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HypoglycemiaPhase 4ALCO1NCT02881060

The Late Effects of Ethanol Intake on the Glucose Response to Subcutaneous Glucagon in Type 1 Diabetes

A Phase 4 study testing Alcohol in people with Hypoglycemia and Diabetes Mellitus, Type 1, run by Hvidovre University Hospital at 1 site in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Objective: Because many people with type 1 diabetes drink ethanol and because glucagon is used to treat mild hypoglycaemia, it is essential to determine whether ethanol will impair the effectiveness of glucagon to increase glucose, which may impair the effectiveness of the dual hormone treatment in preventing… Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Hypoglycemia, Diabetes Mellitus, Type 1
What is being tested?
Alcohol
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
12 participants
Where
1 siteDenmark
Study dates
Aug 2016to 26 Jan 2017
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age 18 - 70 years
  • T1D ≥ 3 year
  • BMI 20-28 kg/m2
  • CSII ≥ 1 year
  • Caucasian origin
  • Hypoglycaemia awareness (assessed by Gold, Clarke and Pedersen-Bjergaard methods)
  • Use of carbohydrate counting and the insulin pump bolus calculator for all meals
  • Ethanol exposure once within 1 year consisting of at least 4 drinks (1 drink contains 12 gram ethanol) within four hours

Who cannot join

  • Allergy or intolerance to lactose or Glucagen®(Novo Nordisk, Bagsværd, DK)
  • Allergy for ethanol or any food ingredients that will be used in the study.
  • Impaired renal function (eGFR < 60 ml/min/1.73m2)
  • Liver disease with ALAT > 2.5 times the upper limit of the reference interval
  • Gastropareses (beat-beat variation < 10 beats per min and/or orthostatic systolic blood pressure > 20 mmHg)
  • Insomnia, sleep apnoea or any troubles with sleeping that according to the investigator's assessment makes the individual unsuitable for study participation.
Show all 19Show fewer
  • Aldehyde dehydrogenase deficiency as determined by a screening questionnaire
  • Unable to refrain from the consumption of ethanol at least 24 hours prior to study start
  • History of drinking problems or alcoholism, regardless of whether active or in remission.
  • Use of benzodiazepines or barbiturates or opiates or other central nervous system depressant drugs that could act synergistically with ethanol to lower the level of consciousness
  • History of drug abuse
  • Current participation in another diabetes-related clinical trial that, in the judgment of the principle investigator, will compromise the results of the study or the safety of the subject.
  • Use of anti-diabetic medicine (other than insulin), corticosteroids or other drugs affecting glucose metabolism during the study period or within 30 days prior to study start
  • Use of medications that are known to cause QT interval prolongation
  • Presence of pheochromocytoma
  • Other concomitant medical or psychological condition that according to the investigator's assessment makes the individual unsuitable for study participation
  • Females who are pregnant, breast-feeding or intend to become pregnant or are not using adequate contraceptive methods.
  • Females who have different basal insulin pattern depending on their menstrual cycle.
  • Inability to understand the individual information and to give informed consent.

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Hvidovre University Hospital

    Hvidovre, 2650

Other trials in Denmark

About this study

Objective: Because many people with type 1 diabetes drink ethanol and because glucagon is used to treat mild hypoglycaemia, it is essential to determine whether ethanol will impair the effectiveness of glucagon to increase glucose, which may impair the effectiveness of the dual hormone treatment in preventing hypoglycaemia.

The purpose of this study is to determine, whether ethanol influences the glucose response to subcutaneous glucagon during mild hypoglycaemia.

Read more

The investigators hypothesize that prior evening ethanol consumption does not reduce the effect of a glucagon bolus to raise plasma glucose compared with no prior ethanol consumption.

The study aims:

  1. To determine the late effects of ethanol on the efficacy of subcutaneous glucagon to restore plasma glucose after an episode of mild hypoglycemia.
  2. To determine the late effects of ethanol on the counter-regulatory hormones and hypoglycaemia awareness during mild hypoglycaemia

A double-blinded placebo-controlled study will be conducted. Participants will serve as their own controls. Eligible participants will after an informed consent complete two study visits, one with and one without ethanol consumption, in a random order. On each study visit, participants are induced a insulin induced hypoglycemia, seven-eight hours after a meal with or without ethanol. Once plasma glucose is below 3.9 mmol/l, a subcutaneous injection of 100 mcg glucagon is administered. Two hours later a second bolus is administered.

Being tested
Alcohol, Placebo
Keywords
Glucagon, Ethanol
Medical subject headings
Hypoglycemia, Diabetes Mellitus, Type 1

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AlcoholDietary supplement

    Also called Cocktail

  • PlaceboDietary supplement

    Also called Mocktail

Study groups in NCT02881060
Study groupRoleWhat they receive
EthanolActive comparatorDrinking a cocktail of ethanol (0.8 g ethanol per kg body weight), diet lemonade and water of 1:1:1 (volume distribution).
Receives: Dietary Supplement: Alcohol
Non-ethanolPlacebo comparatorDrinking a cocktail of diet lemonade and water of 1:2 (volume distribution).
Receives: Dietary Supplement: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Increase in plasma glucose

    The primary endpoint is difference in increase in plasma glucose value after the first injection of 100 µg s.c. glucagon on study nights with ethanol vs. study nights without ethanol consumption.

