Physiologic Response to Glucagon at Varying Insulin Levels

• Status: Completed
• Trial end date: 2013-03-01
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of this research study is to test how different levels of insulin block the effect of glucagon. Insulin is a hormone that lowers blood glucose. Glucagon raises blood glucose. Both are natural hormones made by people without diabetes. Sensor-based blood glucose control studies have been done by our research group using glucagon in small doses to prevent hypoglycemia (low blood sugar). However, sometimes glucagon does not work to raise blood sugar. The investigators believe this is because of too much insulin in the body. This study will help determine how different levels of insulin in the body affect the ability of glucagon to raise blood sugar.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Legacy Health System
• Collaborators: Juvenile Diabetes Research Foundation; Oregon Health and Science University
• Treatments: Glucagon; Glucagon-Like Peptide 1; Insulin; Insulin, Globin Zinc

Criteria

Inclusion Criteria:

• Diagnosis of type 1 diabetes mellitus for at least 1 year

• Male or female subjects 21 to 65 years of age

• Current use of an insulin pump

• Willingness to sign informed consent and HIPAA documents and follow all study procedures

Exclusion Criteria:

• Pregnancy or Lactation: For women of childbearing potential: there is a requirement for a negative urine pregnancy test and for agreement to use contraception during the study and for at least 1 month after participating in the study

• Renal insufficiency (serum creatinine of 2.0 mg/dL or greater)

• Liver abnormalities: Serum ALT or AST equal to or greater than 3 times the upper limit of normal; hepatic synthetic insufficiency as defined as a serum albumin of less than 3.3 g/dL; or serum bilirubin of over 2

• Adrenal insufficiency

• Hematocrit of less than or equal to 34%

• A history of cerebrovascular disease or coronary artery disease regardless of the time since occurrence

• Congestive heart failure, NYHA class III or IV

• Cardiac rhythm disturbance characterized by: 2nd or 3rd degree heart block, bradycardia of less than 50 bpm (exception of bradycardia in an aerobic athlete), tachycardia of greater than 100 bpm, or any arrhythmia judged by the investigator to be exclusionary

• Any active infection

• Active foot ulceration

• Severe peripheral arterial disease characterized by ischemic rest pain or severe claudication

• Active alcohol abuse, substance abuse, or severe mental illness (as judged by the principal investigator)

• Active malignancy, except basal cell or squamous cell skin cancers

• Major surgical operation within 30 days prior to screening

• Seizure disorder

• Any concurrent illness, other than diabetes, that is not controlled by a stable therapeutic regimen

• Chronic usage of any immunosuppressive medication

• Current administration of oral or parenteral corticosteroids

• Use of an investigational drug within 30 days prior to screening

• Bleeding disorder, treatment with warfarin, or platelet count below 50,000

• Allergy to glucagon

• Past history of pheochromocytoma or a family history of MEN 2, neurofibromatosis, or von Hippel-Lindau disease

• Insulin resistance requiring more than 200 units per day