Insulin Resistance Clinical Trial
Official title:
Effect of Linagliptin + Metformin vs Metformin Alone on the Role of Pancreatic Islet Function, Insulin Resistance and Markers of Cardiovascular Risk in Patients With Prediabetes: Randomized Clinical Trial
Type 2 diabetes is a worldwide epidemic disease, and preventive strategies are needed to face this health problem. The goal of this clinical trial is to evaluate the effect of linagliptin + metformin vs metformin alone on physiopathological parameters, such as glucose metabolism, insulin resistance, insulin secretion and pancreatic beta cell function in patients with impaired fasting glucose plus impaired glucose tolerance, during 24 months.
The main goal of this clinical trial is to compare the effect of two different treatments
during 24 months:
1. Lifestyle modification program + metformin 850mg twice daily
2. Lifestyle modification program + linagliptin (2.5mg) and metformin (850mg) twice daily
on the following parameters, after 24 months of treatment:
1. Glucose metabolism, evaluated by the oral glucose tolerance
2. Insulin resistance, evaluated by the oral glucose tolerance in 100% of the patients and
by hyperglycemic clamp in 10 % of the patients
3. Insulin secretion, evaluated by the oral glucose tolerance in 100% of the patients and
by hyperglycemic clamp in 10 % of the patients
4. Pancreatic beta cell function, evaluated by the oral glucose tolerance in 100% of the
patients and by hyperglycemic clamp in 10 % of the patients
5. Systemic inflammation and cardiovascular risk factors, evaluated by cytokines
interlelukin-6 (IL6), C-reactive protein (PCR), and measurement of the intima media
thickness by ultrasound.
All the patients will have a basal evaluation with an oral glucose tolerance test, lipid
profile, body composition, and IMT measurement by ultrasonography; and 10 % will be invited
for the hyperglycemic clamp. After the basal evaluation, if the patients result with IMPAIRED
GLUCOSE TOLERANCE and have at least 2 risk factors, they will be invited to the intervention
phase where they will be randomized to one of the two treatment groups.
Patients will have a follow-up visit every month to review the adherence to the lifestyle
modification program and to the medication. Every 6 months OGTT will be performed on all the
patients, and in a subset of patients hyperglycemic clamp will be performed at 0, 6 and 12
months. After 18 and 24 months, patients will repeat the same evaluation performed as the
basal evaluation.
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