ProSciento
Chula Vista, California, 91911, United States
NCT Number: NCT04502212
This research study is being done to evaluate the effect of hepatic ultrasound insonification on whole-body insulin sensitivity and evaluate the safety and tolerability of hepatic ultrasound insonification in subjects with Type 2 Diabetes Mellitus (T2DM). "Insonify/insonification" is defined as applying to an area or an object carefully-controlled sound waves, typically as in ultrasound imaging. GE Research is sponsoring this research study. The purpose of this research study is to:
* Evaluate the effect of liver ultrasound waves on changes from baseline in whole-body insulin sensitivity * Test the safety and tolerability of liver ultrasound waves in subjects with Type 2 Diabetes Mellitus * Evaluate the effect of liver ultrasound waves on change from baseline in glucose tolerance and insulin secretion * Evaluate the effect of liver ultrasound waves on glucose metabolism
Insulin sensitivity refers to how sensitive the body's cells are in response to insulin.
Glucose tolerance refers to the body's ability to handle (tolerate) glucose. Insulin secretion is a process in which the body releases insulin in response to glucose levels in the blood becoming elevated.
The study device used in this study is cleared for use by the United States Food and Drug Administration (FDA) for ultrasound diagnostic exams, however it has not been tested or approved specifically for modulation of metabolism in people with diabetes. The use of the study device in this study is investigational and is considered a Non-Significant Risk (NSR).
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Notify Me21 year–75 year
All sexes
Interventional
Not applicable
Chula Vista, California, 91911, United States
This was an open label, exploratory pilot study to assess the effects of hepatic ultrasound insonification on glucometabolic parameters in subjects with T2DM through selective hepatic ultrasound of the porta hepatis region of the liver utilizing pulsed ultrasound. The study was to consist of 1 cohort comprising up to 15 subjects. Dropouts and withdrawals could have been replaced until the anticipated number of subjects completed the study. Finally, the study consisted of one cohort with 36 subjects enrolled, including 20 screen failures, 15 subjects that completed the study (1 completer had an incorrect infusion parameter and was removed from clamp analysis), and 1 subject that was discontinued at the discretion of the Investigator. As this was an exploratory, open-label study, no randomization or blinding was performed and no-unblinding codes were required.
The study included a Screening Period, Observational Period 1, 3 consecutive days of hepatic ultrasound insonification, and Observational Period 2. Each Observational Period was divided into an In-house Period and an Outpatient Visit (OPV). The Screening Period was performed up to 28 days prior to the first In-house Period. For eligible subjects with a body mass index (BMI) > 35.0 and ≤ 40.0 kg/m2 and/or a waist circumference > 40 and ≤ 45 inches, an ultrasound examination was added to confirm eligibility, and the Screening Period was extended to at least 30 days. The first Observational Period lasted approximately 2-weeks (Days -1 to 14). On the morning of Day -1, subjects checked into the clinic for a 3-day In-house Period; subjects may have been released from the clinic on Day 2. Subjects were contacted via telephone every other day until the next In-house Period. On Day 8, subjects checked into the clinic for an OPV. On Day 15, subjects checked into the clinic in fasting conditions for a 4-day In-house Period. Insonifications were performed on three consecutive days (Days 15, 16 and 17). Subjects may have been released from the clinic on Day 18. The second Observational Period lasted 11 days (Days 18 to 28). Subjects were contacted via telephone every other day until the Follow-up Visit. On Day 22, subjects checked into the clinic for the OPV. The Follow-up Visit was performed on Day 28.
Healthy volunteers accepted: No
Only the study team can determine whether someone qualifies for participation.
Inclusion criteria
Exclusion criteria
Hepatic ultrasound insonification will be performed after an overnight fast (no food or drinks except for water for at least 10 hours) at approximately the same time on each day for three days.
Time frame: Day 2 (Baseline) to Day 17
To evaluate the effect of hepatic ultrasound insonification on changes from baseline in whole-body insulin sensitivity during a two-step hyperinsulinemic, euglycemic clamp with stable isotope labeled glucose tracer
Time frame: Day 2 (Baseline) to Day 17
To evaluate the effect of hepatic ultrasound insonification on changes from baseline in whole-body insulin sensitivity during a two-step hyperinsulinemic, euglycemic clamp with stable isotope labeled glucose tracer
Time frame: Day 2 (Baseline) to Day 17
To evaluate the effect of hepatic ultrasound insonification on changes from baseline in whole-body insulin sensitivity during a two-step hyperinsulinemic, euglycemic clamp with stable isotope labeled glucose tracer
For each clamp, the degree of EGP suppression from the fasting EGP value was to be determined during the last 30 minutes point during each step of the two-step H-E clamp using the following equation:
% EGP suppression = 1 - (EGP clamp/EGP fasting) Partial suppression of EGP during Step 1 was to be assessed to determine hepatic insulin sensitivity and EGP suppression during Step 2 was to be measured to confirm that EGP was (near) fully suppressed to allow the determination of extrahepatic insulin sensitivity.
