On the Regulation of Hepatic Glucose Metabolism During Insulin-induced Hypoglycemia

What this Trial Is About

Iatrogenic hypoglycemia is a major challenge in managing blood sugar safely and effectively in people with type 1 diabetes. This happens because during insulin-induced hypoglycemia, glucagon secretion is reduced, which lowers liver glucose production and worsens hypoglycemic episodes. Researchers have found that the natural protein C-peptide increases glucagon secretion in dogs during insulin-induced hypoglycemia, and this study aims to explore if the same effect happens in humans with and without type 1 diabetes. The study involves two main groups: healthy control subjects and people with type 1 diabetes. Each participant will undergo two separate hypoglycemia tests where insulin is infused intravenously to cause low blood sugar. During one test, C-peptide will be infused along with insulin, and during the other, saline will be infused instead. For participants with type 1 diabetes, their blood sugar levels will be monitored for 10 days before testing to ensure no recent hypoglycemia. Researchers will compare the effects of C-peptide and saline on liver glucose production and hormone levels during these tests. Participants will be closely observed during the hypoglycemia procedures lasting up to 2.5 hours, with measurements of glucagon and hepatic glucose production as key outcomes. Liver glycogen levels will be assessed before insulin-induced hypoglycemia. The study uses a randomized, double-blind design where neither participants nor researchers know whether C-peptide or saline is being given during each test. Overall, the study will help understand how C-peptide affects glucose regulation during hypoglycemia in humans, lasting from initial screening through the testing visits.

Effect of C-peptide on Hypoglycemic Counterregulation