A Study of Tirzepatide (LY3298176) Once a Week Versus Insulin Glargine Once a Day in Participants With Type 2 Diabetes and Increased Cardiovascular Risk
- Conditions
- Type 2 Diabetes Mellitus
- Interventions
- Registration Number
- NCT03730662
- Lead Sponsor
- Eli Lilly and Company
- Brief Summary
The purpose of the trial is to assess the efficacy and safety of tirzepatide taken once a week to insulin glargine taken once daily in participants with type 2 diabetes and increased cardiovascular risk. The study will last about 108 weeks and may include up to 30 visits.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 2002
Participants must:
- Have been diagnosed with type 2 diabetes mellitus (T2DM)
- Have HbA1c between ≥7.5% and ≤10.5%
- Be on stable treatment with unchanged dose of at least 1 and no more than 3 types of oral antihyperglycemic drugs, which may only include metformin, SGLT-2 inhibitors, and/or sulfonylureas for at least 3 months before screening
- Have increased risk for cardiovascular (CV) events
- Be of stable weight (± 5%)
- Have a BMI ≥25 kilograms per meter squared (kg/m2) at screening
Exclusion Criteria
Participants must not:
- Have type 1 diabetes mellitus
- Have had chronic or acute pancreatitis any time prior to study entry
- Have proliferative diabetic retinopathy or diabetic maculopathy or nonproliferative diabetic retinopathy requiring immediate or urgent treatment
- Have disorders associated with slowed emptying of the stomach, or have had any stomach surgeries for the purpose of weight loss
- Have acute or chronic hepatitis, signs and symptoms of any other liver disease, or blood alanine transaminase (ALT) enzyme level >3.0 times the upper limit of normal (ULN) for the reference range, as determined by the central laboratory. Participants with nonalcoholic fatty liver disease (NAFLD) are eligible for participation in this trial only if there ALT level is ≤3.0 the ULN for the reference range
- Have had a heart attack, stroke, or hospitalization for congestive heart failure in the past 2 months
- Have a personal or family history of medullary thyroid carcinoma or personal history of multiple endocrine neoplasia syndrome type 2
- Have been taking any other diabetes medicines other than metformin, SGLT-2 inhibitors, and/or sulfonylureas during the last 3 months
- Have been taking weight loss drugs, including over-the-counter medications during the last 3 months
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description 10 mg Tirzepatide Tirzepatide 10 mg tirzepatide administered SC once a week. 5 mg Tirzepatide Tirzepatide 5 milligrams (mg) tirzepatide administered subcutaneously (SC) once a week. 15 mg Tirzepatide Tirzepatide 15 mg tirzepatide administered SC once a week. Insulin Glargine Insulin Glargine Insulin glargine administered SC once a day. Doses were individualized and titrated according to protocol-defined targets. The starting dose of insulin glargine was 10 IU/day at bedtime, titrated to a FBG \<100 mg/dL, following a treat-to-target (TTT) algorithm.
- Primary Outcome Measures
Name Time Method Change From Baseline in Hemoglobin A1c (HbA1c) (10 mg and 15 mg) Baseline, Week 52 HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model for post-baseline measures: Variable = Baseline + Pooled Country + Baseline sodium-glucose co-transporter-2 inhibitor (SGLT-2i) use Flag (Yes, No) + Treatment + Time + Treatment\*Time (Type III sum of squares).
- Secondary Outcome Measures
Name Time Method Rate of Hypoglycemia With Blood Glucose <54 Milligram/Deciliter (mg/dL) [<3.0 (Millimole/Liter (mmol/L))] or Severe Hypoglycemia Baseline through Week 52 The hypoglycemia events were defined by participant reported events with blood glucose \<54mg/dL (\<3.0 mmol/L) or severe hypoglycemia. Severe hypoglycemia is defined as an episode with severe cognitive impairment requiring the assistance of another person to actively administer carbohydrate, glucagon, or other resuscitative actions. These episodes may be associated with sufficient neuroglycopenia to induce seizure or coma. Post-baseline comparisons between treatment and control group was evaluated using negative binomial model with variables : Number of episodes = Baseline HbA1c Group (\<=8.5%, \>8.5%) + Pooled Country + Baseline SGLT-2i use Flag (Yes, No) + Treatment, with log (exposure in days/365.25) as an offset variable
Change From Baseline in Body Weight Baseline, Week 52 LS mean was determined by MMRM model for post-baseline measures: Variable = Baseline + Pooled Country + Baseline HbA1c Group (\<=8.5%, \>8.5%) + Baseline SGLT-2i use Flag (Yes, No) + Treatment + Time + Treatment\*Time (Type III sum of squares).
