Effect of ZT-01 on Glucagon During Hypoglycemia in Type 1 Diabetes Mellitus
- Conditions
- HypoglycemiaType 1 Diabetes
- Interventions
- Drug: ZT-01 low doseDrug: ZT-01 high doseDrug: Placebo
- Registration Number
- NCT05007977
- Lead Sponsor
- Zucara Therapeutics Inc.
- Brief Summary
The purpose of this study is to determine whether ZT-01 increases the glucagon response to hypoglycemia in type 1 diabetes (T1D). ZT-01 is a specific somatostatin (SST) type 2 receptor antagonist hypothesized to increase the counterregulatory glucagon release during hypoglycemia, which is impaired in diabetes, and may thus reduce the occurrence of hypoglycemia.
Approximately 25 participants with well-controlled type 1 diabetes will be recruited to a crossover study and be randomized to the order in which they receive a single administration of placebo, low dose and high dose ZT-01 during three euglycemic-hypoglycemic clamps 2 to 6 weeks apart, with a follow-up visit approximately 1 week after the final clamp.
Participants will stay overnight in the clinic before each clamp, and their plasma glucose (PG) will be kept at euglycemic levels with IV insulin and dextrose as needed. The following morning, the clamp will begin and the subject's PG will be kept at 5.5 mmol/L (euglycemia) with variable IV insulin (and dextrose as needed). Study treatment will be administered during this euglycemic period, and then insulin will be increased so that PG falls to a plateau of mild hypoglycemia, and then increased further to clinically significant hypoglycemia. Release of glucagon and other counterregulatory hormones will be measured, and a symptom score will be completed, during euglycemia before and following study treatment, and during each level of hypoglycemia. Following the clamp, the participant's blood glucose will be returned to normal levels prior to leaving the clinic.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 24
- Type 1 diabetes for at least 5 years and receiving insulin as the only T1D therapy
- HbA1c ≥6.0 and ≤9.0 %
- BMI ≥18 to ≤27 kg/m^2
- Normal thyroid function
- Impaired hypoglycemia awareness
- Severe hypoglycemia or diabetic ketoacidosis (DKA) within 3 months
- Abnormal blood pressure or ECG, clinically significant cardiovascular, cerebrovascular or peripheral vascular disease
- History of pheochromocytoma, insulinoma, glucagonoma, acromegaly, Cushing's disease, glycogen storage disease or adrenal insufficiency; ongoing or previous treatment with octreotide, lanreotide or pasireotide
- Current use of systemic corticosteroids or beta-blockers
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- CROSSOVER
- Arm && Interventions
Group Intervention Description Treatment order: low dose, placebo, high dose ZT-01 high dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: high dose, placebo, low dose Placebo Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: placebo, low dose, high dose ZT-01 high dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: placebo, low dose, high dose ZT-01 low dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: low dose, placebo, high dose ZT-01 low dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: low dose, high dose, placebo ZT-01 low dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: low dose, high dose, placebo ZT-01 high dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: low dose, high dose, placebo Placebo Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: high dose, placebo, low dose ZT-01 low dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: high dose, low dose, placebo ZT-01 high dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: placebo, low dose, high dose Placebo Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: placebo, high dose, low dose ZT-01 low dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: low dose, placebo, high dose Placebo Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: high dose, low dose, placebo ZT-01 low dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: placebo, high dose, low dose Placebo Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: high dose, placebo, low dose ZT-01 high dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: placebo, high dose, low dose ZT-01 high dose Subjects will receive a single administration of each treatment in this order during three consecutive clamps Treatment order: high dose, low dose, placebo Placebo Subjects will receive a single administration of each treatment in this order during three consecutive clamps
- Primary Outcome Measures
Name Time Method Change in glucagon between euglycemia and hypoglycemia During each clamp, up to 12 weeks Mean and peak glucagon level during euglycemia and each hypoglycemic period of the clamp
- Secondary Outcome Measures
Name Time Method Insulin infused During each clamp, up to 12 weeks Insulin administered during euglycemia and each hypoglycemic period of the clamp
Change in growth hormone between euglycemia and hypoglycemia During each clamp, up to 12 weeks Growth hormone during euglycemia and each stable hypoglycemic period
Insulin infusion rate During each clamp, up to 12 weeks Rate of insulin administered during euglycemia and each hypoglycemic period of the clamp
Change in catecholamines between euglycemia and hypoglycemia During each clamp, up to 12 weeks Epinephrine and norepinephrine during euglycemia and each stable hypoglycemic period of the clamp
Change in cortisol between euglycemia and hypoglycemia During each clamp, up to 12 weeks Cortisol during euglycemia and each stable hypoglycemic period
Trial Locations
- Locations (1)
LMC Manna Research
🇨🇦Toronto, Ontario, Canada