Effects of Glimepiride on Recovery From Hypoglycemia in Participants With Type 2 Diabetes Mellitus (MK-0000-253)

Phase 1

Completed

Conditions: Type 2 Diabetes Mellitus

Interventions: Drug: Placebo
Drug: Glimepiride 2 mg
Drug: Glimepiride 4 mg
Procedure: Hypoglycemic Clamp

Registration Number: NCT01614769

Lead Sponsor: Merck Sharp & Dohme LLC

Brief Summary: This study aims to assess how glimepiride affects the recovery from hypoglycemia in participants with type 2 diabetes mellitus. The primary objective is to estimate the time taken by participants to recover from hypoglycemia to euglycemia after treatment with either 2 mg or 4 mg of glimepiride when compared to placebo.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 10

Inclusion Criteria

Has clinically confirmed diagnosis of type 2 diabetes mellitus (T2DM) controlled by diet and exercise alone, or treated by metformin only with same dose for >= 12 weeks prior to screening visit.
Females of reproductive potential who demonstrate nongravid state, agree to use (and/or have partner use) two acceptable methods of birth control starting at least two weeks prior to study, throughout study, and at least two weeks after last dose of study drug.
Females of non-reproductive potential, post menopausal, status post hysterectomy, oophorectomy or tubal ligation.
Is in good health, other than T2DM.
Has been a nonsmoker and/or non user of nicotine-containing products for the previous 6 months. If discontinued use for previous 3 months, may be enrolled at investigator's discretion.
Will follow American Heart Association weight maintaining diet and exercise program or equivalent beginning 2 weeks prior to study until poststudy visit.
At screening visit has a Body Mass Index (BMI) =< 40 kg/m^2.
At screening visit has a Hemoglobin A1c (HbA1c) of >= 7% and < 10% (+/- 0.1%).
On the morning of randomization at predose has fasting plasma glucose (FPG) >= 126 mg/dL, and =< 250 mg/dL.

Exclusion Criteria

Has a history of stroke, chronic seizures, or major neurological disorder.
Has a history of any illness that might confound the results of the study or pose additional risk to the participant.
Has a history of type 1 diabetes mellitus, ketoacidosis, C-peptide =< 0.8 ng/mL, secondary forms of diabetes or diabetic complications.
Has a history of neoplastic disease.
Is a nursing mother.
Has been treated =< one year of screening visit with sulfonylurea agents, meglitinides, dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) analogs, or insulin.
Has received treatment within =< 12 weeks of screening visit with a peroxisome proliferator-activated receptor γ (PPARγ) agonist.
Is taking medications for a co-morbid condition or anticipates taking new medications beginning 2 weeks prior to study.
Consumes excessive amounts of alcohol or caffeinated beverages.
Is a regular user of illicit drugs, or has a history of drug abuse within the previous 6 months.
Has had major surgery, lost 500 mL of blood, or participated in another investigational study within 4 weeks prior to screening visit.
Is on a weight loss program, but not in the maintenance phase, or treated with a weight loss medication within 8 weeks of prestudy visit.
Has a history of severe allergies, anaphylactic reaction or intolerability to drugs, food, insulin, glimepiride or sulfonamide derivatives.

