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CompletedNCT04461015Updated Jun 21, 2022Results posted

The Effect of the Interaction of Glucagon and Insulin on Endogenous Glucose Production in Humans

A Phase 3 interventional study of 0.4mU Insulin followed by withdrawal period followed by 0.8mU study and 0.8mU Insulin followed by withdrawal period followed by 0.4mU study in Healthy, sponsored by Adrian Vella. Completed at 1 site in United States. Open to participants aged 18 Years to 40 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-06-21.

Sponsored by Adrian Vella · Phase 3, Interventional, and Basic science

Phase
Phase 3
Study type
Interventional
Enrollment
12
Allocation
Randomized
Ages
18 Years to 40 Years
Sex
All
01

Study summary

The purpose of this research is to help understand the relative importance of changes in insulin secretion (which lowers glucose) and changes in glucagon (which raises glucose) to regulate metabolism and the body's ability to make glucose.

Read the detailed description

Study A (Insulin 0.4mU/Kg/min): Subjects will be admitted to the CRTU at approximately 1700 on the day prior to study. They will then consume a standard 10kcal/kg meal (55% carbohydrate, 30% fat, 15% protein, caffeine free) and fast overnight. Blood will then be sampled for baseline enrichment and 2H20 (1.67g/kg of body water) will be given in 3 divided doses at 2200, 2400 and 0200. The following morning (approximately 0530), a forearm vein will be cannulated to allow infusions to be performed. In addition, a cannula will be inserted retrogradely into a vein of the contra-lateral dorsum of the hand. This will be placed in a heated Plexiglas box maintained at around 120oF to allow sampling of arterialized venous blood. At approximately 0600 (-180 min), a primed, (10microCi prime, 0.1microCi/min continuous) infusion containing trace amounts of glucose labeled with [3-3H] glucose will be started and continued till 0900 (0 min).

At 0900 (0 min), the infusion will be varied so as to mimic the anticipated pattern of fall of EGP. In addition, glucose also labeled with [3-3H] glucose will be infused so as to maintain glucose concentrations at \~ 95mg/dL. Peripheral venous glucose concentrations will be measured every 10 minutes to allow the infusion rate of glucose to be adjusted as necessary.

Simultaneously, an infusion of somatostatin (60ng/kg/min) will be started at time 0 to inhibit endogenous islet secretion and therefore ensure identical portal insulin concentrations on the two study days. Insulin will be infused at a constant rate known to produce \~ 50% suppression of EGP (0.4mU/Kg/min).

From 0900 (0 min) to 1030 (90 min) no glucagon will be infused. Subsequently, a glucagon infusion will commence (91 - 180 min) at 0.35 ng/Kg/min and then increase to 0.70 ng/Kg/min (181- 270 min), a rate which will be maintained till the end of the study (1330).

Study B (0.8mU/Kg/min): Approximately 1-2 weeks after the first study visit, subjects will be asked to return to the CRTU. This study visit will be similar to Study A. However, insulin will be infused at 0.8mU/Kg/min 0 to 270 minutes.

02

Conditions studied

  • Healthy
03

In context

Lead sponsor

Adrian Vella is the lead sponsor of 8 studies on the registry; 1 is open to participants now.

Of its 5 completed or terminated interventional studies of FDA-regulated products, 3 (60%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 40 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • We will recruit 15 otherwise healthy subjects using intramural and local extramural advertising after approval from the Mayo Clinic Institutional Review Board. Individuals who express interest in participating will be invited for a screening visit. Individuals with a BMI \< 19 or > 28 kg/m2 will be excluded from the study to avoid potential confounding effects that may result from extreme leanness or from obesity. Subjects will have no known systemic illness, taking any medication that could affect glucose metabolism and no history of upper gastrointestinal surgery.

