Recruiting nowPhase 4Interventional
What this study is about
This project uses both transcriptomic- and genomic-level data to identify mechanisms of individual responses to glucagon-like peptide-1 (GLP-1) in Mexican-Americans with prediabetes. The GLP-1 hormone is essential for glucose reduction, weight loss, cardiovascular risk reduction, and renal protection. Newly discovered mechanisms will illuminate causal links between disease genotype and phenotype, which may ultimately guide personalized therapeutic approaches for type 2 diabetes, prediabetes, obesity, cardiovascular disease, renal disease, and other related diseases.
A promising-looking record is not the same as confirmed eligibility. The study team must review the full criteria and current recruitment status.
Basic eligibility
Age18 Years to Not listed
SexAll
Healthy volunteersNot accepted
ConditionPreDiabetes
Full registry criteria
Inclusion criteria: 1. Men and women, ages 18 years and older 2. Diagnosis of Prediabetes - defined as either impaired fasting glucose (fasting glucose of 100-125 mg/dL), impaired glucose tolerance (2-hour postprandial blood glucose of 140-199 mg/dL after 75-gram oral glucose challenge), and/or a hemoglobin A1C ranging from 5.7% to 6.4% 3. High risk for progression to diabetes: defined as having at least one of the two following additional factors: Obesity (BMI ≥ 30 kg/m2) and/or metabolically unhealthy status. "Metabolically unhealthy status" is defined as at least two of the following: elevated blood pressure (SBP ≥ 130 mmHg and/or DBP ≥ 85 mmHg), elevated triglycerides ≥ 150 mg/dL, low HDL cholesterol (males \< 40 mg/dL; females \< 50 mg/dL), and elevated fasting glucose ≥ 100 mg/dL (Wu S et al., 2017). 4. Women of childbearing age must agree to use an acceptable method of pregnancy prevention (barrier methods, abstinence, hormonal contraception, intrauterine contraception, or surgical sterilization) for the duration of the study. 5. Patients must have the following laboratory values: Hematocrit ≥ 34 vol%, estimated glomerular filtration rate ≥ 60 mL/min per 1.73 m2, AST (SGOT) \< 2.5 times ULN, ALT (SGPT) \< 2.5 times ULN, alkaline phosphatase \< 2.5 times ULN Exclusion Criteria: 1. History of Type 1 or Type 2 diabetes mellitus 2. Pregnant or breastfeeding women 3. Medications: metformin, DPP-4 inhibitors, GLP-1 receptor agonists, SGLT-2 inhibitors, thiazolidinediones, insulin, sulfonylureas, meglitinides, alpha-glucosidase inhibitors, and/or corticosteroids over the last 3 months. 4. Active malignancy 5. History of clinically significant cardiac, hepatic, pancreatic or renal disease. 6. History of any serious hypersensitivity reaction to the study medication (or any other incretin mimetic) 7. Prisoners or subjects who are involuntarily incarcerated 8. Prior history of pancreatitis, medullary thyroid cancer, or multiple endocrine neoplasia type 2 (MEN 2) 9. Family history of medullary thyroid cancer (a rare form of thyroid cancer) or MEN2. However, as many individuals may not be aware of the specific type of thyroid cancer, will also exclude any family history of thyroid cancer or MEN2. 10. Hospitalization for COVID-19 in last 3 months
Primary outcomes
Mean change in beta cell responsivity12 weeksA rate which measures the ability of beta cells to secrete insulin
Insulin Sensitivity12 weeksMeasurement of the efficacy of insulin action at peripheral tissues
Disposition Index12 weeksProduct of beta cell responsivity and insulin sensitivity (see above)
GLP-1-Induced Potentiation12 weeksMeasurement of GLP-1 (glucagon-like peptide 1) hormonal efficacy in relationship to postprandial insulin secretion
Mean change in GLP-1 Area Under the Curve (AUC)12 weeksComparison of GLP-1 AUC measurements before and after drug intervention
Gene expression changes for minor variants of eQTLs for TCF7L212 weekseQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.
Gene expression changes for minor variants of eQTLs for KCNQ112 weekseQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.
Gene expression changes for minor variants of eQTLs for WFS112 weekseQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.
