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Postprandial Gut Hormone Responses in Patients With Type 1 Diabetes Mellitus

Not Applicable
Conditions
Hunger
type1diabetes
Obesity
Interventions
Diagnostic Test: Standardized test meal
Registration Number
NCT04430946
Lead Sponsor
National and Kapodistrian University of Athens
Brief Summary

The study will compare the postprandial responses to a test meal between subjects with type 1 diabetes and healthy control subjects, in terms of gut hormone levels, meal induced thermogenesis, hunger and satiety perception, as well as futher metabolic parameters.

Detailed Description

Aim of the study

To compare the acute effect of the consumption of a test meal on satiety, gastrointestinal hormones' response, post-meal thermogenesis, and further metabolic parameters in lean patients with type 1 diabetes mellitus (T1DM), obese patients with T1DM, and healthy lean and obese controls.

Study subjects:

Four groups of participants will be recruited, consisting of 15 lean healthy subjects (BMI \<25 kg/m2), 15 obese healthy subjects, 15 lean patients with T1DM (BMI \<25 kg/m2), and 15 obese patients with T1DM (BMI ≥ 30kg/m2). Groups will be matched for age and sex. Healthy volunteers will be recruited from the community, and diabetic individuals from our diabetes clinic. Eligibility criteria will include 18-65 years of age, no use of medications affecting appetite and stable weight (no fluctuations exceeding 5 kg the last 3 months.

Methods:

Demographic data and anthropometric measurements will be collected on the day of visit. Fasting blood samples will be collected for measurement of plasma glucose, insulin, triglycerides, GIP, GLP-1, PYY (total), ghrelin (total). VAS for hunger and satiety will be completed in the fasting state. Participants will then consume a test meal of \~700 kcal consisting of protein and fat (no carbohydrates) within 10 minutes. Blood samples will be drawn and VAS scales completed postprandially at 30, 60, 90, 120, 150, 180 min. RMR measurements using indirect calorimetry will be performed in the fasting state, 1 hour and 3 hours postprandially to assess meal induced thermogenesis. Postprandial responses for these parameters will be assessed as area under the curve (AUC).

Patients with T1DM treated with basal- bolus insulin therapy will receive their regular basal insulin dose and patients on an insulin pump will be kept on their basal rate of insulin infusion. In case of fasting hyperglycemia, the session will be canceled.

Postrpandial glucose excursion will be treated with fast acting insulin.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Type 1 diabetes
  • BMI >30 kg/m2 for the obese groups
Exclusion Criteria
  • Diabetic neuropathy
  • Malignancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Obese patients with type 1 diabetesStandardized test mealTest meal consumed within 10 minutes
Obese healthy control subjectsStandardized test mealTest meal consumed within 10 minutes
Lean patients with type 1 diabetesStandardized test mealTest meal consumed within 10 minutes
Lean healthy control subjectsStandardized test mealTest meal consumed within 10 minutes
Primary Outcome Measures
NameTimeMethod
Gut peptide hormone responses3 hours

Postprandial responses of ghrelin, PYY, GLP-1, Glicentin, Oxyntomodulin measured as area under the curve (AUC)

Secondary Outcome Measures
NameTimeMethod
Meal induced thermogenesis3 hours

Change in basal metabolic rate after meal consumption as assessed by indirect calorimetry

Trial Locations

Locations (1)

Diabetes Clinical Research Laboratory, 1st Department of Propaedeutic Internal Medicine

🇬🇷

Athens, Greece

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