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Acute Effect of Rebaudioside A on Glucose Excursion During an Oral Glucose Tolerance Test in Type 2 Diabetes Mellitus (AREBAG)

Primary Purpose

Type 2 Diabetes Mellitus

Status
Completed
Phase
Phase 1
Locations
Belgium
Study Type
Interventional
Intervention
Rebaudioside A
Placebo
Sponsored by
Universitaire Ziekenhuizen KU Leuven
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 2 Diabetes Mellitus

Eligibility Criteria

35 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Signed and dated written informed consent
  • Understand procedures
  • Type 2 diabetes mellitus
  • Body Mass Index (BMI): 25 - 40 kg/m2
  • HbA1c: 6.5-8%
  • Judged to be in good health

Exclusion Criteria:

  • Subject is unable to

    • Refrain from stevia leaves, stevia extracts or steviol glycoside-containing products from 5 days prior to administration of rebaudioside A or placebo until discharge from the unit after the OGTT on the consecutive day.
    • Refrain from quinine-containing products from 72h prior to administration of rebaudioside A or placebo until discharge from the unit after the OGTT on the consecutive day.
    • Maintain their habitual diets and physical activity patterns and refrain from engaging in strenuous physical activities from 72h prior to administration of rebaudioside A or placebo until discharge from the unit after the OGTT on the consecutive day.
    • Refrain from grapefruit products from 14 days before study visit 1 until discharge from the unit after the OGTT on study visit 4.
    • Refrain from alcohol from 24h prior to administration of rebaudioside A or placebo until discharge from the unit after the OGTT on the consecutive day.
    • Refrain from caffeine containing products from 12h prior to administration of rebaudioside A or placebo until discharge from the unit after the OGTT on the consecutive day.
    • Fast at least 5 hours prior to the administration of rebaudioside A or placebo on study days 1 and 3.
    • Fast at least 10 hours prior to the study days 2 and 4.
  • Women of childbearing potential (last menstruation less than 1 year prior to screening) who are pregnant, lactating or planning to become pregnant during the study.
  • Individuals with other forms of diabetes
  • Current or previous treatment with any diabetes drug within 3 months prior to screening, except for metformin.
  • Symptomatic hyperglycemia requiring immediate therapy during screening, in the judgement of the principal investigator.
  • Evidence of significant diabetic complications.
  • History of pancreas or beta-cell transplantation.
  • Presence or history of clinically relevant medical, surgical or psychiatric conditions likely to affect the subject's safety in this trial or that could confound the study assessments or endpoints.
  • Clinically relevant abnormal physical findings.
  • Clinically significant abnormalities of vital signs:

    • Seated systolic blood pressure outside 90-160 mmHg
    • Diastolic blood pressure outside 40-100 mmHg
    • Heart rate <50 bpm
    • Corrected QT (QTC) using Fridericia's formulae >450 msec (for men) or >470 msec (for women) measured with a 12-lead electrocardiogram.
    • Clinically significant abnormal laboratory values.
    • Moderate or severe renal dysfunction defined as a calculated glomerular filtration rate (GFR) <30 ml/min.
  • Currently active or history of alcohol abuse.
  • Currently active or history of drug addiction or currently a regular user of drugs including "recreational use" of any illicit drug.
  • Smoking cigarettes or using nicotine-containing products, during the last 6 months prior to screening, as nicotine inhibits the Transient Receptor Potential 5 (TRPM5) channel.
  • Individuals for whom a major surgery is planned to occur between screening and the end of the trial.
  • Previous or current use of concomitant medication, which would confound the study conduct or implicate a risk for safety of the participant, as judged by the investigator(s).
  • History of relevant drug or food allergies or a history of severe anaphylactic reaction.
  • History of hypersensitivity to the study drug or any of the excipients or to medicinal products with similar chemical structures.
  • Individuals with hepatitis B and/or hepatitis C virus.
  • Individuals with Human Immunodeficiency Virus (HIV).
  • Participation in another clinical trial involving an investigational product within the 3 months preceding screening or 5-halflives of the drug studied, whichever is longer, prior to study supplement administration. Or, participation in any other type of medical research within 3 months preceding screening judged not to be scientifically or medically compatible with this study.
  • Individuals who have donated or lost more than 500 ml blood or plasma within 3 months prior to screening.
  • Individuals unable to swallow orally administered medication.
  • Individuals in which catheter placement is impossible (amputation, no visible veins, …)
  • Individuals that cannot speak or understand the Dutch language.
  • In the opinion of the principal investigator any other factor that could interfere with the subject's ability to provide informed consent or to complete the study with strict compliance to the study protocol, or that could hold safety concerns for the subject or could impact the outcome of the study results.

