no decrease in patients with NA.
;
Allocation: Non-Randomized, Endpoint Classification: Pharmacodynamics Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Basic Science
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