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Effect of Resistant Starch on Insulin Sensitivity and Beta Cell Function in Subjects With Prediabetes

Primary Purpose

Prediabetes

Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Resistant Starch
Placebo
Sponsored by
Hospital de Clinicas de Porto Alegre
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prediabetes focused on measuring prediabetes, resistant starch, insulin sensitivity

Eligibility Criteria

20 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion criteria

  1. Serum glycated hemoglobin (A1c) values between 5.7 and 6.5%, or fasting glucose ≥ 5.55 mmol/L and < 6.94 mmol/L or oral glucose tolerance test (75g) ≥7.77 and <11.04 mmol /L.
  2. Body mass index (BMI) ≥ 25 kg / m² (≥23 kg / m² for those of Asian origin) and ≤ 35 kg / m² for screening.
  3. Stable weight (maximum variation of approximately 5%) for at least 4 weeks prior to screening.
  4. Apt and willing to provide the written informed consent term and to comply with the requirements of the study protocol.

Exclusion Criteria:

  1. Clinically symptomatic gastrointestinal disease including, but not limited to, inflammatory bowel disease.
  2. History of gastric bypass, antrectomy, or resection of the small intestine.
  3. History of chronic pancreatitis or acute idiopathic pancreatitis.
  4. Myocardial infarction, coronary artery bypass grafting, post-transplant cardiomyopathy or stroke in the last 6 months.
  5. Any anomaly in clinical laboratory tests which may prevent safe participation in the study.
  6. Tumor diagnosed and / or treated (except basal cell skin cancer, cervical carcinoma in situ, or prostate cancer in situ) within the past 5 years.
  7. Hemoglobinopathy or chronic anemia known.
  8. Donation of one unit (500 ml) or more of blood, significant loss of blood equivalent to at least one unit of blood within the last 2 weeks or blood transfusion in the last 8 weeks.
  9. Any concomitant medical condition / disorder which, in the investigator's opinion, is likely to:

    • Will interfere with the patient's ability to complete the entire study period or participate in all study activities;
    • Require, during the study, the administration of a treatment that may affect the interpretation of the efficacy and safety data.
  10. Treatment with any oral antidiabetic medicinal product and / or herbal preparations / non-prescription medicines that may affect glycemic control within 12 weeks prior to screening.
  11. Chronic treatment with oral or parenteral corticosteroids (> 7 consecutive days of treatment) within 4 weeks prior to screening.
  12. Treatment with weight-reducing agents (eg, orlistat, sibutramine, topiramate, bupropion) within the last 12 weeks prior to screening.
  13. History of unstable hypertension (> 170/105 mmHg) in the last 12 weeks prior to screening.
  14. Treatment with a lipid-lowering drug that has not been kept in a stable dose within the last 8 weeks prior to screening.
  15. Treatment with thyroid hormone that has not been kept in a stable dose in the last 12 weeks prior to screening.
  16. Investigational drug use within 30 days or 5 half-lives (whichever is longer) prior to screening unless guidelines from local health authorities require a longer period.
  17. Any of the following laboratory abnormalities in screening:

    • Alanine aminotransferase (ALT) and / or Aspartate aminotransferase (AST) 3 times the upper limit of normality;
    • Glomerular filtration estimated by the equation kidney disease ≤ 60 ml per min by 1.73 m².
    • Fasting triglycerides > 5.6 mmol / L;
    • Thyroid stimulating hormone (TSH) outside normal range.
  18. History of substance abuse (including alcohol) within the last year.
  19. Women with potential to become pregnant and / or who are using local or systemic hormonal contraceptive method; Women in the follicular phase of the menstrual cycle and also pregnant and lactating women.
  20. Potentially unreliable patients and those considered by the Investigator as unsuitable for the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Placebo Comparator

    Arm Label

    Resistant Starch

    Placebo

    Arm Description

    Green banana flour

    Maltodextrin, cellulose and guar gum

    Outcomes

    Primary Outcome Measures

    Insulin sensitivity
    Insulin sensitivity compared to the baseline visit measured by hyperglycemia clamp

    Secondary Outcome Measures

    Hormonal changes
    Alteration of hormones that affect glucose metabolism, such as peptide C
    Change in lipid profile
    Alteration of total cholesterol, HDL-cholesterol and triglycerides
    Change total body fat
    Change total body fat will be compared before and after the intervention by means of bioimpedance
    Beta cell function
    Beta cell function (first and second phase of insulin secretion) will be measured by hyperglycemic clamp
    Glycemic control
    Measured by hemoglobin glycated

    Full Information

    First Posted
    June 28, 2017
    Last Updated
    July 13, 2018
    Sponsor
    Hospital de Clinicas de Porto Alegre
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03294915
    Brief Title
    Effect of Resistant Starch on Insulin Sensitivity and Beta Cell Function in Subjects With Prediabetes
    Official Title
    Effect of Resistant Starch From Green Banana Flour on the Insulin Sensitivity of Subjects With Prediabetes: Randomized Clinical Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2017
    Overall Recruitment Status
    Unknown status
    Study Start Date
    October 2018 (Anticipated)
    Primary Completion Date
    August 2019 (Anticipated)
    Study Completion Date
    May 2020 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Hospital de Clinicas de Porto Alegre

