NCT01813929

Brief Summary

Insulin resistance (IR) is an important contributor to increased cardiovascular disease risk in type 1 diabetes (T1D). The purpose of this study is to measure the effect of metformin on insulin sensitivity, vascular function and compliance, and mitochondrial function in T1D. The long term goal is to identify novel non-glycemic approaches to managing cardiovascular disease risk in T1D. The results of this study may validate a novel approach to T1D treatment that could significantly improve current management of cardiovascular disease risk in this high risk population.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
23

participants targeted

Target at below P25 for phase_4

Timeline
Completed

Started Jun 2011

Longer than P75 for phase_4

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2011

Completed
1.3 years until next milestone

First Submitted

Initial submission to the registry

September 28, 2012

Completed
6 months until next milestone

First Posted

Study publicly available on registry

March 19, 2013

Completed
4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 24, 2017

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 24, 2017

Completed
4.8 years until next milestone

Results Posted

Study results publicly available

January 21, 2022

Completed
Last Updated

January 21, 2022

Status Verified

December 1, 2021

Enrollment Period

5.8 years

First QC Date

September 28, 2012

Results QC Date

October 7, 2021

Last Update Submit

December 21, 2021

Conditions

Keywords

DiabetesInsulinMetforminVascularVesselsType 1

Outcome Measures

Primary Outcomes (2)

  • Insulin Sensitivity by Hyperinsulinemic Euglycemic Clamp

    Determine the effect of metformin on insulin sensitivity in T1D. Reported measure is glucose infusion rate during hyperinsulinemic euglycemic clamp normalized to total body weight. For this measure, insulin was infused at 40 mU/m2 surface area. Blood sugar wass checked every 5 minutes and glucose infusion adjusted to maintain glucose level at 90 mg/dL for 2 hours. The glucose infusion rate for the final 30 minutes is reported as GIR (aka M-value or glucose disposal rate) in mg glucose/kg\*min. A higher value corresponds to greater sensitivity to insulin. There is no strictly defined normal range.

    End of each 6 week intervention period

  • Flow-mediated Brachial Artery Dilation

    Measure of endothelial function by brachial ultrasound of the percent dilation after 5 minutes of occlusion.

    End of each 6 week intervention period

Secondary Outcomes (22)

  • Arterial Stiffness by PWV

    End of each 6 week intervention period

  • Arterial Stiffness by AI@75

    End of each 6 week intervention period

  • Mitochondrial Measures: Oxygen Consumption

    End of each 6 week intervention period

  • Mitochondrial Measures: Protein Expression Levels of Electron Transport Chain Complexes

    End of each 6 week intervention period

  • Inflammatory Marker: hsCRP

    End of each 6 week intervention period

  • +17 more secondary outcomes

Other Outcomes (6)

  • Vascular Markers: PAI-1

    End of each 6 week intervention period

  • Vascular Markers: Exploratory

    End of each 6 week intervention period

  • Oxidative Stress Markers

    End of each 6 week intervention period

  • +3 more other outcomes

Study Arms (2)

Metformin

EXPERIMENTAL
Drug: Metformin

Placebo

PLACEBO COMPARATOR
Drug: Placebo

Interventions

Six week intervention: Study drug/placebo will be given in a forced uptitration with 500 mg once daily for one week, 500 mg twice daily for one week, 500/1000 for one week, and then 1000mg twice daily for the remainder of the 6 week intervention. If uptitration is not tolerated, max dose will be max tolerated dose of at least 500 mg twice daily.

Also known as: glucophage
Metformin

Six-week intervention: Study drug/placebo will be given in a forced uptitration with 500 mg once daily for one week, 500 mg twice daily for one week, and then the higher dose (850 mg) for the remainder of the 6 week intervention.

Placebo

Eligibility Criteria

Age25 Years - 59 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Age 20-59 years of age,
  • Type 1 diabetes based on antibody-positivity, rapid persistent conversion to insulin requirement after diagnosis, absent C-peptide, or DKA at diagnosis, or a clinical course consistent with T1D,
  • HbA1c 6.0 - 9.5, and
  • Willing and able to commit to two 6 week-long periods of blinded medication followed by hyperinsulinemic euglycemic clamp, vascular testing, and muscle biopsies.

You may not qualify if:

  • Any comorbid condition associated with:
  • inflammation,
  • insulin Resistance, or
  • dyslipidemia including:
  • cancer,
  • heart failure,
  • active or end stage liver disease,
  • kidney disease, or
  • rheumatological disease;
  • Tobacco use;
  • Pregnancy or women who are breastfeeding;
  • Steroid use;
  • Scheduled strenuous physical activity \>3 days a week;
  • Angina, known CAD, or any other cardiovascular or pulmonary disease;
  • A history of COPD or asthma;
  • +13 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Colorado Denver

Aurora, Colorado, 80045, United States

Location

MeSH Terms

Conditions

Diabetes Mellitus, Type 1Diabetes MellitusInsulin Resistance

Interventions

Metformin

Condition Hierarchy (Ancestors)

Glucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesAutoimmune DiseasesImmune System DiseasesHyperinsulinism

Intervention Hierarchy (Ancestors)

BiguanidesGuanidinesAmidinesOrganic Chemicals

Results Point of Contact

Title
Irene Schauer, MD
Organization
University of Colorado Denver

Study Officials

  • Irene Schauer, MD, PhD

    University of Colorado, Denver

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
TREATMENT
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

September 28, 2012

First Posted

March 19, 2013

Study Start

June 1, 2011

Primary Completion

March 24, 2017

Study Completion

March 24, 2017

Last Updated

January 21, 2022

Results First Posted

January 21, 2022

Record last verified: 2021-12

Locations