Diabetes is a disorder of energy energy metabolism. Glucose is the main energy substrate for generation of ATP to maintain cellular metabolism, structure and function. Glucokinase (GK) serves as a glucose sensor for the initiation of the energy generation.for energy metabolism. Dorzagliatin is a novel, first-in-class, dual-acting allosteric GK activator (GKA). It increases the affinity of GK for glucose by directly binding a pocket distal to its active site, thus lowering the set point for glucose-stimulated insulin secretion in the beta-cell. Dorzagliatin is a new drug which acts as GK sensor activator (GKA). It can restore the sensitivity of the pancreas cells to glucose and improve glucose control. The drug has been trialled in healthy volunteers and in individuals with type 2 diabetes. The aim of this study is to understand the way in which dorzagliatin works to improve blood sugar control in people with diabetes. The study will look at how dorzagliatin affects insulin secretion and the sensitivity of the pancreas to changes in blood sugar levels. We will examine whether dorzagliatin can restore the function of this GK sensor in patients with known mutations. In a cross-over study, we will evaluate the effects of dorzagliatin, a specific GKA versus placebo in terms of insulin secretion and beta-cell glucose sensitivity in patients with newly-diagnosed T2D and patients who are known heterozygous carriers of GK mutations.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
TRIPLE
Enrollment
18
tablet
placebo
The Chinese University of Hong Kong
Hong Kong, Hong Kong
first phase insulin response to glucose
measure insulin between 0 to 10 minutes
Time frame: 10 mins
First phase C-peptide responses to glucose
measure C peptide between 0 to 10 minutes
Time frame: 10 mins
Maximum concentration (Cmax) 1st phase insulin between 0 to 10 minutes
measure insulin between 0 to 10 minutes
Time frame: 10 mins
Time to maximum (Tmax) of acute phase insulin response between 0 to 10 minutes
measure insulin between 0 to 10 minutes
Time frame: 10 mins
Second phase insulin response
measure insulin at last 40 mins of hyperglycemic clamp
Time frame: 40 mins
Beta cell glucose sensitivity
insulin secretion in last 40 minutes of hyperglycemic clamp
Time frame: 40 mins
Insulin sensitivity index
glucose infusion rate in last 40 minutes of hyperglycemic clamp
Time frame: 40 mins
Area under curve of glucagon levels
measure glucagon from 0-120 mins
Time frame: 120 mins
Area under curve of GLP-1 levels
measure GLP-1 from 0-120 mins
Time frame: 120 mins
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