AzTrials
AzTrials

PreDiabetesPhase 4NCT05119179

Pharmacogenetics of the Response to GLP-1 in Mexican-Americans With Prediabetes

A Phase 4 study testing Semaglutide in people with PreDiabetes, run by The University of Texas Health Science Center, Houston at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

This project uses both transcriptomic- and genomic-level data to identify mechanisms of individual responses to glucagon-like peptide-1 (GLP-1) in Mexican-Americans with prediabetes. The GLP-1 hormone is essential for glucose reduction, weight loss, cardiovascular risk reduction, and renal protection. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
PreDiabetes
What is being tested?
Semaglutide
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
300 participants
Where
1 siteUnited States
Study dates
22 Nov 2021to 31 Oct 2026
Phase
Phase 4
Are there results?
Not yet: the study is under way

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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Men and women, ages 18 years and older
  • Diagnosis of Prediabetes - defined as either impaired fasting glucose (fasting glucose of 100-125 mg/dL), impaired glucose tolerance (2-hour postprandial blood glucose of 140-199 mg/dL after 75-gram oral glucose challenge), and/or a hemoglobin A1C ranging from 5.7% to 6.4%
  • High risk for progression to diabetes: defined as having at least one of the two following additional factors: Obesity (BMI ≥ 30 kg/m2) and/or metabolically unhealthy status. "Metabolically unhealthy status" is defined as at least two of the following: elevated blood pressure (SBP ≥ 130 mmHg and/or DBP ≥ 85 mmHg), elevated triglycerides ≥ 150 mg/dL, low HDL cholesterol (males < 40 mg/dL; females < 50 mg/dL), and elevated fasting glucose ≥ 100 mg/dL (Wu S et al., 2017).
  • Women of childbearing age must agree to use an acceptable method of pregnancy prevention (barrier methods, abstinence, hormonal contraception, intrauterine contraception, or surgical sterilization) for the duration of the study.
  • Patients must have the following laboratory values: Hematocrit ≥ 34 vol%, estimated glomerular filtration rate ≥ 60 mL/min per 1.73 m2, AST (SGOT) < 2.5 times ULN, ALT (SGPT) < 2.5 times ULN, alkaline phosphatase < 2.5 times ULN

Who cannot join

  • History of Type 1 or Type 2 diabetes mellitus
  • Pregnant or breastfeeding women
  • Medications: metformin, DPP-4 inhibitors, GLP-1 receptor agonists, SGLT-2 inhibitors, thiazolidinediones, insulin, sulfonylureas, meglitinides, alpha-glucosidase inhibitors, and/or corticosteroids over the last 3 months.
  • Active malignancy
  • History of clinically significant cardiac, hepatic, pancreatic or renal disease.
  • History of any serious hypersensitivity reaction to the study medication (or any other incretin mimetic)
Show all 10Show fewer
  • Prisoners or subjects who are involuntarily incarcerated
  • Prior history of pancreatitis, medullary thyroid cancer, or multiple endocrine neoplasia type 2 (MEN 2)
  • Family history of medullary thyroid cancer (a rare form of thyroid cancer) or MEN2. However, as many individuals may not be aware of the specific type of thyroid cancer, will also exclude any family history of thyroid cancer or MEN2.
  • Hospitalization for COVID-19 in last 3 months

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

United States1 site, 1 recruiting
  • UTHealth Clinical Research Unit (CRU) at UT Brownsville

    Brownsville, Texas, 78520

    Norma Perez-Olazaran, 956-755-0695, Norma.P.PerezOlazaran@uth.tmc.edu

    Rocio Uribe, (956) 882-5165, Rocio.D.Uribe@uth.tmc.edu

    Recruiting

Other trials in United States

About this study

This project uses both transcriptomic- and genomic-level data to identify mechanisms of individual responses to glucagon-like peptide-1 (GLP-1) in Mexican-Americans with prediabetes. The GLP-1 hormone is essential for glucose reduction, weight loss, cardiovascular risk reduction, and renal protection. Newly discovered mechanisms will illuminate causal links between disease genotype and phenotype, which may ultimately guide personalized therapeutic approaches for type 2 diabetes, prediabetes, obesity, cardiovascular disease, renal disease, and other related diseases.

