NCT05147896

Brief Summary

Diabetes is a chronic disease characterized by chronic hyperglycaemia, causing microvascular and macrovascular complications. The latter lead to various disabilities: blindness, end-stage renal failure, nerve damage, formation of leg ulcers, and atherosclerosis. In people with type 2 diabetes, the probability of these atherosclerosis associated complications is twice as high as in people without diabetes. Cardiovascular diseases are also the main cause of mortality in people with diabetes. Preventive measures are therefore crucial. In people with type 2 diabetes, in addition to good glycaemic control, the choice of antidiabetic drugs is also important. Large-scale research has shown that certain glucagon-like peptide (GLP-1) receptor agonists, in addition to improving the regulation of diabetes, also have a significant effect on reducing the macrovascular complications. It is now possible to use semaglutide, a GLP-1 receptor agonist, in the tablet form. Semaglutide lowers blood sugar only when the blood sugar value rises, due to food in the digestive tract, Thus, not increasing the risk of hypoglycaemia. In addition, semaglutide has a significant effect on weight loss and very beneficial, protective effects on the cardiovascular system. Large studies have shown that in its injectable form, it significantly reduces the incidence of cardiovascular death in patients with type 2 diabetes. Therefore, the aim of the present study is to examine how semaglutide provides protective effects on the cardiovascular system and reduces the risk of diabetes type 2 associated complications. The present study will include 100 people with type 2 diabetes and last for 12 months. The subjects will receive a semaglutide oral tablet daily in addition to their current treatment (combination of metformin and a sulphonyl urea). At the beginning of the study, after 6 months and at the end of the study (after 12 months of treatment), a detailed clinical examination will be performed and blood will be taken for laboratory parameters. In addition to basic blood tests, inflammatory and oxidative stress parameters, as well as lipid fractions parameters will also be assessed. Ultrasound examination of the changes in the carotid arteries and measures of additional properties of the arteries will also be performed. The confidentiality of the data of the participants in the research will be ensured, as the data obtained during the investigation will be encrypted before processing.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
100

participants targeted

Target at P50-P75 for not_applicable diabetes-mellitus-type-2

Timeline
Completed

Started May 2022

Geographic Reach
1 country

1 active site

Status
unknown

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

First Submitted

Initial submission to the registry

November 21, 2021

Completed
16 days until next milestone

First Posted

Study publicly available on registry

December 7, 2021

Completed
5 months until next milestone

Study Start

First participant enrolled

May 1, 2022

Completed
1 year until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2023

Completed
7 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2023

Completed
Last Updated

May 24, 2022

Status Verified

May 1, 2022

Enrollment Period

1 year

First QC Date

November 21, 2021

Last Update Submit

May 17, 2022

Conditions

Keywords

semaglutideatherosclerosisdiabetes mellitus type 2

Outcome Measures

Primary Outcomes (3)

  • Change in morphological arterial wall characteristics

    Ultrasonographic assessment of cIMT (in millimetres)

    1 year

  • Change in functional arterial wall characteristics

    Endothelial function assessment by EndoPAT

    1 year

  • Change in structural arterial wall characteristics

    Arterial stiffness assessment by Sphygmocor device (in meters per second)

    1 year

Secondary Outcomes (4)

  • Change in atherogenic small dense low-density lipoproteins (sdLDL)

    1 year

  • Change in glycated haemoglobin (HbA1c)

    1 year

  • Change in high sensitivity C-reactive protein (hsCRP)

    1 year

  • Correlations between changes in rate of cIMT reduction, % of endothelial function improvement and rate of arterial stiffness reduction on one hand and changes in concentration of sdLDL, % of HbA1c and concentration of hsCRP on the other

    1 year

Study Arms (2)

Interventional Arm

ACTIVE COMPARATOR

Beside metformin and sulphonyl urea treatment, the active, interventional arm, will be receiving Semaglutide Oral Tablets as per protocol, 3 mg for the first month, 7 mg in the second month and 14 mg form the third month onwards.

Drug: Semaglutide Oral Tablet

Comparative Arm

NO INTERVENTION

This group will not be receiving the additional therapy besides metformin and sulphonyl urea treatment. After 6 months a revaluation of glycemic control will be performed, if needed, rescue therapy with basal insulin will be implemented.

Interventions

Semaglutide Oral Tablets will be introduced to the active arm as per protocol for regular therapy introduction.

Also known as: Rybelsus
Interventional Arm

Eligibility Criteria

Age30 Years - 60 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • type 2 diabetes
  • therapy including at least metformin 1000 mg and sulphonyl urea at least half of the maximal dose
  • BMI \> or = 30 kg/m2
  • HbA1c \< or = 8,5%
  • associated risk factors including smoking, dyslipidaemia, arterial hypertension, chronic kidney disease stage 1 to 3.

You may not qualify if:

  • therapy with injectable GLP-1 receptor agonist ongoing or was taking place in the last year
  • manifested cardiovascular disease
  • heart failure
  • chronic kidney disease stages 4 and 5
  • advanced liver disease
  • proliferative retinopathy or maculopathy

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

UMC Ljubljana, Diabetes Outpatient Clinic

Ljubljana, Slovenia

RECRUITING

Related Publications (1)

  • Janic M, Rizzo M, Cosentino F, Pantea Stoian A, Lunder M, Sabovic M, Janez A. Effect of Oral Semaglutide on Cardiovascular Parameters and Their Mechanisms in Patients with Type 2 Diabetes: Rationale and Design of the Semaglutide Anti-Atherosclerotic Mechanisms of Action Study (SAMAS). Diabetes Ther. 2022 Apr;13(4):795-810. doi: 10.1007/s13300-022-01226-y. Epub 2022 Mar 8.

MeSH Terms

Conditions

Diabetes Mellitus, Type 2Atherosclerosis

Interventions

semaglutide

Condition Hierarchy (Ancestors)

Diabetes MellitusGlucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesArteriosclerosisArterial Occlusive DiseasesVascular DiseasesCardiovascular Diseases

Study Officials

  • Andrej Janež, Prof

    University Medical Centre Ljubljana

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Miodrag Janic, MD, PhD

CONTACT

Mojca Lunder, MD, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD, PhD, Prof

Study Record Dates

First Submitted

November 21, 2021

First Posted

December 7, 2021

Study Start

May 1, 2022

Primary Completion

May 1, 2023

Study Completion

December 1, 2023

Last Updated

May 24, 2022

Record last verified: 2022-05

Data Sharing

IPD Sharing
Will not share

Locations