RecruitingEarly Phase 1NCT06609356

Cardiometabolic Benefit of Reducing Iatrogenic Hyperinsulinemia Using Insulin Adjunctive Therapy in Type 1 Diabetes


Sponsor

Vanderbilt University Medical Center

Enrollment

27 participants

Start Date

Jul 3, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

This study aims to understand the heart and blood sugar health benefits of using an adjunctive therapy to lower high insulin levels in people with type 1 diabetes. The investigators will also look at people with a specific type of diabetes called Glucokinase-Maturity Onset Diabetes of the Young (GCK-MODY) and those without diabetes to help interpret the results. The investigators will use a medication that helps the body get rid of sugar, called and SGLT2 inhibitor, with the goal to reduce the body's insulin requirements. The investigators believe this could lead to better heart and blood sugar health, including a better response to insulin and more available nitric oxide, a gas that helps blood vessels function well. The investigators will compare heart and blood sugar health risk factors in participants with type 1 diabetes, participants with Glucokinase-Maturity Onset Diabetes of the Young (GCK-MODY), and non-diabetic healthy volunteers under two conditions: high insulin levels typical of type 1 diabetes and normal insulin levels typical of the other two groups.


Eligibility

Min Age: 18 YearsMax Age: 60 Years

Plain Language Summary

Simplified for easier understanding

This study is examining whether reducing the amount of insulin produced by the body (called reducing iatrogenic hyperinsulinemia) using insulin-sparing add-on medications can improve heart and metabolic health in people with Type 1 diabetes using an automated insulin delivery system. The study also includes people with a rare genetic form of diabetes (GCK-MODY) and healthy controls. **You may be eligible if...** - You are between 18 and 60 years old with a BMI between 18 and 28 - You have Type 1 diabetes (1–30 years duration) with well-controlled blood sugar (HbA1c 5.7–7.5%) using an automated insulin pump - OR you have GCK-MODY diabetes with confirmed genetic testing and similar blood sugar control - OR you are a healthy person with HbA1c below 5.5% **You may NOT be eligible if...** - You had a severe low blood sugar episode in the past 3 months - You were hospitalized for diabetic ketoacidosis in the past 6 months - You have high blood pressure, kidney, or liver problems - You are taking antipsychotics, steroids, or antioxidant supplements Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

PROCEDUREStudy Visit 1

Hyperinsulinemic, euglycemic clamp and flow-mediated dilation (FMD) study. The study will randomize participants to first receive a five-hour intravenous insulin infusion to achieve normal plasma insulin concentrations (Eu-Ins) or higher plasma insulin concentrations (Hi-Ins)

DRUGPlacebo

* T1DM participants in the Hi-Ins study will receive an oral placebo. During the Eu-Ins study they will receive an SGLT2i. * CGK-MODY participants and healthy volunteers will receive placebo in both studies.

PROCEDUREStudy Visit 2

Hyperinsulinemic, euglycemic clamp and flow-mediated dilation (FMD) study. Insulin levels infused during the five-hour insulin infusion will be opposite of the first visit.

DRUGSodium Glucose Co-transporter 2 (SGLT2) Inhibitor

Concurrent with starting the five-hour infusion, T1DM participants in the Eu-Ins study will receive an SGLT2i dose (empagliflozin 25 mg).


Locations(1)

Vanderbilt University Medical Center

Nashville, Tennessee, United States

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NCT06609356


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