Change From Baseline in Fasting Serum Glucose Baseline, Week 52 LS mean was determined by MMRM model for post-baseline measures: Variable = Baseline + Pooled Country + Baseline HbA1c Group (\<=8.5%, \>8.5%) + Baseline SGLT-2i use Flag (Yes, No) + Treatment + Time + Treatment\*Time (Type III sum of squares).
Pharmacokinetics (PK): Steady State Area Under the Concentration Time Curve From Zero to Tau (AUC 0-Tau) of Tirzepatide 1 to 24 hours, 24 to 96 hours, or 120 to 168 hours post dose of Week 7, 15, 23, 35 Pharmacokinetics (PK): Steady State Area Under the Concentration Time Curve From Zero to Tau (AUC 0-Tau) of Tirzepatide
Change From Baseline in HbA1c (5 mg) Baseline, Week 52 HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. LS mean was determined by MMRM model for post-baseline measures: Variable = Baseline + Pooled Country + Baseline SGLT-2i use Flag (Yes, No) + Treatment + Time + Treatment\*Time (Type III sum of squares).
Mean Change From Baseline in Daily Average 7-Point Self-Monitored Blood Glucose (SMBG) Values Baseline, Week 52 The self-monitored plasma glucose (SMBG) data were collected at the following 7 time points: Morning Premeal - Fasting, Morning 2-hour Postmeal, Midday Premeal, Midday 2-hour Postmeal, Evening Premeal, Evening 2-hour Postmeal and Bedtime. LS mean was determined by mixed-model repeated measures (MMRM) model with variables Baseline + Pooled Country + Baseline HbA1c Group (\<=8.5%, \>8.5%) + Baseline SGLT-2i use Flag (Yes, No) + Treatment + Time + Treatment\*Time (Type III sum of squares).
Percentage of Participants With HbA1c of <7.0% Week 52 HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. Imputed data includes observed value and imputed value if endpoint measure is missing.
Trial Locations
- Locations (208)
Woj. Zesp. Spec. Opieki Zdrowotnej
🇵🇱Wroclaw, Poland
Northwestern Feinberg School of Medicine
🇺🇸Chicago, Illinois, United States
Preferred Primary Care Physicians- Bower Hill
🇺🇸Pittsburgh, Pennsylvania, United States
Parkside Family Medical
🇺🇸Philadelphia, Pennsylvania, United States
Primary Care Specialists, LLC
🇺🇸Atlanta, Georgia, United States
Aventiv Research
🇺🇸Columbus, Ohio, United States
Dallas Diabetes Endocrine Center
🇺🇸Dallas, Texas, United States
PCP for Life
🇺🇸Houston, Texas, United States
Fremantle Hospital
🇦🇺Fremantle, Western Australia, Australia
Hospital de la Ribera
🇪🇸Alcira, Valencia, Spain
Cotton O'Neil Diabetes and Endocrinology Center
🇺🇸Topeka, Kansas, United States
BFHC Research
🇺🇸San Antonio, Texas, United States
Instituto Centenario
🇦🇷Ciudad Autonoma de Buenos Aire, Argentina
Cent Priva Especiali Médicas Ambulatorias Inve Clin CEMAIC
🇦🇷Cordoba, Argentina
Rocky Mountain Diabetes and Osteoporosis Center
🇺🇸Idaho Falls, Idaho, United States
Mountain View Clinical Research, Inc.