Time frame: Day 2 (Baseline) to Day 17
To evaluate the effect of hepatic ultrasound insonification on changes from baseline in whole-body insulin sensitivity during a two-step hyperinsulinemic, euglycemic clamp with stable isotope labeled glucose tracer
Time frame: Screening to Day 28
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM. Incidence of adverse device effects included observations of Incidence and severity of clinically significant laboratory abnormalities, Change from baseline in vital signs (blood pressure, temperature, respiratory rate, and heart rate), Incidence and severity of clinical findings on physical examination, Change from baseline in 12-lead electrocardiogram (ECG) parameters; the primary ECG endpoint was QTcF.
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM: [Severity Score: 1=Mild; 2=Moderate; 3=Severe; 4=Life-Threatening; 5=Death]
Time frame: Screening to Day 28
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM
Time frame: Screening to Day 28
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM
Time frame: Baseline to Day 28 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM
Time frame: Baseline to Day 28 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM
Time frame: Baseline to Day 28 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM
Time frame: Baseline to Day 28 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM
Time frame: Screening to Day 28
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM
Time frame: Baseline to Day 28 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM
Time frame: Screening to Day 28
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM
Time frame: Day 2 (Baseline) to Day 17
To evaluate the effect of hepatic ultrasound insonification on changes from baseline in whole-body insulin sensitivity during a two-step hyperinsulinemic, euglycemic clamp with stable isotope labeled glucose tracer.
The Insulin Sensitivity Index was to be calculated from the H-E clamp data using the formula included in the SAP, with Step 1 indicating the first phase of the clamp, or the period of administration of the first (lower) insulin infusion rate and Step 2 indicating the second phase of the clamp or the period of administration of the second (higher) insulin infusion rate. Mean GIRs and mean plasma insulin concentrations were to be calculated during steady state for the applicable step(s).
Change from baseline of SI was then to be computed for each subject as:
Change from baseline (SI) = SI2 - SI1, where Clamp 2 was the second clamp and Clamp 1 was the first clamp (completed on Day 2, prior to first insonification).
Time frame: Day 2 (Baseline) to Day 17
To evaluate the effect of hepatic ultrasound insonification on changes from baseline in whole-body insulin sensitivity during a two-step hyperinsulinemic, euglycemic clamp with stable isotope labeled glucose tracer
Time frame: Day 2 (Baseline) to Day 17
To evaluate the effect of hepatic ultrasound insonification on changes from baseline in whole-body insulin sensitivity during a two-step hyperinsulinemic, euglycemic clamp with stable isotope labeled glucose tracer
Time frame: Day 15 (Baseline) to Day 18
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, assessed by a Homeostasis Model. A higher value denotes an increased level of insulin resistance, and a lower value denotes an decreased level of insulin resistance. The value is computed based on fasting insulin and glucose values.
The HOMA2 results were produced by the HOMA2 calculator with FPG and insulin concentration obtained from safety laboratory assessments as the inputs to the calculator at https://www.dtu.ox.ac.uk/homacalculator/. Please see citation (see references module): "Levy 1998 Levy JC, Matthews DR, & Hermans MP. (1998). Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care. 21:2191-2192."
Time frame: Day 15 (Baseline) to Day 18
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, assessed by a Homeostasis Model. The HOMA2 results were to be produced by the HOMA2 calculator with FPG and insulin concentration obtained from safety laboratory assessments as the inputs to the calculator at https://www.dtu.ox.ac.uk/homacalculator/. HOMA2-B values estimate steady state pancreatic beta cell function, as a percent of a normal reference population. See citation: "Levy JC, Matthews DR, & Hermans MP. (1998). Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care. 21:2191-2192."
Time frame: Baseline to Day 18 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, assessed by fasting plasma glucose blood test
Time frame: Day 1 (Baseline) to Day 16
To evaluate the effect of hepatic ultrasound insonification on change from baseline in glucose tolerance and insulin secretion, assessed by an oral glucose tolerance test (OGTT). AUC in this outcome is calculated using the absolute value of glucose measures (compared to incremental AUC below which uses baseline (time 0 glucose) subtracted values).
Time frame: Day 1 (Baseline) to Day 16
To evaluate the effect of hepatic ultrasound insonification on change from baseline in glucose tolerance and insulin secretion, assessed by an oral glucose tolerance test (OGTT). AUC in this outcome is calculated using the absolute value of insulin measures (compared to incremental AUC below which uses baseline (time 0 insulin) subtracted values).
