Type 1 DiabetesNCT05985135
Impact of Insulin Deprivation and Hyperglycemia on Plasma Protein Synthesis in People With Type 1 Diabetes Mellitus
A study testing Muscle Biopsy, Jell-O with Amino acids and Dextrose in people with Type 1 Diabetes, run by Mayo Clinic at 1 site in United States.
Trial summary
This research is being done to better understand how insulin effects muscle, blood, and the body in people with Type 1 Diabetes. Read more about this study
- Who is it for?
- Ages 18 to 70 yearsHealthy volunteers can take part
- Conditions the study is for
- Type 1 Diabetes
- What is being tested?
- Muscle Biopsy, Jell-O with Amino acids and Dextrose
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 0 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Jun 2026to 31 Jul 2026
- Phase
- Interventional
- 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
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Able to provide written consent.
- Able to provide written consent.
- T1DM treated with continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) (not Degludec).
Who cannot join
- BMI < 20 or > 32 kg/m^2.
- Celiac disease.
- Pregnancy.
- Smoking.
- Reported history of illicit substance use.
- History of active cardiovascular, cerebrovascular, or peripheral vascular disease.
Show all 30Show fewer
- Active renal disease evidenced by estimated glomerular filtration rate (GFR) < 50 mL/min/1.73 m^2.
- Severe peripheral or autonomic neuropathy.
- Dementia or any other neurologic disease.
- Uncontrolled psychiatric disease.
- Any learning disability.
- Anemia.
- Thyroid-stimulating hormone (TSH) ≥ 7 or TSH ≤ 7 and free T4 ≤ 0.9.
- Hemoglobin A1c > 9.0%.
- Type 2 Diabetes Mellitus (T2DM), or impaired fasting glucose.
- Detectable C peptide.
- BMI < 20 or > 32 kg/m^2.
- Celiac disease.
- Pregnancy.
- Smoking.
- Reported history of illicit substance use.
- History of active cardiovascular, cerebrovascular, or peripheral vascular disease.
- Active renal disease evidenced by estimated GFR < 50 mL/min/1.73 m^2.
- Severe peripheral or autonomic neuropathy.
- Dementia or any other neurologic disease.
- Uncontrolled psychiatric disease.
- Any learning disability.
- Anemia.
- TSH ≥ 7 or TSH ≤ 7 and free T4 ≤ 0.9.
- T2DM, or impaired fasting glucose.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Impact of Insulin Deprivation and Hyperglycemia on Plasma Protein Synthesis in People With Type 1 Diabetes Mellitus and Diabetes After Total Pancreatectomy
This research is being done to better understand how insulin effects muscle, blood, and the body in people with Type 1 Diabetes.
Read the detailed description
Insulin's contribution in controlling glucose homeostasis has been well appreciated but, its role in maintaining proteome homeostasis is less understood. Some animal and human studies have demonstrated that insulin signaling regulates protein synthesis and degradation as well as posttranslational modifications at the tissue level. Insulin's effect on the muscle's mitochondrial proteo-stasis has also been elucidated. Insulin deprivation increases global synthesis of splanchnic proteins based on isotope dilution studies across splanchnic bed. Most plasma proteins are derived from liver and preliminary studies suggest that synthesis rates of some plasma proteins increase while others decrease. Fractional rates of synthesis of various plasma proteins from the liver have been demonstrated in insulin deprivation state. These proteins might be implicated in the development of some of the complications from diabetes mellitus type 1. (T1DM) especially of macrovascular. Researchers have recently developed an isotope-based methodology to simultaneously measure in vivo synthesis rates of multiple plasma proteins in human.
