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Trial registered on ANZCTR
Registration number
ACTRN12622001506785
Ethics application status
Approved
Date submitted
21/02/2022
Date registered
2/12/2022
Date last updated
2/12/2022
Date data sharing statement initially provided
2/12/2022
Type of registration
Retrospectively registered
Titles & IDs
Public title
Do short acting glucagon-like receptor agonists (GLP-1 RAs) attenuate the acceleration of gastric emptying induced by hypoglycaemia in type 2 diabetes?
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Scientific title
Do short acting glucagon-like receptor agonists (GLP-1 RAs) attenuate the 'gastric' counter-regulatory response to hypoglycaemia in type 2 diabetes?
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Secondary ID [1]
306489
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Diabetes
325353
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Condition category
Condition code
Metabolic and Endocrine
322737
322737
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Short acting GLP-1 receptor agonist, exenatide twice daily OR placebo
a) exenatide dose 10microgram twice daily
b) duration of administration: 4 weeks - drug and 4 weeks - placebo
c) Mode of administration - subcutaneous injection
d) monitoring adherence - frequent phone calls during trial period to ensure compliance, checking the number of injections left when participant attends study day at the end of each 4 week period.
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Intervention code [1]
322916
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Treatment: Drugs
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Comparator / control treatment
The placebo vial contains normal saline only. Placebo vial prepared by the Royal Adelaide Hospital Pharmacy specifically for this trial.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The primary outcome will be the change in the gastric emptying between hypoglycaemia and euglycaemia after 4 weeks treatment with exenatide BID vs Placebo treatment for 4 weeks.
Gastric emptying will be assessed by scintigraphy (gamma camera) - this is the gold standard technique.
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Assessment method [1]
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Timepoint [1]
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Gastric emptying T100 (T100 is the gastric retention at 100 minutes)
Gastric emptying will be assessed 4 times i.e 4 separate days in total (twice after 4 weeks of exenatide treatment and twice after 4 weeks of placebo) during the trial
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Secondary outcome [1]
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The secondary outcomes will be differences in plasma catecholamines between hypoglycaemia and euglycaemia study days
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Assessment method [1]
406566
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Timepoint [1]
406566
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Plasma catecholamine will be measured at t = -15, 15, 30, 75, 90, 120, 150, and 180 min during the clamp studies.
The clamp studies will occur 4 times in total (twice after 4 weeks of exenatide treatment and twice after 4 weeks of placebo) during the trial
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Secondary outcome [2]
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The additional secondary outcomes will be differences in plasma 3-OMG between hypoglycaemia and euglycaemia study days
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Assessment method [2]
416324
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Timepoint [2]
416324
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Plasma 3-OMG will be measured at t = -15, 15, 30, 75, 90, 120, 150, and 180 min during the clamp studies.
The clamp studies will occur 4 times in total (twice after 4 weeks of exenatide treatment and twice after 4 weeks of placebo) during the trial
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Eligibility
Key inclusion criteria
• Men and women with type 2 diabetes either diet controlled or metformin alone
• Aged 40 - 70 years
• Body Mass Index 20-40 kg/m²
• HbA1c less than or equal to 8.5 %
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Minimum age
40
Years
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Maximum age
70
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• History of type 1 diabetes or on medications other than metformin
• HbA1c >8.5 %
• History of gastrointestinal disease, including known gastroparesis, peptic ulcer disease, significant upper or lower gastrointestinal symptoms, or previous gastrointestinal surgery (other than uncomplicated appendicectomy or cholecystectomy) or a history of migraine or panic attacks.
• Other significant illness, including epilepsy, cardiovascular or respiratory disease.