🇺🇸Greer, South Carolina, United States
Palm Research Center
🇺🇸Las Vegas, Nevada, United States
The Research Center of the Upstate
🇺🇸Mauldin, South Carolina, United States
CEDIC-Centro de Investigaciones Clinicas
🇦🇷Caba, Buenos Aires, Argentina
Centro de Investigacion y Prevencion Cardiovascular (CIPREC)
🇦🇷Ciudad Autonoma de, Buenos Aires, Argentina
Centro Médico Viamonte
🇦🇷Ciudad Autonoma de Buenos Aire, Argentina
Cemediab - Centro Médico Diabetológico Dr. Alejandro Chertkoff
🇦🇷Ciudad Autonoma de Buenos Aire, Argentina
Centro Diabetologico Dr Waitman
🇦🇷Cordoba, Argentina
Glacier View Research Institute
🇺🇸Kalispell, Montana, United States
Chase Medical Research, LLC
🇺🇸Waterbury, Connecticut, United States
Eastern Clinical Research Unit
🇦🇺Box Hill, Victoria, Australia
CEMEDIC
🇦🇷Caba, Buenos Aires, Argentina
Euromedica - General Clinic of Thessaloniki
🇬🇷Thessaloniki, Greece
Rambam Medical Center
🇮🇱Haifa, Israel
Investigacion en Salud y Metabolismo S.C
🇲🇽Chihuahua, Mexico
Praktyka Lekarska
🇵🇱Poznan, Poland
Manati Center for Clinical Research Inc
🇵🇷Manati, Puerto Rico
GCM Medical Group PSC
🇵🇷San Juan, Puerto Rico
SC Nutrilife SRL
🇷🇴Bucuresti, Romania
Novosibirsk Regional Clinical Hospital
🇷🇺Novosibirsk, Russian Federation
City Consultative and Diagnostic Center
🇷🇺Saint-Petersburg, Russian Federation
Research & Practice Ltd
🇷🇺Yaroslavl, Russian Federation
LMC Manna Research
🇨🇦Calgary, Alberta, Canada
Royal Melbourne Hospital
🇦🇺Parkville, Victoria, Australia
Instituto Jalisciense de Investigacion en Diabetes y Obesida
🇲🇽Guadalajara, Jalisco, Mexico
Centro de Estudios de Investigacion Metabolicos y Cardiovasc
🇲🇽Tampico, Tamaulipas, Mexico
Forest Hill Medical and Dental Centre
🇦🇺Forest Hill, Victoria, Australia
Centro Medico Dr Laura Maffei Investigacion Clinica Aplicada
🇦🇷Ciudad Autonoma de Buenos Aire, Buenos Aires, Argentina
Tel Aviv Sourasky Medical Center
🇮🇱Tel Aviv Jaffa, Israel
Montana Medical Research, Inc
🇺🇸Missoula, Montana, United States
Mautalen Salud e Investigación - Servicio de Endocrinología
🇦🇷Caba, Buenos Aires, Argentina
AXISMED SRL - Bioclinica Research Network
🇦🇷Buenos Aires, Argentina
Centro Medico Privado San Vicente Diabetes
🇦🇷Cordoba, Argentina
Manna Research (Quebec)
🇨🇦Levis, Quebec, Canada
AHEPA Hospital
🇬🇷Thessaloniki, Greece
Wolfson Medical Center
🇮🇱Holon, Israel
Sheba Medical Center
🇮🇱Ramat Gan, Israel
St. Lucas Clinical Research Center
🇲🇽Merida, Mexico State, Mexico
NZOZ Przychodnia Specjalistyczna MEDICA
🇵🇱Lublin, Poland
NZOZ Przychodnia Specjalistyczna Henryk RudzkiAndrzej Wittek
🇵🇱Ruda Slaska, Poland
Solaris Clinical Research
🇺🇸Meridian, Idaho, United States
Centrul Medical Dr. Negrisanu
🇷🇴Timisoara, Timis, Romania
Barwon Health - The Geelong Hospital
🇦🇺Geelong, Victoria, Australia
Unidad Medica para la Salud Integral (UMSI)
🇲🇽Monterrey, Nuevo León, Mexico
Iatriko Palaiou Falirou, Medical Center
🇬🇷Palaio Faliro, Athens, Greece
Thermi Clinic
🇬🇷Thermi, Thessaloniki, Greece
Hadassah Medical Center
🇮🇱Jerusalem, Israel
Rabin Medical Center
🇮🇱Petach Tikva, Israel
Ponce School of Medicine CAIMED Center
🇵🇷Ponce, Puerto Rico
Research and Cardiovascular Corp.
