Beta-cell Response to Incretin Hormones in Cystic Fibrosis

• Status: Recruiting
• Trial end date: 2022-10-01
• Target enrollment: 0
• Participant gender: All

Summary

In recent years, diabetes has emerged as one of the most significant co-diseases that many Cystic Fibrosis (CF) patients develop. Type 1 (T1D) and Type 2 (T2D) diabetes results when either the body does not make enough insulin or the body does not respond correctly to this insulin, respectively. Insulin is a hormone which is made by cells in the pancreas and helps carry glucose (sugar) from the food we eat to the cells of the body for energy. While cystic fibrosis related diabetes (CFRD) has many features similar to both T1D and T2D, patients with CF may not have the same symptoms as either T1D or T2D patients. Currently, there is little understanding of CFRD and the best options for treatment remain unclear.

The purpose of this research study is to examine and understand the various mechanisms that contribute to CFRD and gain a better understanding of potential means to treat CFRD. In particular, we plan to study the effects of incretin hormones that can enhance insulin production in CF patients.

Enrollment is complete for the protocol as initially written. In order to further study the role of the incretin hormone on Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) function , we have received approval to extend our investigation to include the following study groups:

• Cystic Fibrosis participants with normal glucose tolerance

• Non-Cystic Fibrosis controls

• Phase: N/A
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: University of Pennsylvania
• Collaborator: Children's Hospital of Philadelphia
• Treatments: Gastric Inhibitory Polypeptide; Glucagon; Glucagon-Like Peptide 1; Hormones; Incretins

Criteria

Inclusion Criteria:

1. Confirmed diagnosis of cystic fibrosis, defined by positive sweat test or CFTR mutation analysis according to CFF diagnostic criteria,

2. Age greater than or equal to 18y on date of consent

3. Pancreatic insufficiency

4. Recent OGTT consistent with Indeterminate-GT, IGT, CFRD w/o fasting hyperglycemia, or an established diagnosis of CFRD without fasting hyperglycemia

5. For female subjects, negative urine pregnancy test at enrollment.

Exclusion Criteria:

1. Established diagnosis of non-CF diabetes (i.e. T1D) or CFRD with fasting hyperglycemia (fasting glucose greater than126 mg/dL)

2. History of clinically symptomatic pancreatitis within last year

3. Prior lung or liver transplant

4. Severe CF liver disease, as defined by portal hypertension

5. Fundoplication-related dumping syndrome

6. Medical co-morbidities that are not CF-related or are unstable per investigator opinion (i.e. history of bleeding disorders, immunodeficiency)

7. Acute illness or changes in therapy (including antibiotics) within 6 weeks prior to study procedures

8. Treatment with oral or intravenous corticosteroids within 6 weeks of study

9. Hemoglobin less than10g/dL, within 90 days of Visit 1 or at Screening

10. Abnormal renal function, within 90 days of Visit 1 or at Screening; defined as Creatinine greater than 2x upper limit of normal (ULN) or potassium greater than 5.5mEq/L on non-hemolyzed specimen

11. Inability to perform study specific procedures (MMTT, GPA)

12. Subjects, who in study team opinion, may be non-compliant with study procedures.