    4. Oversight

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

    5. Study Description

    Brief Summary
    To compare the use supplementation based on green banana flour versus placebo in the insulin sensitivity on individuals who have prediabetes.
    Detailed Description
    In order to evaluate whether supplementation with green banana flour may improve insulin sensitivity of individuals with prediabetes, volunteers will be recruited by advertising on the web page of Hospital de Clinical de Porto Alegre. After screening and selection, they will be submitted to a clinical, laboratory and nutritional standard evaluation, assessment of physical activity and body fat composition.The laboratory evaluation will include the oral glucose tolerance test (OGGT 75g), lipid profile, insulin, C-peptide, glycated hemoglobin and glycated albumin. Insulin sensitivity and beta-cell function will be assessed by the hyperglycemic CLAMP before and after the intervention.Interim statistical analysis will be performed at the end of the participation of ten study volunteers. Subjects will receive green banana flour or placebo for four weeks.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Prediabetes
    Keywords
    prediabetes, resistant starch, insulin sensitivity

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    20 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Resistant Starch
    Arm Type
    Active Comparator
    Arm Description
    Green banana flour
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Maltodextrin, cellulose and guar gum
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    Resistant Starch
    Intervention Description
    Addition of 42g per day of green banana flour (10g / day resistant starch) to the usual diet of study participants
    Intervention Type
    Dietary Supplement
    Intervention Name(s)
    Placebo
    Intervention Description
    Addition of 42g per day of mixture of guar gum, maltodextrin and cellulose to the usual diet of study participants
    Primary Outcome Measure Information:
    Title
    Insulin sensitivity
    Description
    Insulin sensitivity compared to the baseline visit measured by hyperglycemia clamp
    Time Frame
    4 weeks
    Secondary Outcome Measure Information:
    Title
    Hormonal changes
    Description
    Alteration of hormones that affect glucose metabolism, such as peptide C
    Time Frame
    4 weeks
    Title
    Change in lipid profile
    Description
    Alteration of total cholesterol, HDL-cholesterol and triglycerides
    Time Frame
    4 weeks
    Title
    Change total body fat
    Description
    Change total body fat will be compared before and after the intervention by means of bioimpedance
    Time Frame
    4 weeks
    Title
    Beta cell function
    Description
    Beta cell function (first and second phase of insulin secretion) will be measured by hyperglycemic clamp
    Time Frame
    4 weeks
    Title
    Glycemic control
    Description
    Measured by hemoglobin glycated
    Time Frame
    4 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    20 Years
    Maximum Age & Unit of Time
    50 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion criteria Serum glycated hemoglobin (A1c) values between 5.7 and 6.5%, or fasting glucose ≥ 5.55 mmol/L and < 6.94 mmol/L or oral glucose tolerance test (75g) ≥7.77 and <11.04 mmol /L. Body mass index (BMI) ≥ 25 kg / m² (≥23 kg / m² for those of Asian origin) and ≤ 35 kg / m² for screening. Stable weight (maximum variation of approximately 5%) for at least 4 weeks prior to screening. Apt and willing to provide the written informed consent term and to comply with the requirements of the study protocol. Exclusion Criteria: Clinically symptomatic gastrointestinal disease including, but not limited to, inflammatory bowel disease. History of gastric bypass, antrectomy, or resection of the small intestine. History of chronic pancreatitis or acute idiopathic pancreatitis. Myocardial infarction, coronary artery bypass grafting, post-transplant cardiomyopathy or stroke in the last 6 months. Any anomaly in clinical laboratory tests which may prevent safe participation in the study. Tumor diagnosed and / or treated (except basal cell skin cancer, cervical carcinoma in situ, or prostate cancer in situ) within the past 5 years. Hemoglobinopathy or chronic anemia known. Donation of one unit (500 ml) or more of blood, significant loss of blood equivalent to at least one unit of blood within the last 2 weeks or blood transfusion in the last 8 weeks. Any concomitant medical condition / disorder which, in the investigator's opinion, is likely to: Will interfere with the patient's ability to complete the entire study period or participate in all study activities; Require, during the study, the administration of a treatment that may affect the interpretation of the efficacy and safety data. Treatment with any oral antidiabetic medicinal product and / or herbal preparations / non-prescription medicines that may affect glycemic control within 12 weeks prior to screening. Chronic treatment with oral or parenteral corticosteroids (> 7 consecutive days of treatment) within 4 weeks prior to screening. Treatment with weight-reducing agents (eg, orlistat, sibutramine, topiramate, bupropion) within the last 12 weeks prior to screening. History of unstable hypertension (> 170/105 mmHg) in the last 12 weeks prior to screening. Treatment with a lipid-lowering drug that has not been kept in a stable dose within the last 8 weeks prior to screening. Treatment with thyroid hormone that has not been kept in a stable dose in the last 12 weeks prior to screening. Investigational drug use within 30 days or 5 half-lives (whichever is longer) prior to screening unless guidelines from local health authorities require a longer period. Any of the following laboratory abnormalities in screening: Alanine aminotransferase (ALT) and / or Aspartate aminotransferase (AST) 3 times the upper limit of normality; Glomerular filtration estimated by the equation kidney disease ≤ 60 ml per min by 1.73 m². Fasting triglycerides > 5.6 mmol / L; Thyroid stimulating hormone (TSH) outside normal range. History of substance abuse (including alcohol) within the last year. Women with potential to become pregnant and / or who are using local or systemic hormonal contraceptive method; Women in the follicular phase of the menstrual cycle and also pregnant and lactating women. Potentially unreliable patients and those considered by the Investigator as unsuitable for the study.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Fernando Gerchman, MD
    Phone
    +55 51 99993-3491
    Email
    fgerchman@gmail.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Ana Duarte, RND
    Phone
    +55 51 98429-5548
    Email
    nutrianacduarte@gmail.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Fernando Gerchman, MD
    Organizational Affiliation
    Federal University of Rio Grande do Sul
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
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    Effect of Resistant Starch on Insulin Sensitivity and Beta Cell Function in Subjects With Prediabetes

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