GLP-1Ra Impact on Metabolic Outcomes in Stage 2 T1DM While Receiving Teplizumab
Optimizing Stage 2 T1DM Management: Assessing the Impact of GLP-1Ra on Metabolic Outcomes in Patients Receiving Teplizumab
Vanderbilt University Medical Center
24 participants
Jun 12, 2024
INTERVENTIONAL
Conditions
Summary
The goal of this study is to determine how a drug class called glucagon-like peptide-1 receptor agonists (GLP-1Ra) affects people during an early stage of Type 1 Diabetes undergoing clinical teplizumab treatment. This study involves giving participants a liquid meal under different conditions and observing how their bodies respond, focusing on blood sugar levels, insulin effectiveness, and blood vessel function. The meal tests are followed by two post-treatment tests, one with the GLP-1Ra drug and the other with a placebo. Each test involves blood draws before and during the meal test, GLP-1Ra or placebo administration, and an ultrasound to measure blood vessel function. The goal is to see if GLP-1Ra can help manage blood sugar levels and improve cardiovascular health in this population.
Eligibility
Inclusion Criteria13
- Aims 1-3: Stage 2 T1DM with TZIELD® and GLP-1Ra
- Age: 12-50 years
- BMI: 18-31 kg/m2 (adults) or 5-95th %ile (pediatric)
- Stage 2 T1DM (i.e., ≥ 2 islet auto-antibodies and:
- fasting glucose ≥ 100 mg/dL and \< 126 mg/dL OR
- hr OGTT /MMTT ≥ 140 mg/dL and \< 200 mg/dL OR
- During an OGTT having a glucose of \> 199 mg/dL at 30, 60, or 90 minutes)
- Age: 12-50 years
- BMI: 18-31 kg/m2 (adults) or 5-95th %ile (pediatric)
- Early stage 3 T1DM with either
- HbA1c 6.5% to 8.0% at diagnosis OR
- HbA1c 5.7% to 6.4% with oral glucose test meeting ADA criteria for stage 3 T1DM within the past three months prior to or during screening visit
- Time of stage 3 diagnosis: within eight weeks of first study visit
Exclusion Criteria14
- Comorbidities:
- SBP \> 140 mmHg and DBP \> 100 mmHg
- eGFR by MDRD equation of \< 60 mL/min/1.73m2
- AST or ALT \> 2.5 times ULN
- Family history of medullary thyroid carcinoma
- Diagnosis of pancreatitis or gastroparesis within the past 3 years
- Medications: Any diabetes medication, any antioxidant vitamin supplement (\<2 weeks before a study), any systemic glucocorticoid, antipsychotic, atenolol, metoprolol, propranolol, niacin, any thiazide diuretic, any OCP with \> 35 mcg ethinyl estradiol, growth hormone, any immunosuppressant, antihypertensive, any antihyperlipidemic
- Other: pregnancy, peri- or post-menopausal women, active smoker
- DKA history: history of diabetic ketoacidosis requiring hospital admission
- Comorbidities:
- Family history of medullary thyroid carcinoma
- Diagnosis of pancreatitis or gastroparesis within the past 3 years
- Medications: Any diabetes medication, any antioxidant vitamin supplement (\<2 weeks before a study), any systemic glucocorticoid, antipsychotic, atenolol, metoprolol, propranolol, niacin, any thiazide diuretic, any OCP with \> 35 mcg ethinyl estradiol, growth hormone, any immunosuppressant, antihypertensive, any antihyperlipidemic
- Other: pregnancy, peri- or post-menopausal women, active smoker
Interventions
7 mg single dose of Rybelsus® by mouth once before each MMTT
placebo capsule or tablet once before each MMTT.
Locations(1)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT06338553