Biomarker Evaluation for Low Blood Sugar
(E-VAL Trial)
Trial Summary
What is the purpose of this trial?
Hypoglycemic complications are a major impediment to the maintenance of healthy glucose levels in persons with diabetes. The investigators recently completed a clinical pilot and feasibility study (GLIMPSE, NCT02690168), which identified a novel biomarker, glial acetate metabolism, that appears to predict the susceptibility to hypoglycemia. By providing an assay to predict hypoglycemic events and therefore diabetic complications, the development of this biomarker could significantly improve the treatment of persons with diabetes. The goal of this study is to determine the efficacy of our biomarker for predicting susceptibility to insulin-induced hypoglycemia. In order to accomplish this goal the investigatiors will pair our 13C magnetic resonance spectroscopy procedure to assess glial acetate metabolism, developed in the GLIMPSE study, with a hyperinsulinemic-hypoglycemic clamp procedure, developed in the HYPOCLAMP study (NCT03839511). The two procedures will be separated by a three day interval. The investigators will then correlate the participants' rates of glial acetate metabolism with their neuroendocrine responses to the hypoglycemic clamp. This proof of concept study will test the hypothesis that glial acetate metabolism is inversely proportional to the neuroendocrine response to hypoglycemia, that is, as glial acetate metabolism increases the neuroendocrine response will decrease.
Will I have to stop taking my current medications?
Yes, you will need to stop taking medications that affect glucose metabolism, such as benzodiazepines, thiazide diuretics, cortisone, and prednisone, as well as beta-adrenergic antagonists.
What data supports the effectiveness of the treatment Glial Acetate Metabolism for low blood sugar?
Is the treatment for low blood sugar generally safe in humans?
Research shows that brain metabolism of acetate and lactate is increased during low blood sugar in both diabetic and non-diabetic individuals, suggesting that the body adapts to maintain brain function. However, specific safety data for humans using this treatment under the name Glial Acetate Metabolism is not directly provided in the studies.12367
How does this treatment for low blood sugar differ from other treatments?
This treatment may involve the use of acetate, which is unique because it targets glial cells in the brain and can influence energy metabolism differently than traditional glucose-based treatments. Acetate's role in brain metabolism and its potential to modulate cellular energy status through enzyme acetylation makes it a novel approach compared to standard treatments for low blood sugar.2891011
Eligibility Criteria
This trial is for healthy men and women aged 18-40 with a BMI of 20-30 kg/m2. Participants must be medically cleared to join, not pregnant or breastfeeding, consume less than 10 alcoholic drinks per week, have no MRI contraindications, no cardiovascular disease history, normal blood pressure and glucose levels, non-smokers or those who quit over 10 years ago.Inclusion Criteria
Exclusion Criteria
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
13C Magnetic Resonance Spectroscopy
Participants undergo 13C magnetic resonance spectroscopy to assess glial acetate metabolism
Hyperinsulinemic-Hypoglycemic Clamp
Participants undergo a hyperinsulinemic-hypoglycemic clamp procedure to measure neuroendocrine response
Follow-up
Participants are monitored for safety and effectiveness after procedures
Treatment Details
Interventions
- Glial Acetate Metabolism (Metabolic Biomarker)