Type 1 Diabetes Mellitus
Conditions
Keywords
beta cell
Brief summary
test if a food supplementation with GABA can improve insulin production capacity in type 1 diabetes patients by turning alfa cells into beta cells in accordance with mice and cell studies.randomised parallel study with placebo as control
Detailed description
our results indicate that alfa-cells can be regenerated and used to regenerate functional beta-like cells in vivo in type 1 diabetes models. Aiming to eventually apply these findings to type 1 diabetic patients, we initiated multiple screens seeking for compounds inducing alfa-to-beta-cell conversion. Using the mouse as a model, we thereby found that GABA (gamma-aminobutyric acid) could promote a cycle of conversion of alfa-cells into functional beta-like cells,GABA being considered as a non-harmful food supplement, one could envision a trial in type 1 diabetic patients. Indeed, a putative cure for type 1 diabetes may include halting the autoimmune insult to the pancreatic beta-cells and restoring insulin secretion by expanding beta-cell mass by beta-cell-regeneration and/or preventing beta-cell apoptosis induced by cytokines. Immunosuppression initiated at the onset of type 1 diabetes has been shown to preserve beta-cell function, but is associated with significant toxicities. Other studies using nicotinamide and parenteral insulin have failed to prevent development of type 1 diabetes. Objectives Primary objective: To investigate the effect and safety of the dietary supplement GABA provided at a dose of 6 g daily compared to placebo for 12 weeks on change in beta-cell function in patients with C-peptide negative type 1 diabetes as an adjunctive therapy to insulin treatment. Population A total of 30 patients with C-peptide negative type 1 diabetes, randomised 2:1 GABA: Placebo. Intervention After randomisation patients are treated with the dietary supplement GABA or matching placebo, titrated to 3 x 2g, or maximum tolerated dose, for 12 weeks. The insulin dose is reduced if needed according to Self-monitored blood glucose (SMBG) and hypoglycaemic episodes.
Interventions
DIETARY_SUPPLEMENTGama amino butyric acid (GABA)
food supplement Gama amino butyric acid (GABA) as capsules
DIETARY_SUPPLEMENTplacebo
matching placebo
Sponsors
Juvenile Diabetes Research Foundation
Steno Diabetes Center Copenhagen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Masking description
randomised controlled with placebo tablets matching active capsules with investigational product
Intervention model description
randomised controlled study with active compared to placebo for 12 weeks
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
stimulated c peptide \<0.03 mmol/l type 1 diabetes \-
Exclusion criteria
* • Type 2 diabetes * Fertile women not using chemical (tablet/pill, depot injection of progesterone, subdermal gestagen implantation, hormonal vaginal ring or transdermal hormonal patch) or mechanical (spirals) contraceptives * Pregnant or nursing women * Cancer unless in complete remission for \> 5 years * Treatment with oral glucocorticoids * Hypoglycaemia unawareness (unability to register low blood glucose) * Known or suspected hypersensitivity to trial product or related products * Abuse of alcohol or drugs, or any other co-existing condition that would make patients unsuitable to participate in the study, as deemed by the investigators * Receipt of an investigational drug within 30 days prior to visit 0 * Simultaneous participation in any other clinical intervention trial * Chronic systemic use of steroids * Seizure disorder * Current use of Baclofen, Valium, Acamprosate, Neurontin, or Lyrica
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| insulin production | 12 weeks | c peptide production during meal stimulation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| c peptide response beta cell | after 12 weeks | beta cell sensitivity during meal testing, calculated with Homeostatic Model assessment b (HOMAb) |
| glucagon response | after 12 weeks | increase in blood glucagon concentration from fasting to peak during meal testing, |
| metabolic parameters | 12 weeks | hba1c (mmol/mol) change from baseline |
| metabolic parameters dose of insulin | 12 weeks | insulin dose used pr 24 hours |
| metabolic parameters glucose | 12 weeks | hypoglycemia,(number of events of severe and mild hypoglycemia self reported) |
| c peptide response (change from fasting baseline to meal stimulated concentration in blood) | after 12 weeks | maximal c peptide change from baseline during meal testing with sustacal, |
| metabolic parameters weight | 12 weeks | body weight (kg) |
| metabolic parameters waist | 12 weeks | waist circumference (cm) |
| metabolic parameters SMBG | 12 weeks | SMBG self monitored blood glucose (mmol/l) 7 points profile in diary |
| metabolic parameters quality of life | 12 weeks | Quality of life questionnaire |
| metabolic parameters lipid | 12 weeks | lipid (LDL cholesterol ) (mmol/l) |
Countries
Denmark
Contacts
Primary ContactPeter Rossing, MD
Outcome results
None listed