    Measured: 0-120 min after the first glucagon injection

Secondary outcomes (58)
  1. Peak plasma glucose

    Maximal plasma glucose after the first and second glucagon injection

    Measured: 0-240 min after the first glucagon injection

  2. Increase in plasma glucose

    Increase in plasma glucose caused by the second glucagon injection.

    Measured: 0-120 min after the second glucagon injection

  3. Total AUC(0-120)

    Total area under the glucose curve from 0-120 minutes after each glucagon injection

    Measured: 0-240 min after the first glucagon injection

  4. PI-AUC(0-120)

    positive incremental area under the glucose curve from 0-120 minutes after each glucagon injection

    Measured: 0-240 min after the first glucagon injection

  5. Tmax

    Time-to-peak glucose value after each glucagon injection glucagon injection

    Measured: 0-240 min after the first glucagon injection

  6. Time above 4.0mM

    Duration of glucose above 4.0 mmol/l after first and second glucagon injection

    Measured: 0-240 min after the first glucagon injection

  7. Time above baseline

    Duration of glucose above baseline after first and second glucagon injection

    Measured: 0-240 min after the first glucagon injection

  8. Rescue rates

    Numbers of first and second glucagon injections that raises PG > 4.9 mmol/l

    Measured: 0-240 min after the first glucagon injection

  9. Hyperglycemia rates

    Number of first and second glucagon injections that raises PG > 7.1 mmol/l

    Measured: 0-240 min after the first glucagon injection

  10. Changes in plasma ketone bodies, measured as area under the curve

    Measured: 0-240 min after the first glucagon injection

  11. Changes in plasma ketone bodies, measured as incremental peak

    Measured: 0-240 min after the first glucagon injection

  12. Changes in plasma glucagon, measured as area under the curve

    Measured: 0-240 min after the first glucagon injection

  13. Changes in plasma glucagon, measured as incremental peak

    Measured: 0-240 min after the first glucagon injection

  14. Changes in insulin, measured as area under the curve

    Measured: 0-240 min after the first glucagon injection

  15. Changes in insulin, measured as incremental peak

    Measured: 0-240 min after the first glucagon injection

  16. Changes in growth hormones, measured as area under the curve

    Measured: 0-240 min after the first glucagon injection

  17. Changes in growth hormones, measured as incremental peak

    Measured: 0-240 min after the first glucagon injection

  18. Changes in serum corticole, measured as area under the curve

    Measured: 0-240 min after the first glucagon injection

  19. Changes in serum corticole, measured as incremental peak

    Measured: 0-240 min after the first glucagon injection

  20. Changes in plasma ethanol, measured as area under the curve

    Measured: 0-240 min after the first glucagon injection

  21. Changes in plasma ethanol, measured as incremental peak

    Measured: 0-240 min after the first glucagon injection

  22. Changes in free fatty acids, measured as area under the curve

    Measured: 0-240 min after the first glucagon injection

  23. Changes in free fatty acids, measured as incremental peak

    Measured: 0-240 min after the first glucagon injection

  24. Changes in triglycerides, measured as area under the curve

    Measured: 0-240 min after the first glucagon injection

  25. Changes in triglycerides, measured as incremental peak

    Measured: 0-240 min after the first glucagon injection

  26. Average in blood pressure

    Measured: 0-240 min after the first glucagon injection

  27. Average heart rate

    Measured: 0-240 min after the first glucagon injection

  28. Intensity of hypoglycemia

    Average changes in Edinburgh Hypoglycaemia Scale over time during insulin and glucagon phase

    Measured: 0-240 min after the first glucagon injection

  29. Cognitive impairment

    Average scores in cognitive test 30 min before each glucagon injection.

    Measured: 0-240 min after the first glucagon injection

  30. Side effects

    Average visual analogue scale score from 0-180 min for nausea and headache after glucagon injection

    Measured: 0-240 min after the first glucagon injection

  31. Incidence of vomiting

    Incidence of vomiting after 0-4 hours after each glucagon injection.

