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Suppression of Endogenous Glucose Production by Injectable HDV-Insulin Lispro: A Dose Response Study in Human Subjects With Type 1 Diabetes

Primary Purpose

Type 1 Diabetes

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
HDV-Insulin Lispro
Sponsored by
University of California, San Diego
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Type 1 Diabetes

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Male or female of age 18 to 65 years, inclusive, who: Has at Screening been diagnosed as T1D for at least 12 months; preference will be given to potential participants who currently use continuous subcutaneous insulin infusion (CSII) therapy; Has at Screening C-peptide ≤0.8 ng/mL (single retest allowed); Has at Screening a BMI ≥18.0 kg/m2 and ≤33.0 kg/m2; Has at Screening HbA1c ≥6.5% and ≤8.5 %. Exclusion Criteria: Has known or suspected allergy to any component of any of the study drugs in this trial; Is, at Screening, pregnant or breast-feeding, or intends to become pregnant at any time during the duration of the study; Has, at Screening, as judged by the Site Investigator, a history or current evidence of any of advance complications of diabetes; Is, at Screening, judged by the Site Investigator to have a current addiction to alcohol or substances of abuse; Is, at Screening, using one or more drugs that may interfere with the interpretation of trial results or are known to cause clinically relevant interference with insulin action, glucose utilization, or recovery from hypoglycemia (e.g., beta blockers, systemic corticosteroids at pharmacologic doses, cancer chemotherapies); Has, within one (1) month prior to Screening, used either oral anti-diabetic medication or noninsulin anti-diabetic injection therapies (e.g. SGLT-2 inhibitors, pramlintide, GLP-1 agonists, etc.); Has, within one (1) month prior to Screening, received any investigational drug; Has, within three (3) months prior to Screening, smoked tobacco or used any smokeless tobacco or nicotine delivery system (inhaled, oral or buccal); Has at Screening, as judged by the Site Investigator, any condition (intrinsic or extrinsic) that could reasonably be expected to interfere with trial participation, confound evaluation of the data, or pose additional risk to adhering to the study protocol. Examples of such conditions include but are not limited to: Clinically significant active disease of the gastrointestinal, cardiovascular, hepatic, neurological, renal, genitourinary, or hematological systems; History of such an illness or disease; Diminished mental capacity, psychological or behavioral dysfunction, unwilling or resistant to protocol requirements, language barriers.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Placebo Comparator

    Active Comparator

    Active Comparator

    Active Comparator

    Arm Label

    HDV-bound Lispro 0%

    HDV-bound Lispro 1%

    HDV-bound Lispro 10%

    HDV-bound Lispro 100%

    Arm Description

    Subjects will receive insulin lispro with 0% bound HDV

    Subjects will receive insulin lispro with 1% bound HDV

    Subjects will receive insulin lispro with 10% bound HDV

    Subjects will receive insulin lispro with 100% bound HDV

    Outcomes

    Primary Outcome Measures

    Percentage of suppression of endogenous glucose production
    To establish the dose-response relationship between Hepatic-Directed Vesicles (HDV) and endogenous glucose production at a constant dose of insulin lispro (LIS) during euglycemic clamp procedure

    Secondary Outcome Measures

    Full Information

    First Posted
    January 9, 2023
    Last Updated
    June 15, 2023
    Sponsor
    University of California, San Diego
    Collaborators
    The Leona M. and Harry B. Helmsley Charitable Trust
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05689424
    Brief Title
    Suppression of Endogenous Glucose Production by Injectable HDV-Insulin Lispro: A Dose Response Study in Human Subjects With Type 1 Diabetes
    Official Title
    Suppression of Endogenous Glucose Production by Injectable HDV-Insulin Lispro: A Dose Response Study in Human Subjects With Type 1 Diabetes
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    October 2023 (Anticipated)
    Primary Completion Date
    January 2026 (Anticipated)
    Study Completion Date
    January 2026 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    University of California, San Diego
    Collaborators
    The Leona M. and Harry B. Helmsley Charitable Trust

