The Study of HIV Protease Inhibitors and Their Effects on Glucose Metabolism
VA Office of Research and Development
Information provided by (Responsible Party)
VA Office of Research and Development
First received: November 28, 2005
Last updated: September 28, 2009
Last Verified: March 2009
History of Changes
The purpose of this study is to determine the mechanisms by which HIV protease inhibitors contribute to the development of diabetes in HIV-infected patients. The investigators propose that some HIV protease inhibitors impair insulin secretion and increase the production of glucose by the liver.
|Official Title:||The Effects of HIV Protease Inhibitors on Glucose Metabolism|
Further study details as provided by VA Office of Research and Development:
Primary Outcome Measures
- Insulin secretion after a single dose of HIV protease inhibitor versus placebo (insulin secretion assessed by using the hyperglycemic clamp technique)
- Hepatic glucose production, glycogenolysis, and gluconeogenesis after a single dose of HIV protease inhibitor versus placebo (stable isotope analysis with mass isotopic distribution analysis)
- Hepatic glucose production during a somatostatin infusion in the fasting and hyperinsulinemic state after a single dose of HIV protease inhibitor
|Study Start Date:||January 2006|
|Study Completion Date:||September 2008|
HIV protease inhibitors (PIs) have been associated with type 2 diabetes. To design future HIV
drugs that have have the least adverse metabolic effects, it is necessary to identify the
disorders of glucose metabolism with PI therapy. Previously PIs have been shown to acutely
induce insulin resistance in the periphery. Preliminary data show that PIs also impair
insulin secretion and increase hepatic glucose production in humans. These lesions are key
contributors to the development of type 2 diabetes. Due to the difficulty in separating out
factors related to HIV infection from the direct effect of PIs, an effective design is to
study HIV-negative subjects to define the direct effects of PIs on the liver and pancreas on
Specific Aim 1: To determine which PIs acutely inhibit insulin secretion in humans; randomized, double-blind, placebo-controlled trials will be performed on healthy normal volunteers given either a single dose of PI or placebo using the hyperglycemic clamp to assess insulin secretion in relation to insulin sensitivity.
Specific Aim 2: To determine which PIs acutely increase hepatic glucose production, glycogenolysis, and gluconeogenesis; measurements will be assessed in the fasting and hyperinsulinemic states using stable isotope analysis techniques. Samples have already been collected from double-blind, placebo-controlled trials of the effects of a single dose of PI on insulin sensitivity during the euglycemic hyperinsulinemic clamp.
Specific Aim 3: To determine the mechanism by which certain PIs increase hepatic glucose production; an infusion of somatostatin during the fasting state and hyperinsulinemic state will be used to suppress the effects of glucagon. Subjects will undergo a randomized, double-blind, placebo-controlled trial of a single dose of PI or placebo on insulin sensitivity using the euglycemic hyperinsulinemic clamp. Somatostatin, glucagon, and growth hormone will be infused before and during the clamp study. Hepatic glucose production, glycogenolysis, and gluconeogenesis will be assessed using stable isotope tracer techniques. Results will be compared to PIs acutely given in the absence of somatostatin, as stated in Specific Aim 2.
Determination of the effects of PI therapy allows clinicians to identify patients who may be at particular risk for developing diabetes on certain PIs and treat them more effectively. In the future, drugs for the treatment of HIV can be developed that avoid these disorders of glucose metabolism.
|Ages Eligible for Study:||18 Years to 72 Years|
|Sexes Eligible for Study:||All|
|Accepts Healthy Volunteers:||Yes|
- Healthy, HIV-negative volunteers between the ages of 18-72 years
- Any subject with states known to be associated with insulin resistance, such as impaired fasting glucose (glucose > 110 mg/dl), overweight (body mass index [BMI] > 27), dyslipidemia (triglycerides > 150 mg/dl), hypertension (blood pressure [BP] > 130/85 mmHg or on medication), renal disease, systemic use of glucocorticoids, growth hormone, niacin, or antipsychotics.
- Women will be tested for pregnancy immediately prior to study and excluded if
Contacts and LocationsChoosing to participate in a study is an important personal decision.Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00259727
Locations Show More
|United States, California|
|VA Medical Center, San Francisco|
|San Francisco, California, United States, 94121|
Sponsors and CollaboratorsVA Office of Research and Development
|Principal Investigator:||Grace Lee, MD||VA Medical Center, San Francisco|
|Responsible Party:||Lee, Grace - Principal Investigator, Department of Veterans Affairs|
|ClinicalTrials.gov Identifier:||NCT00259727 History of Changes|
|Other Study ID Numbers:||RCD-005-05S|
|Study First Received:||November 28, 2005|
|Last Updated:||September 28, 2009|
Keywords provided by VA Office of Research and Development:Amprenavir
HIV Protease inhibitors
Additional relevant MeSH terms:
HIV Protease Inhibitors
ClinicalTrials.gov processed this data on October 18, 2017
This information is provided by ClinicalTrials.gov.