Time frame: 14:00 on Day -1 to 22:00 on Day 1 (Baseline) to 14:00 on Day 15 to 22:00 on Day 16 - omitting data collected between a subject's OGTT glucose consumption start time + 180 minutes
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, assessed by a continuous glucose monitoring system (CGMS)
Time frame: 14:00 on Day -1 to 22:00 on Day 1 (Baseline) to 14:00 on Day 15 to 22:00 on Day 16 - omitting data collected between a subject's OGTT glucose consumption start time + 180 minutes
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, assessed by a continuous glucose monitoring system (CGMS)
Time frame: 14:00 on Day -1 to 22:00 on Day 1 (Baseline) to 14:00 on Day 15 to 22:00 on Day 16 - omitting data collected between a subject's OGTT glucose consumption start time + 180 minutes
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, assessed by a continuous glucose monitoring system (CGMS)
Time frame: 14:00 on Day -1 to 22:00 on Day 1 (Baseline) to 14:00 on Day 15 to 22:00 on Day 16 - omitting data collected between a subject's OGTT glucose consumption start time + 180 minutes
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, assessed by a continuous glucose monitoring system (CGMS)
To calculate the LBGI and HBGI, the original BG data for each day/period was to be transformed such that it was centered by zero and bound between -sqrt(10) and sqrt(10).
f(BG,α,β) = [(ln(BG))1.084 - 5.381]*1.509
The transformed values were then to be input into the BG risk function:
r(BG) = 10 * f(BG,α,β)2
The risk of each observation was further to be transformed into two series, risk of low BG series, rl(BG), and risk of high BG series, rh(BG):
rl(BG) = r(BG) if f(BG) < 0 and 0 otherwise rh(BG) = r(BG) if f(BG) > 0 and 0 otherwise These series were then to be averaged to produce the LBGI and the HBGI as shown in the equations in the SAP.
Time frame: Screening to Day 28
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM. Incidence of adverse device effects included observations of Incidence and severity of clinically significant laboratory abnormalities, Change from baseline in vital signs (blood pressure, temperature, respiratory rate, and heart rate), Incidence and severity of clinical findings on physical examination, Change from baseline in 12-lead electrocardiogram (ECG) parameters; the primary ECG endpoint was QTcF.
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM: [Severity Score: 1=Mild; 2=Moderate; 3=Severe; 4=Life-Threatening; 5=Death]
Time frame: Screening to Day 28
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM. Incidence of adverse device effects included observations of Incidence and severity of clinically significant laboratory abnormalities, Change from baseline in vital signs (blood pressure, temperature, respiratory rate, and heart rate), Incidence and severity of clinical findings on physical examination, Change from baseline in 12-lead electrocardiogram (ECG) parameters; the primary ECG endpoint was QTcF.
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM: [Severity Score: 1=Mild; 2=Moderate; 3=Severe; 4=Life-Threatening; 5=Death]
Time frame: Screening to Day 28
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM. Incidence of adverse device effects included observations of Incidence and severity of clinically significant laboratory abnormalities, Change from baseline in vital signs (blood pressure, temperature, respiratory rate, and heart rate), Incidence and severity of clinical findings on physical examination, Change from baseline in 12-lead electrocardiogram (ECG) parameters; the primary ECG endpoint was QTcF.
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM: [Severity Score: 1=Mild; 2=Moderate; 3=Severe; 4=Life-Threatening; 5=Death]
Time frame: Screening to Day 28
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM. Incidence of adverse device effects included observations of Incidence and severity of clinically significant laboratory abnormalities, Change from baseline in vital signs (blood pressure, temperature, respiratory rate, and heart rate), Incidence and severity of clinical findings on physical examination, Change from baseline in 12-lead electrocardiogram (ECG) parameters; the primary ECG endpoint was QTcF.
To evaluate safety and tolerability of hepatic ultrasound insonification in subjects with T2DM: [Severity Score: 1=Mild; 2=Moderate; 3=Severe; 4=Life-Threatening; 5=Death]
Time frame: Baseline to Day 18 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, as assessed by exploratory markers in blood samples
Time frame: Baseline to Day 18 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, as assessed by long-term glucose markers in blood samples
Time frame: Baseline to Day 18 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, as assessed by long-term glucose markers in blood samples
Time frame: Baseline to Day 18 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, as assessed by lipid metabolism markers in blood samples
Time frame: Baseline to Day 18 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, as assessed by lipid metabolism markers in blood samples
Time frame: Baseline to Day 18 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, as assessed by inflammatory biomarkers in blood samples
Time frame: Baseline to Day 18 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, as assessed by inflammatory biomarkers in blood samples
Time frame: Baseline to Day 18 - Baseline was defined as the last non-missing value collected prior to the first on study hepatic ultrasound insonification
To evaluate the effect of hepatic ultrasound insonification on glucose metabolism parameters, as assessed by inflammatory biomarkers in blood samples
General Electric Research
Industry
An Open-Label, Pilot Study to Assess the Effects of Hepatic Ultrasound Insonification on Glucometabolic Parameters in Subjects With T2DM
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