A Study of Intracellular Signaling in Muscle and Fat Cells During Ketosis

Not Applicable

Completed

• Conditions: Ketoacidosis; Diabetes Mellitus Type 1
• Interventions: Biological: LPS

• Registration Number: NCT02157155
• Lead Sponsor: University of Aarhus

Brief Summary

Hypothesis

1. To define whether stimulation of ATGL and suppression of G0/G1 switch gene occur in the initial phases of diabetic ketoacidosis and thus can be identified as the primary mechanisms behind this life threatening condition.

2. Make a human model for studying ketoacidosis.

The investigators plan to reduce in their regular insulin over night. In the morning we administer endotoxin, which together with a relative lack of insulin will initiate ketogenesis - a state of ketoacidosis. On another occasion strict glycemic control is imposed by means of intravenous insulin. The testing is done two separate days with at least 3 weeks in between and patients are admitted to hospital the evening before the day of testing. The investigators use isotopic tracers to determine metabolic fluxes and analyse fat (ATGL, G0/G1 switch gene) and muscle biopsies.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2014-05-23
• Status Verified: 2014-06
• Study Start: 2014-06
• Study First Submitted QC: 2014-06-03
• Study First Posted: 2014-06-05
• Primary Completion: 2015-03
• Study Completion: 2015-09
• Last Update Submitted: 2015-12-01
• Last Update Posted: 2015-12-02

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Male
• Target Recruitment: 9

Inclusion Criteria

• Diabetes type 1
• 19 < BMI < 26
• minimal or negative C-peptide
• written consent

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Exclusion Criteria

• Severe comorbidity
• regular medication apart from insulin

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Intervention	LPS	Insulin reduction and mimic infection with LPS

Primary Outcome Measures

Name	Time	Method
Insulin signaling expressed as a CHANGE in phosphorylation of intracellular target proteins and CHANGE in mRNA expression of target genes in muscle- and fat-tissue.	Muscle and fat biopsies obtained on each study day (arm): t1= 6.45 (-75min) am t2=11.15 (195min) am t3= 12.30 pm (270min)	Change in phosphorylation of target proteins and messenger RNA (mRNA) expression of target genes assessed with western blotting technique.

Secondary Outcome Measures

Name	Time	Method
Change in Intracellular markers of lipid metabolism in muscle- and fat tissue biopsies	Muscle and fat biopsies obtained on each study day (arm): t1= 6.45 am (-75min) t2=11.15 (195min) am t3= 12.30 pm (270min)	Muscle and fat at t1 and t2. Muscle biopsy at t3. Intracellular markers are assessed by western blotting.
Metabolism	Change in glucose, fat and protein metabolism between study days and during each study day	Change in glucose, fat and protein metabolism assessed by tracer kinetics on every study day (specific times below) and by indirect calorimetry. \[3H 3\]Glucose tracer from t=0 - 360min. Palmitic acid tracer from t=165min - 360min. Urea tracer from 0min - 240min. amino acid tracer from 60 min - 360 min.
Cytokines and stress hormones	In basal period t=0-240 minutes and in clamp period t=240-390 minutes	Measurement of immune response to endotoxin and hypoinsulinaemia. Estimating the whole body stress during ketoacidosis and pre ketoacidosis.

Trial Locations

Locations (1)

Aarhus University Hospital; 🇩🇰 Aarhus, Denmark