Exclusion criteria

Exclusion Criteria:

  • Subjects \< 18 years of age or > 40 years of age will not be studied to minimize the potential confounding effects of age on glucagon and insulin action. The subjects will not be taking medications that affect glucose metabolism (to be determined by PI) and have no history of chronic illness or upper gastrointestinal surgery. We are seeking to recruit subjects who do not have diabetes (fasting glucose \<100mg/dL).
05

Study design

Phase
Phase 3
Primary purpose
Basic science
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
12 participants (actual)

Study arms

  • Other
    0.4mU Insulin

    During the euglycemic clamp insulin will be infused at 0.4mU/Kg/Min

    Drug: 0.4mU Insulin followed by withdrawal period followed by 0.8mU study · Drug: 0.8mU Insulin followed by withdrawal period followed by 0.4mU study

  • Other
    0.8mU Insulin

    During the euglycemic clamp insulin will be infused at 0.8mU/Kg/Min

    Drug: 0.4mU Insulin followed by withdrawal period followed by 0.8mU study · Drug: 0.8mU Insulin followed by withdrawal period followed by 0.4mU study

Interventions

  • Drug0.4mU Insulin followed by withdrawal period followed by 0.8mU study

    Clamp study with insulin infused at 0.4 mU/Kg/min, followed by a 2 week withdrawal period followed by a clamp study with insulin infused at 0.8 mU/Kg/min

    Also known as: 0.4 then 0.8

  • Drug0.8mU Insulin followed by withdrawal period followed by 0.4mU study

    Clamp study with insulin infused at 0.8 mU/Kg/min, followed by a 2 week withdrawal period followed by a clamp study with insulin infused at 0.4 mU/Kg/min

    Also known as: 0.8 then 0.4

06

What researchers measure

Primary outcomes

  1. Endogenous Glucose Production (EGP)

    is calculated by tracer-based measurement and expressed per kg lean body mass

    Time frame: It will be quantified at 90, 180 and 270 minutes for the study with 0.4mU insulin infusion and compared to values obtained for the study with 0.8mU insulin infusion at the same timepoints

07

Results

Posted Jun 21, 2022
Limitations and caveats
The main caveat is that during the experiment insulin is kept constant - i.e. not quite like what happens in the postprandial situation

Participant flow

Participant flow — Overall Study
Milestone0.4 Then 0.80.8 Then 0.4
Started57
Completed55
Not completed02
Withdrew: Iv access lost during the study01
Withdrew: Withdrawal by subject01

Outcome measures

PrimaryEndogenous Glucose Production (EGP)

is calculated by tracer-based measurement and expressed per kg lean body mass

Time frame:
It will be quantified at 90, 180 and 270 minutes for the study with 0.4mU insulin infusion and compared to values obtained for the study with 0.8mU insulin infusion at the same timepoints
Reported as:
Mean · umol/kg/min
Endogenous Glucose Production (EGP)
umol/kg/min0.4mU Insulin0.8mU Insulin
At 90 minutes4.99 ± 0.535.02 ± 0.74
At 180 minutes6.82 ± 0.825.52 ± 0.96
At 270 minutes8.48 ± 1.075.38 ± 1.13

Adverse events

Collected over 3 months. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
0.4 Events0/12 (0%)0/12 (0%)1/12 (8.3%)
0.8 Events0/12 (0%)0/12 (0%)2/12 (16.7%)
Most frequent other events
Most frequent other events
Event0.4 Events0.8 Events
PhlebitisBlood and lymphatic system disorders1/122/12
NauseaGastrointestinal disorders1/120/12

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)0.4 Then 0.80.8 Then 0.4Total
<=18 years000
Between 18 and 65 years5510
>=65 years000
Age, Continuous
Age, Continuous(years)0.4 Then 0.80.8 Then 0.4Total
Mean34 ± 1337 ± 1035 ± 11
Sex: Female, Male
Sex: Female, Male(Participants)0.4 Then 0.80.8 Then 0.4Total
Female5510
Male022
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)0.4 Then 0.80.8 Then 0.4Total
Count of participants——0
Region of Enrollment
Region of Enrollment(participants)0.4 Then 0.80.8 Then 0.4Total
United States5712
08

Study locations

1 site
  • Mayo Clinic in Rochester
    Rochester, Minnesota 55905, United States
09

References and documents

Study documents

  • Protocol and statistical analysis plan · Jan 13, 2021

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 21, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04461015
Lead sponsor
Adrian Vella
Responsible party
Adrian Vella (Principal Investigator, Mayo Clinic) — Sponsor-investigator
First posted
Jul 8, 2020
Start date
Oct 14, 2020
Primary completion
Jul 30, 2021
Completion
Jan 6, 2022
Results posted
Jun 21, 2022
Last update
Jun 21, 2022

Study contacts

Adrian Vella
principal investigator · Mayo Clinic

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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