Read the detailed description

This clinical trial will uncover new mechanisms of inter-individual responses to endogenous and exogenous glucagon-like peptide-1 (GLP-1) in Hispanics/Latinos (H/Ls) with prediabetes. The results move the management of prediabetes, type 2 diabetes mellitus (T2DM), and relevant metabolic diseases to a more individualized approach in an understudied and at-risk population. Few options exist for prediabetes treatment, and the current pharmaceutical management of T2DM does not predict drug treatment failures, nor differences in individual treatment responses and adverse effects. A precise, genetics-based approach will provide superior therapeutic management for patients. GLP-1-based therapies reduce blood glucose, promote weight loss, decrease cardiovascular events, and improve renal function. Prior genetic studies, most done in Caucasians, identified associations between genetic variants and decreased GLP-1-induced insulin secretion, in an effort to guide individualized treatment. However, these associations do not provide a clear mechanistic relationship between genotype and phenotype. Transcriptomic analyses will uncover many of these mechanisms. Here, we propose to 1) test the association of single nucleotide polymorphisms (SNPs) that regulate expression (eQTLs) of 11 candidate genes in a range of relevant metabolic tissues with differential GLP-1 response, 2) perform RNA sequencing before and after treatment to identify eQTLs in blood that predict response to GLP-1 therapy and develop risk-based prediction models in H/Ls, and 3) determine the effects of genetic regulation of candidate genes and newly discovered eQTLs phenome-wide in a large existing biobank, BioVU. For aims 1 and 2, responses will be measured in 300 study subjects with prediabetes recruited from an established Mexican-American cohort via the oral minimal model method, before and after GLP-1 therapy, quantifying GLP-1 hormone efficacy and GLP-1-induced pancreatic beta cell insulin release and peripheral insulin sensitivity. Procedures include serial measurements of plasma glucose, insulin, C-peptide, and GLP-1, and peripheral blood collection for RNA sequencing. Our central hypotheses are: (1) metabolic tissue-based eQTLs of GLP-1-associated genes will be associated with physiological response to endogenous and exogenous GLP-1,(2) identification of eQTLs associated with GLP-1 treatment-induced changes in whole blood will identify new gene targets, and (3) this data will lead to the creation of eQTL-based prediction models for related diseases. The study is innovative because it uses a novel combination of eQTL analysis and oral minimal model to assess GLP-1 response, examines a population highly underrepresented in pharmacogenomic studies, and utilizes novel statistical methods and applications to study gene expression. The significance of this newly acquired mechanistic information will ultimately guide precision therapeutic regimens for diabetes prevention and treatment, weight loss, cardiovascular risk reduction, and related metabolic complications in an understudied population.

Conditions
PreDiabetes
Being tested
Semaglutide
Keywords
prediabetes, Mexican-American, GLP-1, pharmacogenetics, expression quantitative trait loci
Medical subject headings
Prediabetic State

What participants receive

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

  • SemaglutideDrug

    Also called Ozempic

    Glucagon-like Peptide 1 Receptor Agonist

Study groups in NCT05119179
Study groupRoleWhat they receive
SemaglutideExperimentalSemaglutide 0.25 mg subcutaneously weekly for 4 weeks, followed by semaglutide 0.5 mg subcutaneously weekly for 8 weeks.
Receives: Drug: Semaglutide

What is being measured

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

  1. Mean change in beta cell responsivity

    A rate which measures the ability of beta cells to secrete insulin

    Measured: 12 weeks

  2. Insulin Sensitivity

    Measurement of the efficacy of insulin action at peripheral tissues

    Measured: 12 weeks

  3. Disposition Index

    Product of beta cell responsivity and insulin sensitivity (see above)

    Measured: 12 weeks

  4. GLP-1-Induced Potentiation

    Measurement of GLP-1 (glucagon-like peptide 1) hormonal efficacy in relationship to postprandial insulin secretion

    Measured: 12 weeks

  5. Mean change in GLP-1 Area Under the Curve (AUC)

    Comparison of GLP-1 AUC measurements before and after drug intervention

    Measured: 12 weeks

  6. Gene expression changes for minor variants of eQTLs for TCF7L2

    eQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.