🇵🇷Ponce, Puerto Rico
Spitalul Judetean de Urgenta Satu Mare
🇷🇴Satu-Mare, Jud Satu-Mare, Romania
Cabinetul Medical Nicodiab SRL
🇷🇴Bucharest, Romania
SPb GUZ "Diagnostic Center #85"
🇷🇺Saint Petersburg, Russian Federation
MEDI-DIA s.r.o.
🇸🇰Sabinov, Slovakia
Kuang Tien General Hospital
🇨🇳Taichung County, Taiwan
Centre De Recherche Clinique De Laval
🇨🇦Laval, Quebec, Canada
Diseno y Planeacion en Investigacion Medica S.C.
🇲🇽Guadalajara, Jalisco, Mexico
FSBI Endocrinological Research Center of the MOH of the ROF
🇷🇺Moscow, Russian Federation
LMC Endocrinology Centres Ltd.
🇨🇦Ville St-Laurent, Quebec, Canada
Ha'Emek Medical Center
🇮🇱Afula, Israel
CMI DNBM Dr. Pop Lavinia
🇷🇴Baia Mare, Maramures, Romania
Centrul Medical de Diagnostic si Tratament Ambulatoriu Neomed SRL
🇷🇴Brasov, Romania
Milena Sante SRL
🇷🇴Galati, Romania
Tatratrial s.r.o.
🇸🇰Roznava, Slovakia
China Medical University Hospital
🇨🇳Taichung, Taiwan
Chi-Mei Medical Center
🇨🇳Tainan City, Taiwan
C-Health Diabetes and Endocrinology Clinic Calgary
🇨🇦Calgary, Alberta, Canada
Q & T Research Outaouais
🇨🇦Gatineau, Quebec, Canada
Synergy Medical Research
🇨🇦Sherwood Park, Alberta, Canada
Poradnia Diabetologiczna SN ZOZ Lege Artis
🇵🇱Bialystok, Poland
University Of Puerto Rico
🇵🇷Rio Pedras, Puerto Rico
Consultorio Medico
🇵🇷San Juan, Puerto Rico
SC Gama Diamed SRL
🇷🇴Mangalia, Constanta, Romania
Cosamext SRL
🇷🇴Targu Mures, Mures, Romania
Ryazan Regional Clinincal Cardiology Dispensary
🇷🇺Ryazan, Russian Federation
Medical Military Academy
🇷🇺Saint Petersburg, Russian Federation
Human care s.r.o.
🇸🇰Kosice, Slovak Republic, Slovakia
MediVet s.r.o.
🇸🇰Malacky, Slovak Republic, Slovakia
DIA-MED CENTRUM s.r.o.
🇸🇰Puchov, Slovakia
Arkhangelsk the first city clinical hospital
🇷🇺Arkhangelsk, Russian Federation
City Hospital of Saint Martyr Elizabeth
🇷🇺Saint Petersburg, Russian Federation
Regional Clinical Hospital
🇷🇺Saratov, Russian Federation
Chang Gung Memorial Hospital - Kaohsiung
🇨🇳Kaohsiung City, Taiwan
NZOZ CenterMed Lublin
🇵🇱Lublin, Poland
Nzoz Neuro - Kard
🇵🇱Poznan, Poland
Scripps Whittier Diabetes Institute
🇺🇸La Jolla, California, United States
LCGK Research
🇺🇸San Carlos, California, United States
Catalina Research Institute, LLC
🇺🇸Montclair, California, United States
Desert Medical Group Inc
🇺🇸Palm Springs, California, United States
National Research Institute
🇺🇸Los Angeles, California, United States
Iowa Diabetes Research
🇺🇸West Des Moines, Iowa, United States
Valley Clinical Trials, Inc.
