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Sponsors and Collaborators: |
Radboud University Dutch Diabetes Fund |
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Information provided by: | Radboud University |
ClinicalTrials.gov Identifier: | NCT00184821 |
In this proof-of-concept study, forearm vulnerability to ischemic exercise is studied in patients with type 1 diabetes mellitus with and without prior ischemic preconditioning (short period of ischemia that protects against subsequent ischemic exercise). Annexin A5 scintigraphy is used to quantify subtle signs of mild and reversible forearm injury that results from ischemic exercise.
The following hypotheses are tested:
Condition | Intervention |
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Diabetes Mellitus, Insulin-Dependent Ischemia-Reperfusion Injury |
Procedure: Ischemic preconditioning Procedure: Forearm ischemic exercise Procedure: Annexin A5 scintigraphy Drug: Diazoxide Drug: glibenclamide Drug: adenosine |
Study Type: | Observational |
Study Design: | Screening, Cross-Sectional, Defined Population, Prospective Study |
Official Title: | Acute Local Ischemic Preconditioning in Patients With Type 1 Diabetes in Vivo |
Estimated Enrollment: | 20 |
Study Start Date: | June 2004 |
Study Completion Date: | May 2005 |
All patients will be studied in supine position after an overnight fast, while plasma glucose levels are monitored. In the first 8 patients intravenous insulin is administered as needed, to reach target glucose levels between 5-7 mmol/l. Patients will be subjected to 10 minutes of forearm ischemia (non-dominant arm), combined with handgripping at 50% of maximal force until exhaustion. Upon reperfusion, Tc-99m-HYNIC-Annexin A5 will be injected intravenously. Targeting of annexin A5 to thenar muscle and forearm flexor muscle will be quantified as the percentage difference in radioactivity between experimental and control side. This procedure will be performed twice (randomized cross-over design), with at least 2 week interval, either with or without 10 minutes ischemia followed by 10 minutes of reperfusion prior to ischemic exercise.
Depending on the results of this study, substudies will be performed to study the effect of diazoxide (K-ATP channel opener, may mimic ischemic preconditioning), glibenclamide (K-ATP channel blocker, may inhibit ischemic preconditioning) or adenosine (infusion into brachial artery of non-dominant arm as a substitute for ischemic preconditioning).
Ages Eligible for Study: | 18 Years to 50 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
Netherlands, Gelderland | |
Clinical Research Centre Nijmegen; Radboud University Nijmegen Medical Centre | |
Nijmegen, Gelderland, Netherlands, 6500 HB |
Study Chair: | Richard Engbersen, MD | Radboud University Nijmegen Medical Centre; department of Pharmacology-Toxicology |
Study Chair: | Gerard Rongen, MD, PhD | Radboud University Nijmegen Medical Centre; Department of Pharmacology-Toxicology |
Study Chair: | Wim Oyen, MD, PhD | Radboud University Nijmegen Medical Centre; Department of Nuclear Medicine |
Study Chair: | Marc Mol, MD, PhD | Canisius Wilhelmina Ziekenhuis Nijmegen; Department of Internal Medicine |
Principal Investigator: | Paul Smits, MD, PhD | Radboud University Nijmegen Medical Centre; Department of Pharmacology-Toxicology |
Study Chair: | B. Bravenboer, MD, PhD | Catharina Hospital Eindhoven, Dept. of Internal Medicine |
Study ID Numbers: | QKF03-diab, 2004.11.022 |
Study First Received: | September 9, 2005 |
Last Updated: | April 4, 2007 |
ClinicalTrials.gov Identifier: | NCT00184821 |
Health Authority: | Netherlands: The Central Committee on Research Involving Human Subjects (CCMO) |
Diabetes Ischemia Annexin A5 scintigraphy |
Glyburide Metabolic Diseases Autoimmune Diseases Diazoxide Diabetes Mellitus Vascular Diseases Annexin A5 Endocrine System Diseases |
Ischemia Diabetes Mellitus, Type 1 Postoperative Complications Endocrinopathy Glucose Metabolism Disorders Metabolic disorder Adenosine Reperfusion Injury |
Vasodilator Agents Hypoglycemic Agents Pathologic Processes Molecular Mechanisms of Pharmacological Action Immune System Diseases Therapeutic Uses |
Physiological Effects of Drugs Enzyme Inhibitors Cardiovascular Diseases Cardiovascular Agents Antihypertensive Agents Pharmacologic Actions |