Insulin Effects on Cardiac Function in Patients With Diabetes Mellitus

NCT02962921 | Completed Phase 4

• 1 other identifier: 1558-RMB-CTIL
• Study Type: interventional
• Target: 6
• Locations: 1 country
• Sites: 1

Brief Summary

Our investigation studies the role of acute insulin administration on the diabetic heart, its corresponding effective blood-insulin level and the time-course applicability of insulin in a routine clinical setting. A case series of six male (48.1 ± 4.9 y/o) patients with controlled diabetes (HbA1c of 6.6 ± 0.3%, disease duration of 14.4 ± 6.7 yr). Each subject was evaluated for glucose homeostatic, hemodynamic and echocardiographic systolic and diastolic parameters at baseline and following two successive insulin-load steps of a euglycemic hyperinsulinemic clamp study, each 2 h in duration. Results are presented as a mean ± SEM and analysed using the student's t-test.

Conditions

Diabetes Mellitus; Ventricular Dysfunction

Outcome Measures

Primary Outcomes (1)

• Left ventricle ejection fraction (%)

  1 year

Secondary Outcomes (1)

• Time needed to exert insulin effect on myocardial function (hour)

  1 year

Other Outcomes (7)

• Blood insulin levels (μU/ml: micro international unit per milliliter)

  1 year

• Left ventricle fractioning shortening (%)

  1 year

• E wave (centimeter per second)

  1 year

Study Arms (1)

Diabetic patients

EXPERIMENTAL

Diabetic patients were treated with insulin loads, left ventricle functional parameters were compared to those of healthy persons. Metabolic indices of insulin effect: blood insulin levels, glucose disposal rates under insulin infusion, were compared to respective group of healthy persons, studied earlier at our institution Insulin LISPRO intravenous loading

Drug: Insulin LISPRO intravenous loading

Interventions

Insulin LISPRO intravenous loading DRUG

intravenous infusion of insulin Lispro.

Also known as: Humalog Insulin

Diabetic patients

Eligibility Criteria

• Age: 30 Years - 65 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Diabetes mellitus duration of 2 years and over.

You may not qualify if:

• Previous cardiac disease: valvular, Pacing, Arrhythmias, Primary Cardiomyopathy.

Sponsors & Collaborators

• Rambam Health Care Campus: lead

Study Sites (1)

Rambam Medical Center

Haifa, Israel

Location

Related Publications (24)

• Adeghate E. Molecular and cellular basis of the aetiology and management of diabetic cardiomyopathy: a short review. Mol Cell Biochem. 2004 Jun;261(1-2):187-91. doi: 10.1023/b:mcbi.0000028755.86521.11.

  PMID: 15362503 RESULT

• Francis GS. Diabetic cardiomyopathy: fact or fiction? Heart. 2001 Mar;85(3):247-8. doi: 10.1136/heart.85.3.247. No abstract available.

  PMID: 11179253 RESULT

• Kitzman DW, Gardin JM, Gottdiener JS, Arnold A, Boineau R, Aurigemma G, Marino EK, Lyles M, Cushman M, Enright PL; Cardiovascular Health Study Research Group. Importance of heart failure with preserved systolic function in patients > or = 65 years of age. CHS Research Group. Cardiovascular Health Study. Am J Cardiol. 2001 Feb 15;87(4):413-9. doi: 10.1016/s0002-9149(00)01393-x.

  PMID: 11179524 RESULT

• Gutierrez C, Blanchard DG. Diastolic heart failure: challenges of diagnosis and treatment. Am Fam Physician. 2004 Jun 1;69(11):2609-16.

  PMID: 15202695 RESULT

• McMurray JJ, Stewart S. Epidemiology, aetiology, and prognosis of heart failure. Heart. 2000 May;83(5):596-602. doi: 10.1136/heart.83.5.596. No abstract available.

  PMID: 10768918 RESULT

• Rubler S, Dlugash J, Yuceoglu YZ, Kumral T, Branwood AW, Grishman A. New type of cardiomyopathy associated with diabetic glomerulosclerosis. Am J Cardiol. 1972 Nov 8;30(6):595-602. doi: 10.1016/0002-9149(72)90595-4. No abstract available.

  PMID: 4263660 RESULT

• Poornima IG, Parikh P, Shannon RP. Diabetic cardiomyopathy: the search for a unifying hypothesis. Circ Res. 2006 Mar 17;98(5):596-605. doi: 10.1161/01.RES.0000207406.94146.c2.

  PMID: 16543510 RESULT

• Fein FS, Strobeck JE, Malhotra A, Scheuer J, Sonnenblick EH. Reversibility of diabetic cardiomyopathy with insulin in rats. Circ Res. 1981 Dec;49(6):1251-61. doi: 10.1161/01.res.49.6.1251.

  PMID: 7030513 RESULT

• Hiramatsu K, Ohara N, Shigematsu S, Aizawa T, Ishihara F, Niwa A, Yamada T, Naka M, Momose A, Yoshizawa K. Left ventricular filling abnormalities in non-insulin-dependent diabetes mellitus and improvement by a short-term glycemic control. Am J Cardiol. 1992 Nov 1;70(13):1185-9. doi: 10.1016/0002-9149(92)90053-2.

  PMID: 1414944 RESULT

• Iliadis F, Kadoglou N, Didangelos T. Insulin and the heart. Diabetes Res Clin Pract. 2011 Aug;93 Suppl 1:S86-91. doi: 10.1016/S0168-8227(11)70019-5.

  PMID: 21864757 RESULT

• Cohen P, Harel C, Bergman R, Daoud D, Pam Z, Barzilai N, Armoni M, Karnieli E. Insulin resistance and acanthosis nigricans: evidence for a postbinding defect in vivo. Metabolism. 1990 Oct;39(10):1006-11. doi: 10.1016/0026-0495(90)90158-9.