Sites / Locations

  • Centrum Clinical Pharmacology

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

First rebaudioside A and then placebo

First placebo and then rebaudioside A

Arm Description

Outcomes

Primary Outcome Measures

Area under the curve (AUC) blood glucose concentrations during an OGTT
Area under the curve blood glucose concentrations during an OGTT

Secondary Outcome Measures

AUC glucose/insulin/glucagon
AUC glucose/insulin/glucagon
AUC glucose/insulin/glucagon
AUC glucose/insulin/glucagon
AUC glucose/insulin/glucagon
AUC glucose/insulin/glucagon
Maximal blood glucose
Maximal blood glucose
Maximal blood glucose excursion
Maximal blood glucose excursion
Maximal serum insulin
Maximal serum insulin
Maximal serum glucagon
Maximal serum glucagon
Concentration(t) (C(t))rebaudioside A, steviol and steviol glucuronide
Concentration of rebaudioside A, steviol and steviol glucuronide on different time points

Full Information

First Posted
April 17, 2018
Last Updated
April 27, 2021
Sponsor
Universitaire Ziekenhuizen KU Leuven
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1. Study Identification

Unique Protocol Identification Number
NCT03510624
Brief Title
Acute Effect of Rebaudioside A on Glucose Excursion During an Oral Glucose Tolerance Test in Type 2 Diabetes Mellitus
Acronym
AREBAG
Official Title
Investigation of the Acute Effect of Rebaudioside A on the Glucose Excursion During an Oral Glucose Tolerance Test in 30 Patients With Type 2 Diabetes Mellitus (AREBAG)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
November 9, 2018 (Actual)
Primary Completion Date
April 1, 2021 (Actual)
Study Completion Date
April 1, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Universitaire Ziekenhuizen KU Leuven

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Investigate the acute effect of the steviol glycoside, rebaudioside A, on the glucose excursion during an oral glucose tolerance test in 30 patients with type 2 diabetes mellitus.
Detailed Description
Eligible individuals with type 2 diabetes mellitus will be invited for four study visits. During the first and third study visit, rebaudioside A or the placebo will be administered. During the second and fourth study visit, an oral glucose tolerance test (OGTT) will be executed to measure the response of administration of rebaudioside A versus placebo on the glucose homeostasis. The area under the curve blood glucose values during the first two hours of the OGTT will be compared for both conditions.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type 2 Diabetes Mellitus

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
First rebaudioside A and then placebo
Arm Type
Experimental
Arm Title
First placebo and then rebaudioside A
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Rebaudioside A
Intervention Description
Rebaudioside A 3g
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Empty capsules
Primary Outcome Measure Information:
Title
Area under the curve (AUC) blood glucose concentrations during an OGTT
Description
Area under the curve blood glucose concentrations during an OGTT
Time Frame
0 to 2 hours after glucose challenge
Secondary Outcome Measure Information:
Title
AUC glucose/insulin/glucagon
Description
AUC glucose/insulin/glucagon
Time Frame
-30 to 0 min of OGTT
Title
AUC glucose/insulin/glucagon
Description
AUC glucose/insulin/glucagon
Time Frame
0 to 30 min of OGTT
Title
AUC glucose/insulin/glucagon
Description
AUC glucose/insulin/glucagon
Time Frame
0 to 4 hours of OGTT
Title
Maximal blood glucose
Description
Maximal blood glucose
Time Frame
-30 min to 4 hours of OGTT
Title
Maximal blood glucose excursion
Description
Maximal blood glucose excursion
Time Frame
-30 min to 4 hours of OGTT
Title
Maximal serum insulin
Description
Maximal serum insulin
Time Frame
-30 min to 4 hours of OGTT
Title
Maximal serum glucagon
Description
Maximal serum glucagon
Time Frame
-30 min to 4 hours of OGTT
Title
Concentration(t) (C(t))rebaudioside A, steviol and steviol glucuronide
Description
Concentration of rebaudioside A, steviol and steviol glucuronide on different time points
Time Frame
-30 min to 4 hours of OGTT

