An observational study in Type1 Diabetes Mellitus, sponsored by University of California, Irvine. Completed at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2009-05-29.
Sponsored by University of California, Irvine · Observational
The pancreas is an organ that plays major roles in the digestion of food. A part of the pancreas called islet beta-cells produces insulin, which regulates the amount of glucose (a sugar) present in the blood at all times. Type-1 Diabetes Mellitus (T1DM), an autoimmune disorder characterized by destruction of pancreatic islet beta-cells (the cells that produce insulin), affects at least a million individuals in the US alone. In T1DM, a type of white blood cells called T lymphocytes attacks and destroys the pancreatic islet beta-cells, leading to a loss of insulin, an increase in blood glucose, and a dependence on insulin injections for survival. Despite rigorous control of blood sugar, the majority of diabetic patients develop serious complications including retinopathy, nephropathy, neuropathy, microangiopathy and strokes.
Non-invasive methods to monitor pancreatic beta-cell loss associated with type-1 diabetes mellitus (T1DM) could improve early diagnosis, provide tools to measure responsiveness to new therapies, and evaluate the efficiency of pancreatic transplantation and graft survival.
Our goal is to develop a non-invasive PET-CT imaging method based on binding of a molecule (18F-fallypride) for tracking beta-cell loss during the progression of T1DM. In preliminary studies we demonstrated specific binding of 18F-fallypride to D2 receptors in rat pancreatic sections and we demonstrated that the loss of pancreatic beta cells in streptozotocin-treated rats was associated with a corresponding decrease in 18F-fallypride binding to pancreatic sections. A preliminary 18F-fallypride PET-CT study done by a collaborator in Ohio on a healthy volunteer, revealed 18F-fallypride-uptake by the pancreas that was distinguishable from surrounding tissues. Aim-1 of our project will measure the variability of 18F-fallypride PET-scanning of the pancreas in six healthy volunteers scanned twice with an interval of 4-6 weeks. In Aim-2 of our project, we will compare fallypride PET-CT scans of 12 patients with long-standing T1DM (nearly all beta cells destroyed) with 12 age- and sex-matched healthy volunteers. If we are able to distinguish between the two groups, we will in future (a) optimize the method so as to be able to detect a 20-30% loss of beta cells, and (b) perform PET-CT studies in new-onset T1DM patients and in at-risk first degree relatives of T1DM patients.
10,923 studies on the registry are indexed under Diabetes Mellitus; 1,318 are open to participants now.
This study's planned enrollment of 30 is below the median of 233 across 2,218 observational studies indexed under Diabetes Mellitus.
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Of its 41 completed or terminated interventional studies of FDA-regulated products, 30 (73%) have results posted.
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Joslin Diabetes Clinic at the University of California Irvine, age-matched controls will be obtained from Orange County California.
Exclusion Criteria:
Healthy individuals with normal C-peptide levels following i.v. glucagon challenge. These individuals will be administered 18F-fallypride and then subjected to PET-CT scanning of the pancreas and brain. The subject will be positioned in the PET/CT scanner and a low-dose CT (15-20 secs) of the abdomen carried out (with subjects breathing normally). A 30-min PET acquisition will then be started (three 10 min static frames or one 30 min static frame). The subject will then be repositioned for a low-dose CT scan of the head (15-20 secs) following which a 20-min PET acquisition will then be started (two 10 min static frames or one 20 min static frame).
Drug: 18F-fallypride
Patients with longstanding T1DM and \<20% C-peptide levels following i.v. glucagon challenge will be consented. 18F-Fallypride injected intravenously and subjects allowed to wait for approx 1 hr for the uptake.(b) Subject positioned in the PET/CT scanner and a low-dose CT (15-20 secs) of the abdomen (pancreas) carried out (with subjects breathing normally).(c) A 30-min PET acquisition will then be started (three 10 min static frames or one 30 min static frame).(d) Subject repositioned for a low-dose CT scan of the head (15-20 secs).(e) A 20-min PET acquisition will then be started (two 10 min static frames or one 20 min static frame).(f) End of PET/CT scanning procedures. Subject taken out of the scanner.
Drug: 18F-fallypride
Single bolus i.v. injection 60 minutes before PET-CT scanning. Maximum activity per single administration 5 mCi; maximum amount of drug per administration \<10 micrograms.
I.v. bolus maximum activity per single administration 5 mCi; maximum amount of drug per administration \<10 micrograms.
Difference in fallypride binding in the pancreas of long-standing T1DM patients versus healthy controls
Time frame: At the end of the study when 12 controls and 12 patients have been studied.
This study is completed, as verified in May 2009. You cannot join it, but the record below documents what was studied.
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University of California, Irvine