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Precision Dosing of Metformin in Youth With T2D

Early Phase 1
Recruiting
Conditions
Type 2 Diabetes
Interventions
Registration Number
NCT06120881
Lead Sponsor
University of California, San Francisco
Brief Summary

The purpose of this study to compare the typically prescribed dose of metformin (1000mg twice a day) with a higher dose of metformin (1350mg twice a day).

Detailed Description

Based on the investigators previous studies of young people who take metformin, the study team found that young people's bodies process metformin faster than older people and young people may need higher doses of metformin for the best treatment outcomes. The purpose of this study is to compare the typically prescribed dose of metformin (1000mg twice a day) with a higher dose of metformin (1350mg twice a day).

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Age 10-21 years
  • Provider diagnosis of T2D
  • Stable medication regimen for 2 weeks before screening visit (No addition or removal of medications and no more than 20% change in insulin dose)
  • ≥ 1 month from T2D diagnosis
  • Taking regular metformin (not extended-release formula)
  • Ability to wear CGM for a total of 6 weeks while in the study.
  • English or Spanish speakers.
  • Willing to abide by recommendations and study procedures.
  • Willing and able to sign the Informed Consent Form (ICF) and/or has a parent or guardian willing and able to sign the ICF.
  • Participant and parent(s)/guardian(s) willingness to participate in all training sessions as directed by study staff. Written informed consent (and assent when applicable) obtained from subject or subject's legal representative and ability for subject to comply with the requirements of the study.
Exclusion Criteria
  • Pancreatic autoantibody positivity (GAD-65, insulin, IA-2, ICA 512, Zn-T8).
  • Known history of ongoing renal or hepatic disease.
  • Known history of significant mental illness or developmental delay impacting the ability to complete study activities independently.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Active ComparatorMetformin1000mg metformin twice per day
ExperimentalMetformin1350mg metformin twice per day
Primary Outcome Measures
NameTimeMethod
Acceptability of Higher Metformin Dose measured with the Acceptability of Intervention Measure (AIM)Measured at 3 months

The perception that a higher dose of Metformin is agreeable or satisfactory measured with the 4-item Acceptability of Intervention Measure (AIM). A 4-item measure of perceived intervention acceptability. Items are measured on a 5-point Likert scale (Completely Disagree-Completely Agree). Score is calculated mean. The greater the score, the better the acceptability.

Feasibility of Higher Metformin Dose measured with the Feasibility of Intervention Measure (FIM)Measured at 3 months

The extent to which a higher dose Metformin study can be successfully carried out measured with 4-item Feasibility of Intervention Measure (FIM). A 4-item instrument to assess perceived intervention feasibility. Items are measured on a 5-point Likert scale (Completely Disagree-Completely Agree). Score is calculated mean. The greater the score, the better the feasibility.

Secondary Outcome Measures
NameTimeMethod
Glycemic ChangeBaseline (0) to 3 months

Change in serum HbA1C at 3 months adjusted for the baseline value youth with T2D on higher dose of metformin compared to standard dose

Time in target glucose rangeBaseline (0) to 3 months

Time spent in target glucose range of 70 to 180 mg/dL

Time above high glucose rangeBaseline (0) to 3 months

Percent of readings and time \>250 mg/dL

Time above glucose rangeBaseline (0) to 3 months

Percent of readings and time 181-250 mg/dL

Time in glucose rangeBaseline (0) to 3 months

Percent of readings and time 70-180 mg/dL

Time below glucose rangeBaseline (0) to 3 months

Percent of readings and time 54-69 mg/dL

Time below low glucose rangeBaseline (0) to 3 months

Percent of readings and time \<54 mg/dl

Glucose management indicatorBaseline (0) to 3 months

Continuous glucose monitoring (CGM) metric that indicates average blood glucose.

Glucose Management Indicator (GMI) approximates the laboratory A1C level expected based on average glucose measured using CGM values. Average glucose is derived from 14 or more days of CGM readings.

Co-efficient of variation of glucoseBaseline (0) to 3 months

CGM metric that measures variability in CGM values

Trial Locations

Locations (2)

UCSF Benioff Children's Hospital San Francisco, Madison Clinic for Pediatric Diabetes

🇺🇸

San Francisco, California, United States

UCSF Benioff Children's Hospital Oakland, Pediatric Diabetes Clinic

🇺🇸

Oakland, California, United States

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