• Impaired renal function (as assessed by calculated creatinine clearance < 50 mL/min using the Cockcroft-Gault equation) or if iron stores or liver function tests are outside the following normal ranges:
- Alanine aminotransferase (ALT) < 110 U/L
- Alkaline phosphatase (ALP) 30 - 110 U/L
- Aspartate transaminase (AST) < 90 U/L
- Total bilirubin 2 - 24 µmol/L
- Haemoglobin 130 – 180 g/L (Males)
- Haemoglobin 115 – 155 g/L (Females)
- Ferritin > 30 µg/L (Males)
- Ferritin > 15 µg/L
(Females)
• Requirement for medication known to influence gastrointestinal function, (e.g. prokinetic drugs [metoclopramide, domperidone, erythromycin], antiemetics [ondansetron], antidiarrhoeals [loperamide], H2 receptor antagonists [ranitidine], drugs with substantial anticholinergic effects [amitriptyline, doxepin, dothiepin, mirtazapine, haloperidol, chlorpromazine, risperidone, oxybutynin], opioids [morphine, oxycodone, codeine], orlistat.
• Evidence of drug or alcohol abuse, or consumption of more than 20 g alcohol or 10 cigarettes on a daily basis.
• Vegetarian
• Donation of blood within the previous 3 months
• Participation in any other research studies within the previous 3 months
• Previous exposure to radiation for research purposes in the preceding 12 months
• Inability to give informed consent
• Positive pregnancy status or lactating (breast-feeding) female
• Contra-indication to use of exenatide
• A known history of intolerance or unwilling to self-inject exenatide
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
22/06/2020
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
12
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Accrual to date
3
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
21793
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The Royal Adelaide Hospital - Adelaide
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Recruitment postcode(s) [1]
36850
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5000 - Adelaide
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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RAH Clinical Grants
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Address [1]
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Royal Adelaide Hospital, Port Rd, Adelaide SA 5005
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Royal Adelaide Hospital
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Address
Royal Adelaide Hospital, Port Rd, Adelaide SA 5005
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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none
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Address [1]
312089
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none
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Country [1]
312089
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
310400
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CALHN Human Research Ethics Committee
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Ethics committee address [1]
310400
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level 3, Roma Mitchell House, 136 North Terrace, Adelaide, South Australia SA 5000
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Ethics committee country [1]
310400
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Australia
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Date submitted for ethics approval [1]
310400
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Approval date [1]
310400
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15/01/2020
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Ethics approval number [1]
310400
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Summary
Brief summary
Gastric emptying (GE), which exhibits a wide inter-individual variation, determines the rate of exposure of nutrients (including carbohydrates) to the small intestine, where they are absorbed into the circulation. Insulin-induced hypoglycaemia (~2.5 mmol/L) accelerates gastric emptying substantially in both health and diabetes. The major mechanism for lowering of postprandial glycaemia by GLP-1 receptor agonists is by slowing gastric emptying. Although GLP-1RAs themselves are associated with minimal risk of hypoglycaemia (since their insulinotropic effects are glucose-dependent), the risk of hypoglycaemia is increased substantially when GLP-1RAs, especially short-acting, are combined with exogenous insulin or insulin secretagogues. Our aim is to determine whether treatment with short-acting GLP-1RAs, attenuates the acceleration of gastric emptying during insulin-induced hypoglycaemia in patients with type 2 diabetes.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Chinmay Marathe
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Address
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Work Organisation: University of Adelaide
Level 5, AHMS Building, North Terrace, Adelaide SA 5000
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Country
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Australia
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Phone
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+61 431266075
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Fax
117526
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Email
117526
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[email protected]
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Contact person for public queries
Name
117527
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Chinmay Marathe
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Address
117527
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Work Organisation: University of Adelaide
Level 5, AHMS Building, North Terrace, Adelaide SA 5000
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Country
117527
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Australia
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Phone
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+61 431266075
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Fax
117527
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Email
117527
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[email protected]
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Contact person for scientific queries
Name
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Chinmay Marathe
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Address
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Work Organisation: University of Adelaide
Level 5, AHMS Building, North Terrace, Adelaide SA 5000
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Country
117528
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Australia
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Phone
117528
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+61 431266075
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Fax
117528
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Email
117528
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
15181
Ethical approval
383617-(Uploaded-21-02-2022-13-28-42)-Study-related document.pdf
15183
Informed consent form
383617-(Uploaded-21-02-2022-13-34-26)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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