    Measured: 0-240 min after the first glucagon injection

  32. Meal induced glucose excursion

    Total and incremental area under the glucose curve from 0-120 and 0-240 min after eating the mixed meal

    Measured: 0-3 hours after meal

  33. Meal induced hormonal changes

    Total and incremental area under the glucose curve from 0-120 and 0-240 min after eating the mixed meal

    Measured: 0-3 hours after meal

  34. Nocturnal changes in plasma glucose

    Area under the curve during sleep

    Measured: 0-6 hours after start of sleep

  35. Nocturnal changes in corticol

    Area under the curve during sleep

    Measured: 0-6 hours after start of sleep

  36. Nocturnal changes in growth hormone

    Area under the curve during sleep

    Measured: 0-6 hours after start of sleep

  37. Nocturnal changes in ketones

    Area under the curve during sleep

    Measured: 0-6 hours after start of sleep

  38. Nocturnal changes in ethanol

    Area under the curve during sleep

    Measured: 0-6 hours after start of sleep

  39. Nocturnal changes in glucagon

    Area under the curve during sleep

    Measured: 0-6 hours after start of sleep

  40. Difference between the first second glucagon injection and between both study visits in peak change plasma glucose

    Measured: 0-240 min after the first glucagon injection

  41. Difference between glucagon injections on both study visits in positive incremental area under the glucose curve from 0-120 minutes

    Measured: 0-240 min after the first glucagon injection

  42. Difference between glucagon injections on both study visits in total area under the glucose curve from 0-120 minutes

    Measured: 0-240 min after the first glucagon injection

  43. Difference between glucagon injections on both study visits in time-to-peak glucose value

    Measured: 0-240 min after the first glucagon injection

  44. Difference between glucagon injections on both study visits in duration of glucose above 4.0 mmol/l after first and second glucagon injection

    Measured: 0-240 min after the first glucagon injection

  45. Difference between glucagon injections on both study visits in duration of glucose above baseline after first and second glucagon injection

    Measured: 0-240 min after the first glucagon injection

  46. Difference in glucose sensor data on study night with alcohol vs. study night without alcohol - Mean absolute relative difference (MARD) values of glucose sensors compared with YSI from 7 PM- 8 AM.

    Intentions to treat analysis

    Measured: 0-10 hours after meal

  47. Difference in glucose sensor data on study night with alcohol vs. study night without alcohol - Precision absolute relative difference (PARD) 120 min before and 120 after each glucagon injection.

    Intentions to treat analysis

    Measured: 0-10 hours after meal

  48. Difference in glucose sensor data on study night with alcohol vs. study night without alcohol - MARD values between glucose sensors 0-120 minutes after each glucagon injection.

    Intentions to treat analysis

    Measured: 0-10 hours after meal

  49. Difference in glucose sensor data within 2 days after study night with alcohol vs. study night without alcohol - Time in range (glucose sensor value =4.0-10.0mmol/l)

    Intentions to treat analysis

    Measured: 0-2 days after the first glucagon injection

  50. Difference in glucose sensor data within 2 days after study night with alcohol vs. study night without alcohol - Time in hypoglycaemia (glucose sensor value < 4.0 mmol/l)

    Intentions to treat analysis

    Measured: 0-2 days after the first glucagon injection

  51. Difference in glucose sensor data within 2 days after study night with alcohol vs. study night without alcohol - Time in hyperglycaemia (glucose sensor value >10.0mmol/l)

    Intentions to treat analysis

    Measured: 0-2 days after the first glucagon injection

  52. Difference in glucose sensor data within 2 days after study night with alcohol vs. study night without alcohol - Number of hypoglycaemia episodes (glucose sensor value < 4.0 mmol/l)

    Intentions to treat analysis

    Measured: 0-2 days after the first glucagon injection

  53. Difference in glucose sensor data between the study period with and without alcohol - Clarke- Error Grid analysis for both sensors compared with YSI during study visit

    Intentions to treat analysis

    Measured: -2 to 4 days after study visits

  54. Difference in glucose sensor data between the study period with and without alcohol - PARD values from day 1-7

    Intentions to treat analysis

    Measured: -2 to 4 days after study visits

  55. Difference in glucose sensor data between the study period with and without alcohol - PARD values <4.0 mmol/L from day 1-7

    Intentions to treat analysis

    Measured: -2 to 4 days after study visits

  56. Difference in glucose sensor data between the study period with and without alcohol - PARD values 4.0-10.0 mmol/L from day 1-7

    Intentions to treat analysis

    Measured: -2 to 4 days after study visits

  57. Difference in glucose sensor data between the study period with and without alcohol PARD values >10.0 mmol/L from day 1-7

    Intentions to treat analysis

    Measured: -2 to 4 days after study visits

  58. Difference in glucose sensor data between the study period with and without alcohol - Number of hypoglycaemia episodes (glucose sensor value < 4.0 mmol/l)

    Intentions to treat analysis

    Measured: -2 to 4 days after study visits

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Aug 2016 (estimated)
  2. Study startAug 2016
  3. Primary completion26 Jan 2017
  4. Study completion26 Jan 2017

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
12 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02881060
Sponsor's protocol ID
H-16027080
Acronym
ALCO1
Status last verified
Jul 2017
First submitted
11 Aug 2016
Last updated
24 Jul 2017
Results posted
No
Data monitoring committee
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Alcohol in people with Hypoglycemia and Diabetes Mellitus, Type 1, run by Hvidovre University Hospital at 1 site in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Increase in plasma glucose (time frame: 0-120 min after the first glucagon injection). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Jul 2017; AzTrials last refreshed its copy on 7 Nov 2026.

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