    4. Oversight

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

    5. Study Description

    Brief Summary
    Single-center, double-blind, random-sequence study assessing the HDV dose-response relationship to Endogenous Glucose Production (EGP), Free Fatty Acids (FFA) and Glucose Disposal Rate (GDR) during a euglycemic clamp procedure following overnight stabilization of blood glucose with intravenous insulin (and, if needed intravenous glucose). EGP and GDR will be determined using established radioisotope methodology. The concentration of Hepatic Directed Vesicles (HDV) in the insulin lispro (LIS) infused during the clamp procedure will be varied such that the percentage of HDV-bound LIS will range from 0%, 1%, 10%, and 100%. Each participant will thus undergo four clamp procedures at the four different HDV levels. LIS will be infused at a constant dose (6 mU/m2/min) for each of the four procedures.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Type 1 Diabetes

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Single Group Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    18 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    HDV-bound Lispro 0%
    Arm Type
    Placebo Comparator
    Arm Description
    Subjects will receive insulin lispro with 0% bound HDV
    Arm Title
    HDV-bound Lispro 1%
    Arm Type
    Active Comparator
    Arm Description
    Subjects will receive insulin lispro with 1% bound HDV
    Arm Title
    HDV-bound Lispro 10%
    Arm Type
    Active Comparator
    Arm Description
    Subjects will receive insulin lispro with 10% bound HDV
    Arm Title
    HDV-bound Lispro 100%
    Arm Type
    Active Comparator
    Arm Description
    Subjects will receive insulin lispro with 100% bound HDV
    Intervention Type
    Drug
    Intervention Name(s)
    HDV-Insulin Lispro
    Intervention Description
    The name of the investigational drug is Hepatic Directed Vesicles + Insulin Lispro (HDV-bound LIS). It is a nano-carrier-based formulation of insulin which is the active therapeutic ingredient in the product. The nano-carrier component of the formulation contains a hepatic target molecule, biotin phosphatidylethanolamine, which has an affinity for hepatocytes and enables the product to deliver insulin directly to the liver.
    Primary Outcome Measure Information:
    Title
    Percentage of suppression of endogenous glucose production
    Description
    To establish the dose-response relationship between Hepatic-Directed Vesicles (HDV) and endogenous glucose production at a constant dose of insulin lispro (LIS) during euglycemic clamp procedure
    Time Frame
    0 through 6 hours

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    65 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Male or female of age 18 to 65 years, inclusive, who: Has at Screening been diagnosed as T1D for at least 12 months; preference will be given to potential participants who currently use continuous subcutaneous insulin infusion (CSII) therapy; Has at Screening C-peptide ≤0.8 ng/mL (single retest allowed); Has at Screening a BMI ≥18.0 kg/m2 and ≤33.0 kg/m2; Has at Screening HbA1c ≥6.5% and ≤8.5 %. Exclusion Criteria: Has known or suspected allergy to any component of any of the study drugs in this trial; Is, at Screening, pregnant or breast-feeding, or intends to become pregnant at any time during the duration of the study; Has, at Screening, as judged by the Site Investigator, a history or current evidence of any of advance complications of diabetes; Is, at Screening, judged by the Site Investigator to have a current addiction to alcohol or substances of abuse; Is, at Screening, using one or more drugs that may interfere with the interpretation of trial results or are known to cause clinically relevant interference with insulin action, glucose utilization, or recovery from hypoglycemia (e.g., beta blockers, systemic corticosteroids at pharmacologic doses, cancer chemotherapies); Has, within one (1) month prior to Screening, used either oral anti-diabetic medication or noninsulin anti-diabetic injection therapies (e.g. SGLT-2 inhibitors, pramlintide, GLP-1 agonists, etc.); Has, within one (1) month prior to Screening, received any investigational drug; Has, within three (3) months prior to Screening, smoked tobacco or used any smokeless tobacco or nicotine delivery system (inhaled, oral or buccal); Has at Screening, as judged by the Site Investigator, any condition (intrinsic or extrinsic) that could reasonably be expected to interfere with trial participation, confound evaluation of the data, or pose additional risk to adhering to the study protocol. Examples of such conditions include but are not limited to: Clinically significant active disease of the gastrointestinal, cardiovascular, hepatic, neurological, renal, genitourinary, or hematological systems; History of such an illness or disease; Diminished mental capacity, psychological or behavioral dysfunction, unwilling or resistant to protocol requirements, language barriers.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Todd May, MS
    Phone
    858-246-2169
    Email
    tmay@health.ucsd.edu

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    IPD Sharing Plan Description
    IPD will not be shared

    Learn more about this trial

    Suppression of Endogenous Glucose Production by Injectable HDV-Insulin Lispro: A Dose Response Study in Human Subjects With Type 1 Diabetes

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