Diabetes Mellitus Clinical Trial
Official title:
Metabolic and CD4+ T Cell Dysregulation in Post-Transplant Diabetes Mellitus
This clinical trial studies the physiology and immunology of new-onset post-transplant diabetes mellitus in patients undergoing allogeneic stem cell transplantation. Oral glucose tolerance testing (OGTT), euglycemic hyperinsulinemic clamps, and immune assays will be used to define the mechanisms associated with abnormal glucose homeostasis following stem cell transplantation. Information from this clinical trial could be used to develop standardized screening procedures or to develop optimal treatment strategies for patients developing post-transplant diabetes mellitus.
PRIMARY OBJECTIVES:
I. To determine whether pre-transplant insulin resistance predicts for the development of new
onset post-transplant diabetes mellitus (PTDM) in individuals without diabetes undergoing
matched related donor (MRD) hematopoietic stem cell transplant (HCT).
II. To define the role of circulating tissue-specific Th1 cells in the development of PTDM.
III. To characterize the phenotype and function of circulating tissue-specific regulatory T
cells (Tregs) in HCT recipients with or without PTDM.
OUTLINE:
Patients undergo OGTT and a standard 2-step euglycemic hyperinsulinemic clamp procedure prior
to HCT. Patients then undergo repeat OGTT and a 2-step euglycemic hyperinsulinemic clamp
procedure once after HCT between days 90-100.
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