The goal of this study is to demonstrate that leucine in combination with a low does of metformin can serve as an adjunct to diet and exercise to improve blood glucose levels in type 2 diabetic subjects. This study will compare three doses of a leucine-metformin combination to the standard metformin dose in controlling blood glucose levels in type 2 diabetic patients.
This is a randomized, 4-week, active-controlled, double-blind study to evaluate the effect of various fixed-dose combinations of leucine and metformin compared to standard metformin monotherapy on glycemic control. In this study, standard metformin therapy will be defined as 1000 g/day for Day 1 to Day 14 and then escalated to 1700 g/day for Day 15 to Day 28. Subjects meeting all inclusion criteria and no exclusion criteria will be randomized to one of four treatment arms. The primary objective of the study is to evaluate the change in fasting plasma glucose from Baseline (Day 1) to Week 4 (Day 28) in subjects receiving various fixed-dose combinations of leucine and metformin compared to standard metformin monotherapy. Secondary objectives will also assess changes in baseline-corrected plasma glucose and insulin area under the concentration curves from baseline to day 28 and changes in insulin secretory rates as assessed during a 3-hour meal tolerance test. Finally the effects of gastrointestinal symptoms will be assessed by subject questionnaires. The study will include a total of 3 periods: screening or washout of current diabetic monotherapy, a pre-treatment period to ensure subjects will be compliant, and a treatment period of 4 weeks, with the first dosing of medication on day 1 of the study. Each day blood glucose readings will be measured and recorded by patients. Three-hour standardized meal tests will be performed at Baseline (Day 1) and at Study Termination (Day 28). In addition, two, 7-day continuous glucose assessments will be conducted, as well as two seven point glucose profiles. Patients will also be asked about any gastrointestinal side effects they experience.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
96
1100 mg L Leucine in combination with 125 mg of Metformin BID
500 mg metformin BID until day 14 with dose escalation at day 14 to 850 mg metformin BID
1100 mg of Leucine in combination with 250 mg Metformin BID
Catalina Research Institute
Chino, California, United States
Palm Beach Research
Palm Beach, Florida, United States
Meridien Research
Tampa, Florida, United States
River Birch Research Alliance
Change From Baseline to Day 28 in Absolute Plasma Glucose Area Under the Curve (AUC) 0-3hr
The primary endpoint for NS 0100 01 was the absolute plasma glucose AUC (0-3 hr) change from Day 1 to Day 28.
Time frame: 0, 15min, 30min, 45min, 1hr, 1.5hrs, 2hrs, 2.5hrs and 3 hrs
Change From Baseline to Day 28 in Incremental Plasma Glucose Area Under the Curve (AUC)
The baseline incremental (baseline-subtracted) glucose AUC0-3h was evaluated for treatment differences at baseline.
Time frame: Baseline, Day 28
Change in Fasting Plasma Glucose
Change in fasting plasma glucose for the fixed dose leucine and metformin combination treatments A, B and C was evaluated.
Time frame: Baseline, Day 28
Change in Hemoglobin A1c (HbA1c)
Changes in HbA1c which is a marker of long-term glucose control was assessed.
Time frame: Baseline, Day 28
Change in Homeostasis Model Assessment-estimated Insulin Resistance (HOMA-IR)
Effect on insulin sensitivity across fixed-dose leucine and metformin combination treatments or the standard metformin reference treatment.
Time frame: Baseline, Day 28
Change In 7-Point Glucose Profiles
The meal induced glucose change in pre-meal and post-meal glucose were measured 7 times during the day. Subjects self-monitored blood glucose (preprandial and postprandial) concentrations at least 7 times, including before and 1 to 2 hours after breakfast, lunch, dinner, and snacks). For each study day, the pre-meal values from the 7 point test for each subject were averaged to generate a single pre-meal glucose value. Similarly, for each study day the post-meal values from the 7-point test for each subject were averaged to generate a single post-meal glucose value. The average change from baseline (i.e., \[(Mean Pre/Post-meal value at Day 28 - Mean Pre/Post-meal value at Baseline) + (Mean Pre/Post-meal value at Day 21- Mean Pre/Post-meal value at Baseline) + (Mean Pre/Post-meal value at Day 7- Mean Pre/Post-meal value at Baseline)\]/ 3) over multiple time points listed in Time Frame. The mean pre-meal and post-meal values for baseline, day7, day 21 and day28 were used for comparison.
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1100 mg of Leucine in combination with 500 mg Metformin BID
Blue Ridge, Georgia, United States
Meridian Research
Savannah, Georgia, United States
Streling Research Group
Cincinnati, Ohio, United States
Medical Research South
Charleston, South Carolina, United States
Meharry Medical College
Nashville, Tennessee, United States
Vanderbilt University Medical Center, Diabetes, Endocrinology, and Metabolism
Nashville, Tennessee, United States
Time frame: Baseline, Day 7, Day 21, Day 28
Plasma Insulin Absolute and Incremental Meal Tolerance Test Area Under the Curve (AUC) 0-2hr
Change in meal tolerance test insulin area under the curve (0-2 hr) from Day 1 to Day 28 for fixed-dose leucine and metformin combination treatments.
Time frame: Baseline,Day 28
Change From Baseline to Day 28 in Fasting Plasma Insulin Concentration
Effect on fasting plasma insulin concentrations across fixed-dose leucine and metformin combination treatments or the standard metformin reference treatment was evaluated.
Time frame: Baseline, Day 28