Recurrent Hypoglycemia in Type 1 Diabetes (Aim 1)
| Status: | Recruiting |
|---|---|
| Conditions: | Endocrine, Diabetes, Diabetes |
| Therapuetic Areas: | Endocrinology |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 10/13/2018 |
| Start Date: | May 24, 2018 |
| End Date: | December 2023 |
| Contact: | Anjali Kumar, PA-C |
| Email: | studydiabetes@umn.edu |
| Phone: | 612-301-7040 |
Measurement of Glucose Homeostasis in Human Brain by NMR: Effect of Recurrent Hypoglycemia on Type 1 Diabetes (Aim 1)
This study will explore the cerebral mechanisms of impaired awareness of hypoglycemia (IAH)
in type 1 diabetics following exposure to experimental recurrent hypoglycemia (HG). To induce
IAH, patients with T1D identified to have normal awareness of hypoglycemia (NAH) will undergo
three 2-hour long hypoglycemic clamps. Neurochemical profiles will be measured by high field
MRS before and after induction of IAH. Subject glycemic variability for 2 weeks and
activity/sleep for 1 week before each study will be monitored as all factors have been shown
to alter responses to HG.
in type 1 diabetics following exposure to experimental recurrent hypoglycemia (HG). To induce
IAH, patients with T1D identified to have normal awareness of hypoglycemia (NAH) will undergo
three 2-hour long hypoglycemic clamps. Neurochemical profiles will be measured by high field
MRS before and after induction of IAH. Subject glycemic variability for 2 weeks and
activity/sleep for 1 week before each study will be monitored as all factors have been shown
to alter responses to HG.
The long-term goal of this project is to identify how recurrent hypoglycemia (HG) leads to
the clinical syndrome of impaired awareness of hypoglycemia (IAH) in type 1 diabetes (T1D).
This study will test the hypothesis that recurrent HG in T1D leads to an upregulation in
brain glucose transport and alterations in glutamatergic and GABAergic tone. The
investigators will use MRS methodology that permits evaluation of cerebral cortex and
hypothalamus in the same session to simultaneously evaluate the cerebral correlates/mediators
of impaired awareness and impaired counterregulatory hormone responses (CRR). High MR data
quality and reproducibility will be ensured by using high field MR scanners and technical
advances (automated voxel placement, real-time voxel position, frequency, shim updates).
Continuous glucose monitoring and actigraphy will be used to chronicle glucose variability
and activity/exercise/sleep in the weeks before each experiment to assess the impact of these
variables on IAH.
the clinical syndrome of impaired awareness of hypoglycemia (IAH) in type 1 diabetes (T1D).
This study will test the hypothesis that recurrent HG in T1D leads to an upregulation in
brain glucose transport and alterations in glutamatergic and GABAergic tone. The
investigators will use MRS methodology that permits evaluation of cerebral cortex and
hypothalamus in the same session to simultaneously evaluate the cerebral correlates/mediators
of impaired awareness and impaired counterregulatory hormone responses (CRR). High MR data
quality and reproducibility will be ensured by using high field MR scanners and technical
advances (automated voxel placement, real-time voxel position, frequency, shim updates).
Continuous glucose monitoring and actigraphy will be used to chronicle glucose variability
and activity/exercise/sleep in the weeks before each experiment to assess the impact of these
variables on IAH.
Inclusion Criteria:
- Type 1 diabetes diagnosed on clinical or laboratory grounds
- Diabetes duration 2 - 30 years
- Hemoglobin A1C <8.5%
Exclusion Criteria:
- Impaired awareness of hypoglycemia as determined by the Cox and Gold questionnaires
- Pregnant or plan to become pregnant during the study period
- Uncontrolled hypertension (blood pressure > 145/95 mmHg at screening)
- Evidence of autonomic neuropathy (presence of orthostatic hypotension or history of
gastroparesis)
- Proliferative retinopathy
- Impaired kidney function (GFR < 45)
- History of myocardial infarction, stroke, seizures, neurosurgical procedures, major
depression requiring hospitalization within the last 5 years, arrhythmias
- Current substance abuse
- Use of drugs that can alter glucose metabolism including but not limited to
glucocorticoids and niacin, and excluding insulin and glucose lowering drugs used to
treat diabetes, as determined by a clinician
- Inability to undergo MRI scanning, including but not limited to unable to remain still
in an MRI scanner for more than 30 minutes, claustrophobia, presence of paramagnetic
substances or pacemakers in body, weight over 300 lbs
We found this trial at
1
site
Minneapolis, Minnesota 55455
(612) 625-5000
Principal Investigator: Elizabeth R Seaquist, MD
Phone: 612-624-9176
Univ of Minnesota With a flagship campus in the heart of the Twin Cities, and...
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