SGLT2 Inhibition in Older Obese Adults With Pre-diabetes
Lay Description
Inhibitors of the sodium-glucose co-transporter (SGLT2) are FDA-approved for the treatment of type 2 diabetes (T2DM). Their mechanism of action involves lowering of blood glucose concentration secondary to increased glucose excretion of glucose by the kidney. These drugs also improve body weight, blood pressure, and cardiac function. Based on these pleiotropic effects, including its calorie restriction-mimetic properties, the study team hypothesize that SGLT2 drugs will impact several basic aging-related processes, including reductions in oxidative damage to DNA and proteins, advanced glycation end products (AGE) and receptor for AGE (RAGE), cellular senescence, and mitochondrial function.
Category
- Aging and Geriatric
- IRB Number
- 20190766HU
- NCT Number
- NCT04401904
- Open to Enrollment
- Yes
Eligibility
- Eligible Ages
- Over 60 Years
- Eligible Genders
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- Men or post-menopausal women.
- Age= 60+ years.
- All ethnic groups.
- Body Mass index (BMI) between 30-38 kg/m2.
- Diagnosis of pre-diabetes (HbA1c 5.7-6.4% and 2 hr. Oral Glucose Tolerance Test (OGTT) glucose between 140-199 mg/dL, evaluated at Visit 1 and 2).
- Stable body weight (±3% for ≥3 months).
- Willing to adhere to medication regimen for three months.
- Montreal Cognitive Assessment score ≥21
Exclusion Criteria
- Diagnosis of diabetes based on American Diabetes Association (ADA) criteria
- Impaired renal function with estimated Glomerular Filtration Rate (eGFR) < 45 mL/min/1.73m2 .
- Impaired liver function with labs ≥3 times upper limits of normal range
- Abnormal hematocrit with lower limits of ≤30%
- Abnormal triglycerides with upper limits ≥600 mg/dL
- Abnormal Thyroid stimulating hormone (TSH) values ≤0.3 and ≥10
- Urinalysis results with ˃ 5-10 white blood cell count
- Concomitant medications known to affect glucose and lipid homeostasis (anti-diabetes medications, glucocorticoids, atypical antipsychotics, anti-transplant rejection medications, anti-retrovirals).
- Current treatment with anticoagulants (warfarin). Aspirin (up to 325 mg) and clopidogrel will be permitted if these can be held for seven days prior to the biopsies.
- History of recent cardiovascular event in the last 6 months or Heart Failure (New York Heart Classification greater than class III-IV; recent EKG changes that suggest active heart disease
- Poorly controlled blood pressure (systolic BP>180, diastolic BP>100 mmHg).
- Active inflammatory, autoimmune, infectious, hepatic, gastrointestinal, malignant, and uncontrolled psychiatric disease (Subjects with depression, anxiety, PTSD, etc. can enroll if controlled and on stable medication)
- Blood donation within 2 months prior to enrollment
- History of frequent UTI
Study Design
Arm Groups
Study Contact
Regulatory Point of Contact
Tiffany Cortes
(210) 450-8998
cortest@uthscsa.edu
Regulatory Point of Contact
Diana Jarbeau-may
(210) 617-5390
jarbeaumay@uthscsa.edu
Regulatory Point of Contact
Carolina Solis-Herrera
(210) 567-4900
solisherrera@uthscsa.edu
Local Recruitment Point of Contact
Tiffany Cortes
(210) 450-8998
cortest@uthscsa.edu
Principal Investigator
Carolina Solis-Herrera