🇺🇸Northridge, California, United States
Diablo Clinical Research
🇺🇸Walnut Creek, California, United States
AA Medical Research Center
🇺🇸Flint, Michigan, United States
Advanced Research Center
🇺🇸Anaheim, California, United States
Lillestol Research LLC
🇺🇸Fargo, North Dakota, United States
Marin Endocrine Associates
🇺🇸Greenbrae, California, United States
Intend Research
🇺🇸Norman, Oklahoma, United States
Alpine Research Organization
🇺🇸Farmington, Utah, United States
Paratus Clinical Blacktown Clinic
🇦🇺Blacktown, New South Wales, Australia
PharmQuest
🇺🇸Greensboro, North Carolina, United States
First Valley Medical Group
🇺🇸Lancaster, California, United States
Cedoes Centro Diagnostico Pequisa Osteoporose E Santo Ltd
🇧🇷Vitoria, ES, Brazil
Suncoast Research Group, LLC
🇺🇸Miami, Florida, United States
Victoria Point Medical and Dental Centre
🇦🇺Victoria Point, Queensland, Australia
Coastal Metabolic Research Centre
🇺🇸Ventura, California, United States
University of Iowa Hospital & Clinic
🇺🇸Iowa City, Iowa, United States
Heritage Valley Medical Group, Inc.
🇺🇸Beaver, Pennsylvania, United States
Private: Dr. Larry Stonesifer
🇺🇸Federal Way, Washington, United States
Sameh Fikry Medicine Professional Corporation
🇨🇦Waterloo, Ontario, Canada
Southern New Hampshire Diabetes and Endocrinology
🇺🇸Nashua, New Hampshire, United States
Troy Internal Medicine, PC
🇺🇸Troy, Michigan, United States
Saltzer Medical Group. P.A.
🇺🇸Nampa, Idaho, United States
NECCR PrimaCare Research, LLC
🇺🇸Fall River, Massachusetts, United States
Rapid Medical Research Inc
🇺🇸Cleveland, Ohio, United States
Centro de Pesquisa Clinica do Brasil
🇧🇷Brasilia, Distrito Federal, Brazil
Walla Walla Clinic
🇺🇸Walla Walla, Washington, United States
Milestone Research Inc.
🇨🇦London, Ontario, Canada
AusTrials Pty Ltd
🇦🇺Sherwood, Queensland, Australia
Aggarwal and Associates Ltd
🇨🇦Brampton, Ontario, Canada
Centro de Diabetes Curitiba
🇧🇷Curitiba, Parana, Brazil
GP Plus Marion
🇦🇺Oaklands Park, South Australia, Australia
Campbelltown Medical & Dental Centre
🇦🇺Campbelltown, New South Wales, Australia
Manna Research, Inc.
🇨🇦Stoney Creek, Ontario, Canada
CPQuali Pesquisa Clínica Ltda.
🇧🇷São Paulo, SP, Brazil
Centro de Pesq. em Diabetes e Doencas Endocrino Metabol.
🇧🇷Fortaleza, Brazil
Dr. Consulta Clínica Médica LTDA
🇧🇷São Paulo, Brazil
Hospital Universitario Quiron Madrid
🇪🇸Pozuelo de Alarcon, Madrid, Spain
Hospital Universitario Marques De Valdecilla
🇪🇸Santander, Cantabria, Spain
Centralny Szpital Kliniczny MSWiA Klinika Dermatologiczna
🇵🇱Warszawa, Mazowieckie, Poland
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Spain
NZOZ Diab-Endo-Met
🇵🇱Krakow, Poland
Centrum Terapii Wspolczesnej J.M. Jasnorzewska S.K.A.
🇵🇱Lodz, Poland
Gabinety Terpa
🇵🇱Lublin, Poland
Chung Shan Medical University Hospital
🇨🇳Taichung City, Taiwan
National Cheng Kung University Hospital
🇨🇳Tainan, Taiwan
National Taiwan University Hospital
🇨🇳Taipei City, Taiwan
Complexo Hospitalario Universitario A Coruña, CHUAC
🇪🇸La Coruña, Spain
Hospital Quironsalud Barcelona- END
🇪🇸Barcelona, Spain
Centro Especialidades San Jose Obrero (Barbarela)
🇪🇸Malaga, Spain
Clinica Juaneda
🇪🇸Palma de Mallorca, Spain
Hospital Clinico Universitario San Cecilio
🇪🇸Granada, Spain
Clinica Nuevas Tecnologias en Diabetes y Endocrinologia
🇪🇸Seville, Spain
Instituto de Ciencias medicas
🇪🇸Alicante, Spain
Clinical Research Professionals
🇺🇸Chesterfield, Missouri, United States
Paratus Clinical Kanwal Clinic
🇦🇺Kanwal, New South Wales, Australia
Havana Research Institute
🇺🇸Pasadena, California, United States
University Clinical Investigators, Inc.
