Type 2 Diabetes Clinical Trial
Official title:
Effects of 3 Months of SSRI-Treatment on Metabolism and HPA-axis in Young Men Born With Low Birth Weight - a Randomized, Double Blinded and Placebo-controlled Trial
Chronic stress has been proposed to be involved the development of western life-style
diseases such as cardiovascular disease and type 2 diabetes (T2DM). At the same time chronic
stress is also believed to cause psychiatric disease such as melancholic depression (MD)and
anxiety disorders.
Accordingly, humans born with low birth weight (LBW) (ei. less than 5,0 LB) display an
increased risk for T2DM and MD. Studies suggest stress and adrenal stress hormones
(glucocorticoids) (GCC) might be involved in the development of both of these conditions.
Recent studies of animals born LBW suggest, that SSRI-compounds, usually employed in the
treatment of MD-related diseases, reduces stress-responses and levels of stress hormones
such adrenal steroids and at the same time has a positive influence on glucose metabolism.
In present study, the investigators aim to measure levels of GCC and stress and assess
glucose metabolism in healthy young men (20-35 years) born LBW (40 subjects). The volume and
structure of a certain brain area (ie. hippocampus) involved in regulation of adrenal GCC
and known to be malfunctioning in chronically stressed individuals will be assessed by
magnetic resonance imaging (MRI). Further metabolic examination will be accompanied by MRI
spectroscopy of liver and muscle fat content as well as total fat content (Dexa-scanning)
and contents of fat in the abdomen (by MRI) . Psychiatric well-ness and symptoms will be
characterized by well-established questionnaires such as MDI and SCL-92 and responses as
regards blood pressure, heart rate and changes in basal plasma concentrations of GCC and
Epinephrine will be assessed while performing a Stroop Stress Test. Finally, a 24 hour blood
pressure profile test will be included.
After this extensive examination program, subjects will be randomized to 3-4 months of
treatment with either Escitalopram (an SSRI-compound) or Placebo. Subsequently, at the end
of the treatment, the whole examination program will be repeated to detect potential
beneficial changes.
A group of young normal birth weight men (20 subjects) will serve as a healthy baseline
group for comparison and will not be exposed to any medical treatment.
This trial will add understanding to the mechanism underlying the development of type 2
diabetes and depression in LBW. Additionally, present trial might be capable of proposing a
novel treatment strategy to prevent the development of these diseases in LBW man.
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