Type 1 Diabetes Clinical Trial
Official title:
Effects of Sitagliptin (Januvia®) on Blood Glucose Control in Patients With Type 1 Diabetes and CGM Substudy of the Investigator Initiated Study Protocol Effects of Sitagliptin (Januvia) on Glucagon Suppression and GLP-1 Levels in Patients With Type 1 Diabetes; CGM Substudy
This is a multi-center, prospective, randomized, double-blind, parallel, placebo controlled
clinical trial evaluating the efficacy of sitagliptin in suppressing glucagon release in
subjects with type 1 diabetes over a 16 week treatment period. The hypothesis of this study
is that sitagliptin (Januvia™) will decrease post-prandial glucagon release and may result
in improved glucose control in adult patients with type 1 diabetes. There is only one small,
pilot study of sitagliptin in patients with type 1 diabetes which significantly reduced
total daily insulin dose and A1c values while improving mean blood glucose (MBG) and time
spent in euglycemic range (1). In the pilot study, GLP-1 and glucagon levels were not
assessed. The purpose of this trial is to determine if sitagliptin can suppress the
paradoxical rise of glucagon, and thus can decrease A1c.
This study will enroll a maximum of 140 patients (with an expected 10% dropout rate) with
A1c values between 7.5-10% who will be randomized in a 1:1 fashion to either the study drug
or placebo. 100 of these patients will wear a continuous glucose monitor. Subjects may be
using insulin via continuous subcutaneous insulin infusion (CSII) or multiple daily
injections (MDI). The clinic visits will be conducted at screening, -1 week,
baseline/randomization, 4 weeks, 12 weeks, and 16 weeks in addition to telephone visits
(Appendix 1 and 2). At home, starting at week 0 (randomization/baseline), subjects will take
100 mg/day of sitagliptin or placebo and continue for the study duration. Laboratory
analysis will be performed at various time points assessing glucagon, A1c, C-peptide,
glucagon-like-peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), and insulin
levels.
n/a
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Supportive Care
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