10. Eligibility

Sex
All
Minimum Age & Unit of Time
35 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed and dated written informed consent Understand procedures Type 2 diabetes mellitus Body Mass Index (BMI): 25 - 40 kg/m2 HbA1c: 6.5-8% Judged to be in good health Exclusion Criteria: Subject is unable to Refrain from stevia leaves, stevia extracts or steviol glycoside-containing products from 5 days prior to administration of rebaudioside A or placebo until discharge from the unit after the OGTT on the consecutive day. Refrain from quinine-containing products from 72h prior to administration of rebaudioside A or placebo until discharge from the unit after the OGTT on the consecutive day. Maintain their habitual diets and physical activity patterns and refrain from engaging in strenuous physical activities from 72h prior to administration of rebaudioside A or placebo until discharge from the unit after the OGTT on the consecutive day. Refrain from grapefruit products from 14 days before study visit 1 until discharge from the unit after the OGTT on study visit 4. Refrain from alcohol from 24h prior to administration of rebaudioside A or placebo until discharge from the unit after the OGTT on the consecutive day. Refrain from caffeine containing products from 12h prior to administration of rebaudioside A or placebo until discharge from the unit after the OGTT on the consecutive day. Fast at least 5 hours prior to the administration of rebaudioside A or placebo on study days 1 and 3. Fast at least 10 hours prior to the study days 2 and 4. Women of childbearing potential (last menstruation less than 1 year prior to screening) who are pregnant, lactating or planning to become pregnant during the study. Individuals with other forms of diabetes Current or previous treatment with any diabetes drug within 3 months prior to screening, except for metformin. Symptomatic hyperglycemia requiring immediate therapy during screening, in the judgement of the principal investigator. Evidence of significant diabetic complications. History of pancreas or beta-cell transplantation. Presence or history of clinically relevant medical, surgical or psychiatric conditions likely to affect the subject's safety in this trial or that could confound the study assessments or endpoints. Clinically relevant abnormal physical findings. Clinically significant abnormalities of vital signs: Seated systolic blood pressure outside 90-160 mmHg Diastolic blood pressure outside 40-100 mmHg Heart rate <50 bpm Corrected QT (QTC) using Fridericia's formulae >450 msec (for men) or >470 msec (for women) measured with a 12-lead electrocardiogram. Clinically significant abnormal laboratory values. Moderate or severe renal dysfunction defined as a calculated glomerular filtration rate (GFR) <30 ml/min. Currently active or history of alcohol abuse. Currently active or history of drug addiction or currently a regular user of drugs including "recreational use" of any illicit drug. Smoking cigarettes or using nicotine-containing products, during the last 6 months prior to screening, as nicotine inhibits the Transient Receptor Potential 5 (TRPM5) channel. Individuals for whom a major surgery is planned to occur between screening and the end of the trial. Previous or current use of concomitant medication, which would confound the study conduct or implicate a risk for safety of the participant, as judged by the investigator(s). History of relevant drug or food allergies or a history of severe anaphylactic reaction. History of hypersensitivity to the study drug or any of the excipients or to medicinal products with similar chemical structures. Individuals with hepatitis B and/or hepatitis C virus. Individuals with Human Immunodeficiency Virus (HIV). Participation in another clinical trial involving an investigational product within the 3 months preceding screening or 5-halflives of the drug studied, whichever is longer, prior to study supplement administration. Or, participation in any other type of medical research within 3 months preceding screening judged not to be scientifically or medically compatible with this study. Individuals who have donated or lost more than 500 ml blood or plasma within 3 months prior to screening. Individuals unable to swallow orally administered medication. Individuals in which catheter placement is impossible (amputation, no visible veins, …) Individuals that cannot speak or understand the Dutch language. In the opinion of the principal investigator any other factor that could interfere with the subject's ability to provide informed consent or to complete the study with strict compliance to the study protocol, or that could hold safety concerns for the subject or could impact the outcome of the study results.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bart Van der Schueren
Organizational Affiliation
UZ Leuven
Official's Role
Principal Investigator
Facility Information:
Facility Name
Centrum Clinical Pharmacology
City
Leuven
State/Province
Flanders
ZIP/Postal Code
3000
Country
Belgium

12. IPD Sharing Statement

Citations:
PubMed Identifier
36057030
Citation
Simoens C, Philippaert K, Wuyts C, Goscinny S, Van Hoeck E, Van Loco J, Billen J, de Hoon J, Ampe E, Vangoitsenhoven R, Mertens A, Vennekens R, Van der Schueren B. Pharmacokinetics of Oral Rebaudioside A in Patients with Type 2 Diabetes Mellitus and Its Effects on Glucose Homeostasis: A Placebo-Controlled Crossover Trial. Eur J Drug Metab Pharmacokinet. 2022 Nov;47(6):827-839. doi: 10.1007/s13318-022-00792-7. Epub 2022 Sep 3.
Results Reference
derived

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Acute Effect of Rebaudioside A on Glucose Excursion During an Oral Glucose Tolerance Test in Type 2 Diabetes Mellitus

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