  PMID: 2215248 RESULT

• DeFronzo RA, Tobin JD, Andres R. Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol. 1979 Sep;237(3):E214-23. doi: 10.1152/ajpendo.1979.237.3.E214.

  PMID: 382871 RESULT

• Whitlow PL, Rogers WJ, Smith LR, McDaniel HG, Papapietro SE, Mantle JA, Logic JR, Russell RO Jr, Rackley CE. Enhancement of left ventricular function by glucose-insulin-potassium infusion in acute myocardial infarction. Am J Cardiol. 1982 Mar;49(4):811-20. doi: 10.1016/0002-9149(82)91963-4. No abstract available.

  PMID: 7039286 RESULT

• Rizza RA, Mandarino LJ, Gerich JE. Dose-response characteristics for effects of insulin on production and utilization of glucose in man. Am J Physiol. 1981 Jun;240(6):E630-9. doi: 10.1152/ajpendo.1981.240.6.E630.

  PMID: 7018254 RESULT

• Cohen P, Barzilai N, Barzilai D, Karnieli E. Correlation between insulin clearance and insulin responsiveness: studies in normal, obese, hyperthyroid, and Cushing's syndrome patients. Metabolism. 1986 Aug;35(8):744-9. doi: 10.1016/0026-0495(86)90242-8.

  PMID: 3526086 RESULT

• Khouri SJ, Maly GT, Suh DD, Walsh TE. A practical approach to the echocardiographic evaluation of diastolic function. J Am Soc Echocardiogr. 2004 Mar;17(3):290-7. doi: 10.1016/j.echo.2003.08.012.

  PMID: 14981433 RESULT

• Jonassen AK, Sack MN, Mjos OD, Yellon DM. Myocardial protection by insulin at reperfusion requires early administration and is mediated via Akt and p70s6 kinase cell-survival signaling. Circ Res. 2001 Dec 7;89(12):1191-8. doi: 10.1161/hh2401.101385.

  PMID: 11739285 RESULT

• Kahn JK, Zola B, Juni JE, Vinik AI. Radionuclide assessment of left ventricular diastolic filling in diabetes mellitus with and without cardiac autonomic neuropathy. J Am Coll Cardiol. 1986 Jun;7(6):1303-9. doi: 10.1016/s0735-1097(86)80150-4.

  PMID: 3011872 RESULT

• Sasso FC, Carbonara O, Cozzolino D, Rambaldi P, Mansi L, Torella D, Gentile S, Turco S, Torella R, Salvatore T. Effects of insulin-glucose infusion on left ventricular function at rest and during dynamic exercise in healthy subjects and noninsulin dependent diabetic patients: a radionuclide ventriculographic study. J Am Coll Cardiol. 2000 Jul;36(1):219-26. doi: 10.1016/s0735-1097(00)00717-8.

  PMID: 10898438 RESULT

• Khankirawatana B, Khankirawatana S, Peterson B, Mahrous H, Porter TR. Peak atrial systolic mitral annular velocity by Doppler tissue reliably predicts left atrial systolic function. J Am Soc Echocardiogr. 2004 Apr;17(4):353-60. doi: 10.1016/j.echo.2003.12.023.

  PMID: 15044870 RESULT

• Mak GS, Sawaya H, Khan AM, Arora P, Martinez A, Ryan A, Ernande L, Newton-Cheh C, Wang TJ, Scherrer-Crosbie M. Effects of subacute dietary salt intake and acute volume expansion on diastolic function in young normotensive individuals. Eur Heart J Cardiovasc Imaging. 2013 Nov;14(11):1092-8. doi: 10.1093/ehjci/jet036. Epub 2013 Mar 20.

  PMID: 23515219 RESULT

• Diaz R, Goyal A, Mehta SR, Afzal R, Xavier D, Pais P, Chrolavicius S, Zhu J, Kazmi K, Liu L, Budaj A, Zubaid M, Avezum A, Ruda M, Yusuf S. Glucose-insulin-potassium therapy in patients with ST-segment elevation myocardial infarction. JAMA. 2007 Nov 28;298(20):2399-405. doi: 10.1001/jama.298.20.2399.

  PMID: 18042917 RESULT

• Mamas MA, Neyses L, Fath-Ordoubadi F. A meta-analysis of glucose-insulin-potassium therapy for treatment of acute myocardial infarction. Exp Clin Cardiol. 2010 Summer;15(2):e20-4.

  PMID: 20631859 RESULT

• Daoud Naccache D, Yalonetsky S, Bar-Yoseph R. Acute Effects of Insulin on Cardiac Function in Patients with Diabetes Mellitus: Clinical Applicability and Feasibility. Int J Endocrinol. 2020 Mar 17;2020:8134548. doi: 10.1155/2020/8134548. eCollection 2020.

  PMID: 32308680 DERIVED

MeSH Terms

Conditions

Diabetes Mellitus; Ventricular Dysfunction

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Heart Diseases; Cardiovascular Diseases

Study Officials

• Eddy Karnieli, MD

  Professor emeritus, Faculty of medicine, Technion. Haifa, Israel

  STUDY CHAIR

• Ronen Bar Yoseph, MD

  Pediatric Pulmonary Institute

  PRINCIPAL INVESTIGATOR

• Sergey Yalonetsky, MD

  Cardiology Division

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 4
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 10, 2016
• First Posted: November 15, 2016
• Study Start: February 1, 2003
• Primary Completion: May 1, 2003
• Study Completion: November 1, 2004
• Last Updated: November 15, 2016

Record last verified: 2016-11

Locations

IL (1)