Study & Design

Study Type: INTERVENTIONAL

Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Glimepiride 4 mg → Placebo → Glimepiride 2 mg	Glimepiride 2 mg	Participants received 4 mg glimepiride in the first period, placebo in the second period and 2 mg glimepiride in the third period, with a 7-day washout between each period.
Glimepiride 4 mg → Glimepiride 2 mg → Placebo	Glimepiride 2 mg	Participants received 4 mg glimepiride in the first period, 2 mg glimepiride in the second period and placebo in the third period, with a 7-day washout between each period.
Placebo → Glimepiride 2 mg → Glimepiride 4 mg	Glimepiride 2 mg	Participants received placebo in the first period, 2 mg glimepiride in the second period and 4 mg glimepiride in the third period, with a 7-day washout between each period.
Placebo → Glimepiride 4 mg → Glimepiride 2 mg	Glimepiride 4 mg	Participants received placebo in the first period, 4 mg glimepiride in the second period and 2 mg glimepiride in the third period, with a 7-day washout between each period.
Placebo → Glimepiride 2 mg → Glimepiride 4 mg	Glimepiride 4 mg	Participants received placebo in the first period, 2 mg glimepiride in the second period and 4 mg glimepiride in the third period, with a 7-day washout between each period.
Glimepiride 2 mg → Glimepiride 4 mg → Placebo	Glimepiride 4 mg	Participants received 2 mg glimepiride in the first period, 4 mg glimepiride in the second period and placebo in the third period, with a 7-day washout between each period.
Glimepiride 2 mg → Glimepiride 4 mg → Placebo	Glimepiride 2 mg	Participants received 2 mg glimepiride in the first period, 4 mg glimepiride in the second period and placebo in the third period, with a 7-day washout between each period.
Glimepiride 4 mg → Placebo → Glimepiride 2 mg	Glimepiride 4 mg	Participants received 4 mg glimepiride in the first period, placebo in the second period and 2 mg glimepiride in the third period, with a 7-day washout between each period.
Placebo → Glimepiride 2 mg → Glimepiride 4 mg	Hypoglycemic Clamp	Participants received placebo in the first period, 2 mg glimepiride in the second period and 4 mg glimepiride in the third period, with a 7-day washout between each period.
Glimepiride 2 mg → Glimepiride 4 mg → Placebo	Placebo	Participants received 2 mg glimepiride in the first period, 4 mg glimepiride in the second period and placebo in the third period, with a 7-day washout between each period.
Placebo → Glimepiride 2 mg → Glimepiride 4 mg	Placebo	Participants received placebo in the first period, 2 mg glimepiride in the second period and 4 mg glimepiride in the third period, with a 7-day washout between each period.
Glimepiride 2 mg → Glimepiride 4 mg → Placebo	Hypoglycemic Clamp	Participants received 2 mg glimepiride in the first period, 4 mg glimepiride in the second period and placebo in the third period, with a 7-day washout between each period.
Glimepiride 4 mg → Placebo → Glimepiride 2 mg	Placebo	Participants received 4 mg glimepiride in the first period, placebo in the second period and 2 mg glimepiride in the third period, with a 7-day washout between each period.
Glimepiride 4 mg → Placebo → Glimepiride 2 mg	Hypoglycemic Clamp	Participants received 4 mg glimepiride in the first period, placebo in the second period and 2 mg glimepiride in the third period, with a 7-day washout between each period.
Placebo → Glimepiride 4 mg → Glimepiride 2 mg	Placebo	Participants received placebo in the first period, 4 mg glimepiride in the second period and 2 mg glimepiride in the third period, with a 7-day washout between each period.
Placebo → Glimepiride 4 mg → Glimepiride 2 mg	Glimepiride 2 mg	Participants received placebo in the first period, 4 mg glimepiride in the second period and 2 mg glimepiride in the third period, with a 7-day washout between each period.
Placebo → Glimepiride 4 mg → Glimepiride 2 mg	Hypoglycemic Clamp	Participants received placebo in the first period, 4 mg glimepiride in the second period and 2 mg glimepiride in the third period, with a 7-day washout between each period.
Glimepiride 2 mg → Placebo → Glimepiride 4 mg	Placebo	Participants received 2 mg glimepiride in the first period, placebo in the second period and 4 mg glimepiride in the third period, with a 7-day washout between each period.
Glimepiride 2 mg → Placebo → Glimepiride 4 mg	Glimepiride 2 mg	Participants received 2 mg glimepiride in the first period, placebo in the second period and 4 mg glimepiride in the third period, with a 7-day washout between each period.
Glimepiride 2 mg → Placebo → Glimepiride 4 mg	Glimepiride 4 mg	Participants received 2 mg glimepiride in the first period, placebo in the second period and 4 mg glimepiride in the third period, with a 7-day washout between each period.
Glimepiride 2 mg → Placebo → Glimepiride 4 mg	Hypoglycemic Clamp	Participants received 2 mg glimepiride in the first period, placebo in the second period and 4 mg glimepiride in the third period, with a 7-day washout between each period.
Glimepiride 4 mg → Glimepiride 2 mg → Placebo	Placebo	Participants received 4 mg glimepiride in the first period, 2 mg glimepiride in the second period and placebo in the third period, with a 7-day washout between each period.
Glimepiride 4 mg → Glimepiride 2 mg → Placebo	Glimepiride 4 mg	Participants received 4 mg glimepiride in the first period, 2 mg glimepiride in the second period and placebo in the third period, with a 7-day washout between each period.
Glimepiride 4 mg → Glimepiride 2 mg → Placebo	Hypoglycemic Clamp	Participants received 4 mg glimepiride in the first period, 2 mg glimepiride in the second period and placebo in the third period, with a 7-day washout between each period.

Primary Outcome Measures

Name	Time	Method
Recovery Time From Hypoglycemia to Euglycemia	From 1 to 180 minutes post hypoglycemic clamp	Immediately after release of the hypoglycemic clamp, which maintained blood glucose close to 50 mg/dL, the time taken until glucose reached euglycemia, defined as 3 consecutive measurements \>= 70 mg/dL, is called the recovery time.
Rate of Recovery From Hypoglycemia to Euglycemia	From 1 to 180 minutes post hypoglycemic clamp	The rate of recovery is the difference in concentration between blood glucose at euglycemia and at the end of the hypoglycemic clamp, divided by the recovery time.
Incremental Weighted Average Blood Glucose Concentration Over 3 Hours of Hypoglycemic Recovery	From 1 to 180 minutes post hypoglycemic clamp	The incremental weighted average qualitatively assesses overall hypoglycemic recovery by measuring mean glycemia over the 3 hour recovery period. Blood glucose measured at the release of the hypoglycemic clamp, considered the baseline value, was subtracted from blood glucose values measured over the ensuing 3 hours of hypoglycemic recovery. These differences from baseline were averaged to calculate the incremental weighted average blood glucose concentration.