    Measured: 12 weeks

  7. Gene expression changes for minor variants of eQTLs for KCNQ1

    eQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.

    Measured: 12 weeks

  8. Gene expression changes for minor variants of eQTLs for WFS1

    eQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.

    Measured: 12 weeks

  9. Gene expression changes for minor variants of eQTLs for THADA

    eQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.

    Measured: 12 weeks

  10. Gene expression changes for minor variants of eQTLs for CNR1

    eQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.

    Measured: 12 weeks

  11. Gene expression changes for minor variants of eQTLs for CTRB1

    eQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.

    Measured: 12 weeks

  12. Gene expression changes for minor variants of eQTLs for CTRB2

    eQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.

    Measured: 12 weeks

  13. Gene expression changes for minor variants of eQTLs for GLP1R

    eQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.

    Measured: 12 weeks

  14. Gene expression changes for minor variants of eQTLs for CHST3

    eQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.

    Measured: 12 weeks

  15. Gene expression changes for minor variants of eQTLs for MTNR1B

    eQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.

    Measured: 12 weeks

  16. Gene expression changes for minor variants of eQTLs for SORCS1

    eQTLs (expresion quantitative trait loci) are genes which affect the mRNA expression of another target gene.

    Measured: 12 weeks

  17. Previously unidentified cis-eQTLs associated with change in gene expression due to GLP-1 challenge

    Study has statistical power to detect previously unidentified eQTLs

    Measured: 12 weeks

Secondary outcomes (6)
  1. Mean change in glucose Area Under the Curve (AUC)

    Comparison of glucose AUC measurements before and after drug intervention

    Measured: 12 weeks

  2. Mean change in C-peptide Area Under the Curve (AUC)

    Comparison of C-peptide AUC measurements before and after drug intervention

    Measured: 12 weeks

  3. Change in hemoglobin A1C

    Change in hemoglobin A1C (measured once on each study day) before and after intervention

    Measured: 12 weeks

  4. Mean change in insulin Area Under the Curve (AUC)

    Comparison of insulin AUC measurements before and after drug intervention

    Measured: 12 weeks

  5. Creation of eQTL-based disease prediction models

    Create and apply eQTL-based prediction models to investigate the clinical consequences of variable GLP-1- induced gene expression changes (identified as above) in large electronic health records (EHRs), and use these models to predict disease risk phenome-wide.

    Measured: 5 years

  6. Polygenic prediction model for GLP-1 therapy-associated outcomes

    Creation of Polygenic prediction model using above data

    Measured: 5 years

Timeline

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

  1. First posted15 Nov 2021
  2. Study start22 Nov 2021
  3. Primary completion31 Oct 2026 (estimated)
  4. Study completion31 Oct 2026 (estimated)

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
Not applicable
Intervention model
Single group
Model description
Single center, before and after clinical trial
Masking
None (open label)
Enrolment
300 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05119179
Sponsor's protocol ID
HSC-MS-21-0297
Other IDs
5R01DK127084
Status last verified
Mar 2026
First submitted
5 Aug 2021
Last updated
17 Mar 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Semaglutide in people with PreDiabetes, run by The University of Texas Health Science Center, Houston at 1 site in United States.

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 5 inclusion and 10 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: looking for participants now, as of the sponsor's last update on 17 Mar 2026. 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 United States. 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. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Norma Perez-Olazaran ((956) 755-0695, Norma.P.PerezOlazaran@uth.tmc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean change in beta cell responsivity (time frame: 12 weeks). The study lists 17 primary outcomes in all. 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 17 Mar 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in