CClinicalTrials.gg
RecruitingNCT04615546Updated Dec 4, 2024

Role of Nutrient Transit in Hyperinsulinemic Hypoglycemia

An interventional study of Use of Continuous Glucose Monitor (CGM) and Use of "Cardea Solo" monitoring in Post-Bariatric Hypoglycemia, sponsored by Stanford University. Recruiting at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-12-04.

Sponsored by Stanford University · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
60
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

Severe hypoglycemia (low blood sugar)after gastric bypass surgery is an increasingly recognized condition, characterized by symptoms of hypoglycemia after eating and inappropriately elevated insulin concentrations that occur at the time of hypoglycemia. Severe hypoglycemia can be dangerous and debilitating and can also impact cognitive function. At the moment no medical therapies have been developed for this disorder. Determining why some but not other patients develop this condition would allow for improved prediction, prevention, and treatment approaches. The purpose of the study is to understand the physiological changes observed in those patients who undergo gastric bypass and develop symptomatic hypoglycemia.

02

Conditions studied

  • Post-Bariatric Hypoglycemia
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Male or female patients 18-70 years of age
  • Post-bariatric surgery more than 6 months prior to signing the informed consent (not required for non-surgical controls)
  • Documented history of hyperinsulinemic hypoglycemia (not required for post-bariatric and non-surgical controls)

Exclusion criteria

Exclusion Criteria:

  • Patients currently using sulfonylureas or other medications that may interfere with glucose metabolism within 5 half-lives of drug.
  • Participation in any clinical investigation within 4 weeks prior to dosing
  • History of or current insulinoma
  • Active infection or significant acute illness within 2 weeks prior to dosing
  • Female patients who are pregnant or lactating
  • Women of childbearing potential and not utilizing effective contraceptive methods
  • Inadequate end organ function as defined by: Serum creatinine >2.0 mg/dL, alanine transaminase (ALT) and aspartate aminotransferase (AST) > 2 x Upper Normal Limit
  • Allergy to test meal or medications used in the study
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
60 participants (estimated)

Study arms

  • Experimental
    Remote Phase: Post-Bariatric Hypoglycemia Patients

    Participants will wear continuous glucose monitor (CGM) in a blinded manner (cannot see data output) for 20 days followed by in an unblinded manner (can see data output) for 20 days.

    Behavioral: Use of Continuous Glucose Monitor (CGM) · Other: Use of "Cardea Solo" monitoring

  • No intervention
    In-Clinic Phase: Post-Bariatric Hypoglycemia Patients

    Participants will attend 1-3 study visits over the period of approximately 2 months, with metabolic parameters assessed under a variety of conditions. This group will also wear CGM during a portion of the metabolic tests. This may include participants from the Remote Phase or newly enrolled participants.

  • No intervention
    In-Clinic Phase: Surgical Controls

    Participants will attend 1-3 study visits over the period of approximately 2 months, with metabolic parameters assessed under a variety of conditions.

  • No intervention
    In-Clinic Phase: Nonsurgical Controls

    Participants will attend 1-3 study visits over the period of approximately 2 months, with metabolic parameters assessed under a variety of conditions.

  • No intervention
    In-Clinic Phase: Post-Bariatric Hypoglycemia Patients with indwelling gastrostomy tube

    Participants will undergo standardized mixed meal tolerance tests via oral, gastrostomy tube, and concomitant oral + gastrostomy tube routes of delivery with metabolic parameters assessed.

Interventions

  • BehavioralUse of Continuous Glucose Monitor (CGM)

    Participants will wear CGM

  • OtherUse of "Cardea Solo" monitoring

    Participants will wear a "Cardea Solo" patch during blinded CGM use

05

What researchers measure

Primary outcomes

  1. Steady state plasma glucose (SSPG) as a measure of insulin sensitivity

    This endpoint applies to the In-Clinic Phase cohorts: Post-Bariatric Hypoglycemia, Surgical Controls, Non-Surgical Controls. This is a one day in-person appointment lasting approximately 6 hours.

    Time frame: Baseline 4-hour SSPG

  2. Rate of gastric emptying

    This endpoint applies to the In-Clinic Phase cohorts: Post-Bariatric Hypoglycemia, Surgical Controls, Non-Surgical Controls. This is an in-person appointment lasting approximately 5 hours.

    Time frame: Baseline 4-hour scintigraphy procedure

  3. Concentration of Glucagon-Like peptide 1 secretion augmentation of insulin secretion rate

    This endpoint applies to the In-Clinic Phase cohorts: Post-Bariatric Hypoglycemia, Surgical Controls, Non-Surgical Controls. The blood collected from the SSPG will be stored and analyzed for the concentration of GLP-1 at multiple timepoints.

    Time frame: Baseline 4-hour graded-glucose infusion

  4. Rate of clinically important hypoglycemia (Level 2 hypoglycemia, <54 mg/dL)

    This endpoint applies to Remote Phase participants

    Time frame: 40 days

  5. Percent time in clinically important hypoglycemia (Level 2 hypoglycemia, <54 mg/dL)

    This endpoint applies to Remote Phase participants

    Time frame: 40 days

  6. Rate of arrhythmia during hypoglycemia

    This endpoint applies to Remote Phase participants

    Time frame: 10 days

06

Study locations

1 of 1 sites recruiting
  • Stanford University School of Medicine
    Stanford, California 94305-5103, United States
    Recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04615546
Lead sponsor
Stanford University
Collaborators
American Diabetes Association
Responsible party
Tracey McLaughlin (Professor of Medicine, Endocrinology, Stanford University) — Principal investigator
First posted
Nov 4, 2020
Start date
May 6, 2020
Primary completion
Dec 2025 (estimated)
Completion
Jun 2026 (estimated)
Last update
Dec 4, 2024

Study contacts

Tracey McLaughlin, MD
principal investigator · Stanford University
Colleen Craig, MD
study director · Stanford University

Oversight

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

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