Role of Alpha-to-beta Cell Communication to Adapt Insulin Secretion to Insulin Resistance.

ConditionDiabetes (DM)
Trial statusRecruiting
Trial phasePhase 1
Trial typeInterventional
Biological sexAll
Age18-60
SponsorDavid D'Alessio, M.D.

About this trial

Glucagon secretion from α-cells has long been viewed as primarily a counterregulatory mechanism - e.g. an agent with a role to prevent blood sugar from decreasing to levels that compromise function. Our group, along with other researchers, have begun to identify a much more complex role for α-cells, raising questions about when and how glucagon may influence blood glucose levels. This proposal looks to detail proglucagon peptide secretion from α-cells and the impact this has on β-cell function and glucose tolerance, in preclinical studies of human islets and translational studies in human subjects.

This protocol registration describes Aim 2 from this NIH grant which involves 2 study populations and separate protocols but addresses a common question. Aim 3 in the grant is focused on a separate hypothesis and will be conducted and published separately from Aim 2.

Eligibility criteria

Qualifiers

Age 18-45

Body Mass Index (BMI) < 27.0

Fasting plasma glucose of ≤ 95 mg/dL or HbA1c value ≤ 5.8% as measured at screening visit

Disqualifiers

Active medical disease: e.g. active infectious, inflammatory, neurodegenerative or mental health disorders

Personal history of diabetes or pancreatitis

Personal history of cardiac, gastrointestinal, renal or liver disease

Immediate family history of diabetes

Trial design

Treatments tested in this trial

  • Exendin-9 is a 30 amino acid peptide that is an established competitive antagonist of the GLP-1 receptor. Subjects will receive exendin-9 by intravenous infusion at a rate of 600 pmol/kg/min
  • Dexamethasone

Treatment groups

30 Participants
are divided into 4 treatment groups

Sponsors and collaborators

David D'Alessio, M.D.

Lead sponsor

Duke University

Sponsor institution

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Collaborator