Effect of Metformin, Dapagliflozin, Combination of Metformin and Pioglitazone in Patients With Type 2 Diabetes
Primary Purpose
Type2diabetes, Insulin Resistance
Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Metformin
Dapagliflozin
Fixed-dose combination of metformin and pioglitazone (500mg metformin plus 15mg pioglitazone)
Sponsored by
About this trial
This is an interventional treatment trial for Type2diabetes
Eligibility Criteria
Inclusion Criteria:
- Willing to participate in this present study;
- Regular diet and exercise;
- Age 18 to 60 years;
- Screening glycated hemoglobin (HbA1c) > 9.0%;
- Body mass index (BMI) ≥ 24.0 kg/m2
Exclusion Criteria:
- Other forms of diabetes;
- Insulin allergy or intolerance of metformin, pioglitazone and dapagliflozin;
- Renal dysfunction (estimated glomerular filtration rate < 45 mL/min);
- Severe liver disease or elevated transaminases (2.5-fold the upper limit);
- History of alcohol dependence or drug abuse in the past 5 years;
- Systemic steroids therapy or other medication influencing cholesterol metabolism in the past 3 months;
- Acute infection or stress state 1 month prior to this study;
- Pregnancy or lactation;
- History of diabetic ketoacidosis (DKA) within the previous year;
- Psychiatric disease;
- Other comorbid serious condition including severe heart and pulmonary disease, heart failure of New York Heart Association class IV, and tumors.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Active Comparator
Active Comparator
Arm Label
Metformin
Fixed-dose combination of metformin and pioglitazone (500mg metformin plus 15mg pioglitazone)
Dapagliflozin
Arm Description
Outcomes
Primary Outcome Measures
Insulin resistance
change from baseline insulin resistance at the fifth week
Secondary Outcome Measures
Full Information
NCT ID
NCT05591235
First Posted
October 16, 2022
Last Updated
October 20, 2022
Sponsor
Nanjing First Hospital, Nanjing Medical University
1. Study Identification
Unique Protocol Identification Number
NCT05591235
Brief Title
Effect of Metformin, Dapagliflozin, Combination of Metformin and Pioglitazone in Patients With Type 2 Diabetes
Official Title
Effect of Metformin, Dapagliflozin, Fixed Combination of Metformin and Pioglitazone in Overweighted Patients With Newly Diagnosed Type 2 Diabetes
Study Type
Interventional
2. Study Status
Record Verification Date
September 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
November 2022 (Anticipated)
Primary Completion Date
December 2022 (Anticipated)
Study Completion Date
February 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nanjing First Hospital, Nanjing Medical University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
Although, a number of drugs are promising treatment strategies for insulin resistance, a critical question arises to which drug benefits patients with type 2 diabetes more from reduced insulin resistance and consequent glycemic control. In this study, we aim to evaluate the effect of metformin, dapagliflozin and the fixed-dose combination of metformin and pioglitazone (500mg metformin plus 15mg pioglitazone) on insulin sensitivity and glycemic control in overweight patients with newly diagnosed type 2 diabetes.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type2diabetes, Insulin Resistance
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
60 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Metformin
Arm Type
Active Comparator
Arm Title
Fixed-dose combination of metformin and pioglitazone (500mg metformin plus 15mg pioglitazone)
Arm Type
Active Comparator
Arm Title
Dapagliflozin
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Metformin
Intervention Description
After the screening period, eligible subjects took the hyperinsulinemic euglycemic clamp test and were then admitted to insulin with metformin for 4 weeks. During this timeframe, all patients were instructed to change the insulin pump infusion site and provide one profile of 7-point self-monitored blood glucose every three days. The insulin doses were titrated every day by physicians to achieve the glycemic goal. Participants who failed to attain the glycemic target in three consecutive times or could not afford the side effects of hypoglycemic medications were excluded from this study. On the last day of week 4, a FreeStyle Libre Pro Sensor (FGM system) was inserted to record the glycemic data for up to 14 days. At the end of week 5, all antidiabetic agents were stopped and the hyperinsulinemic euglycemic clamp test was performed again for remaining subjects.
Intervention Type
Drug
Intervention Name(s)
Dapagliflozin
Intervention Description
After the screening period, eligible subjects took the hyperinsulinemic euglycemic clamp test and were then admitted to insulin with dapagliflozin (100mg one day) for 4 weeks. During this timeframe, all patients were instructed to change the insulin pump infusion site and provide one profile of 7-point self-monitored blood glucose every three days. The insulin doses were titrated every day by physicians to achieve the glycemic goal. Participants who failed to attain the glycemic target in three consecutive times or could not afford the side effects of hypoglycemic medications were excluded from this study. On the last day of week 4, a FreeStyle Libre Pro Sensor (FGM system) was inserted to record the glycemic data for up to 14 days. At the end of week 5, all antidiabetic agents were stopped and the hyperinsulinemic euglycemic clamp test was performed again for remaining subjects.
Intervention Type
Drug
Intervention Name(s)
Fixed-dose combination of metformin and pioglitazone (500mg metformin plus 15mg pioglitazone)
Intervention Description
After the screening period, eligible subjects took the hyperinsulinemic euglycemic clamp test and were then admitted to insulin with fixed-dose combination of metformin and pioglitazone (two tablets of 500mg metformin plus 15mg pioglitazone) for 4 weeks. During this timeframe, all patients were instructed to change the insulin pump infusion site and provide one profile of 7-point self-monitored blood glucose every three days. The insulin doses were titrated every day by physicians to achieve the glycemic goal. Participants who failed to attain the glycemic target in three consecutive times or could not afford the side effects of hypoglycemic medications were excluded from this study. On the last day of week 4, a FreeStyle Libre Pro Sensor (FGM system) was inserted to record the glycemic data for up to 14 days. At the end of week 5, all antidiabetic agents were stopped and the hyperinsulinemic euglycemic clamp test was performed again for remaining subjects.
Primary Outcome Measure Information:
Title
Insulin resistance
Description
change from baseline insulin resistance at the fifth week
Time Frame
week 5
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Willing to participate in this present study;
Regular diet and exercise;
Age 18 to 60 years;
Screening glycated hemoglobin (HbA1c) > 9.0%;
Body mass index (BMI) ≥ 24.0 kg/m2
Exclusion Criteria:
Other forms of diabetes;
Insulin allergy or intolerance of metformin, pioglitazone and dapagliflozin;
Renal dysfunction (estimated glomerular filtration rate < 45 mL/min);
Severe liver disease or elevated transaminases (2.5-fold the upper limit);
History of alcohol dependence or drug abuse in the past 5 years;
Systemic steroids therapy or other medication influencing cholesterol metabolism in the past 3 months;
Acute infection or stress state 1 month prior to this study;
Pregnancy or lactation;
History of diabetic ketoacidosis (DKA) within the previous year;
Psychiatric disease;
Other comorbid serious condition including severe heart and pulmonary disease, heart failure of New York Heart Association class IV, and tumors.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jianhua Ma, professor
Phone
18951670116
Email
majianhua196503@126.com
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Effect of Metformin, Dapagliflozin, Combination of Metformin and Pioglitazone in Patients With Type 2 Diabetes
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