🇺🇸Tustin, California, United States
Olive View Medical Center
🇺🇸Sylmar, California, United States
New Horizon Research Center
🇺🇸Miami, Florida, United States
South Florida Wellness & Clinical Research Institute
🇺🇸Margate, Florida, United States
Robley Rex VAMC
🇺🇸Louisville, Kentucky, United States
Progressive Medical Research
🇺🇸Port Orange, Florida, United States
The Corvallis Clinic P.C.
🇺🇸Corvallis, Oregon, United States
Ohio State Univ College Of Medicine
🇺🇸Columbus, Ohio, United States
Capital Area Research
🇺🇸Newport, Pennsylvania, United States
Martin Diagnostic Clinic
🇺🇸Tomball, Texas, United States
Capital Clinical Research Center
🇺🇸Olympia, Washington, United States
Consano Clinical Research
🇺🇸Shavano Park, Texas, United States
Oregon Health and Science University
🇺🇸Portland, Oregon, United States
Western University of Health Sciences
🇺🇸Pomona, California, United States
Monterey Endocrine & Diabetes Institute, Inc.
🇺🇸Monterey, California, United States
Advanced Pharma Research
🇺🇸Cutler Bay, Florida, United States
ALL Medical Research, LLC
🇺🇸Cooper City, Florida, United States
Clinical Neuroscience Solutions Inc
🇺🇸Orlando, Florida, United States
Detweiler Family Medicine
🇺🇸Lansdale, Pennsylvania, United States
Burke Internal Medicine & Research
🇺🇸Burke, Virginia, United States
Centro de Investigaciones Metabólicas (CINME)
🇦🇷Caba, Buenos Aires, Argentina
Investigaciones Medicas IMOBA S.R.L.
🇦🇷Caba, Buenos Aires, Argentina
CIPADI
🇦🇷Godoy Cruz, Mendoza, Argentina
The AIM Centre
🇦🇺Merewether, New South Wales, Australia
Royal North Shore Hospital
🇦🇺St. Leonards, New South Wales, Australia
Morayfield Medical and Dental Centre
🇦🇺Morayfield, Queensland, Australia
Instituto de Ensino e Pesquisa Clinica do Ceara
🇧🇷Fortaleza, Ceara, Brazil
CCBR Brasil Centro de Analises e Pesquisas Clínicas LTDA
🇧🇷Rio de Janeiro, RJ, Brazil
Cpclin Centro de Pesquisas Clinicas
🇧🇷São Paulo, SP, Brazil
LMC Endocrinology Centers Brampton
🇨🇦Brampton, Ontario, Canada
Bluewater Clinical Research Group Inc
🇨🇦Sarnia, Ontario, Canada
Medicor Research Inc
🇨🇦Sudbury, Ontario, Canada
University General Hospital of Larissa
🇬🇷Larissa, Greece
Soroka Medical Center
🇮🇱Beer Sheva, Israel
Sakhnin Community Clinic, Clalit Health Services
🇮🇱Sakhnin, Israel
Emanuelli Research & Development Center, LLC
🇵🇷Arecibo, Puerto Rico
Centro Periférico de Especialidades Bola Azul
🇪🇸Almeria, Spain
Areteus s.r.o.
🇸🇰Trebisov, Slovak Republic, Slovakia
Cardinal Tien Hospital
🇨🇳Sindian City, Taipei County, Taiwan
Taipei Veterans General Hospital
🇨🇳Taipei, Taiwan
New Phase Research & Development
🇺🇸Knoxville, Tennessee, United States
Touro University
🇺🇸Vallejo, California, United States
Holston Medical Group Clinical Research
🇺🇸Kingsport, Tennessee, United States
NorthShore University HealthSystem
🇺🇸Skokie, Illinois, United States
CORE Research Group Pty Ltd
🇦🇺Brisbane, Queensland, Australia
Canadian Centre for Research on Diabetes
🇨🇦Smiths Falls, Ontario, Canada