In order to further investigate the effects of insulin deprivation researchers will apply the novel non-radioactive stable isotope-based approach on the rate of different plasma protein synthesis in T1DM and Diabetes after total pancreatectomy (DATP) in comparison with non-diabetic controls. Researchers will study pancreatectomized people because like T1DM they also are insulin deficient but unlike pancreatectomized people also are deficient in glucagon. Some tantalizing data from many studies indicate that glucagon also have catabolic effect not only on liver derived proteins but also on skeletal muscle-based proteins. Since skeletal muscle has no glucagon receptors, researchers hypothesize that unknown factors are released to the circulation that act on skeletal muscle to release amino acids for consumption in liver. Researchers will measure amino metabolites, acyl carnitines, organic acids, and ceramides in plasma and determine the blood exosome cargo by mass spectrometry-proteins and lipids and miRNA by PCR.
Researchers have previously shown reduced muscle mitochondrial ATP production during insulin deprivation in both T1D humans and diabetic mice and here researchers will measure mitochondrial energy dynamics in all study participants by the established techniques available in our lab.
- Conditions
- Type 1 Diabetes
- Being tested
- Muscle Biopsy, Jell-O with Amino acids, Dextrose
- Keywords
- Continuous subcutaneous insulin infusion, Multiple daily injections of insulin
- Medical subject headings
- Diabetes Mellitus, Type 1
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Muscle BiopsyProcedure or surgery
Needle muscle biopsy of the outer thigh muscle
Jell-O with Amino acidsOther
An amino acid mixture containing 13C6 Lysine isotope label
DextroseDietary supplement
Intravenous form of sugar
| Study group | Role | What they receive |
|---|---|---|
| Type 1 Diabetes Mellitus (T1DM) Insulin Deprived | Experimental | Subjects will have their insulin infusions replaced with saline and have blood draws to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. Receives: Procedure: Muscle Biopsy; Other: Jell-O with Amino acids |
| Type 1 Diabetes Mellitus (T1DM) Insulin Treated | Experimental | Subjects will continue their baseline insulin infusion while maintaining a target blood glucose range. Blood draws will be obtained to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. Receives: Procedure: Muscle Biopsy; Other: Jell-O with Amino acids |
| Type 1 Diabetes Mellitus (T1DM) Insulin-Treated with Hyperglycemia | Experimental | Subjects will be continue their baseline insulin infusion for 2 hours and then receive an intravenous dextrose infusion to maintain elevated blood sugar levels. Blood draws will be obtained to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. Receives: Procedure: Muscle Biopsy; Other: Jell-O with Amino acids; Dietary Supplement: Dextrose |
| Non-Diabetic Controls | Other | Subjects will have blood draws to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. Receives: Procedure: Muscle Biopsy; Other: Jell-O with Amino acids |
| Diabetes after Total Pancreatectomized (DATP) Insulin Treated | Experimental | Subjects will continue their baseline insulin infusion while maintaining a target blood glucose range. Blood draws will be obtained to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. Receives: Procedure: Muscle Biopsy; Other: Jell-O with Amino acids |
| Diabetes after Total Pancreatectomized (DATP) Insulin Deprived | Experimental | Subjects will have their insulin infusions replaced with saline and have blood draws to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. Receives: Procedure: Muscle Biopsy; Other: Jell-O with Amino acids |
What is being measured
The primary outcome is the main question the study is designed to answer.
Protein synthesis
Measurement of isotope abundance in peptides derived from the digested proteins
Measured: Approximately 7 hours
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Aug 2023
- Study start1 Jun 2026 (estimated)
- Primary completion31 Jul 2026
- Study completion31 Jul 2026
Why it stopped: Changed IRB number
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Type 1 DiabetesStudies of the same condition, open and under way.
- More trials run by Mayo ClinicThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- Mayo Clinic
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, K. Sreekumaran Nair, Mayo Clinic
- Investigators
- K. Sreekumaran Nair, MD, Principal investigator, Mayo Clinic
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05985135
- Sponsor's protocol ID
- 21-000001
- Status last verified
- Jul 2026
- First submitted
- 2 Aug 2023
- Last updated
- 5 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 5 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Impact of Insulin Deprivation and Hyperglycemia on Plasma Protein Synthesis in People With Type 1 Diabetes Mellitus and Diabetes After Total Pancreatectomy
- ClinicalTrials.gov ID
- NCT05985135
- Acronym / sponsor ID
- 21-000001
- Conditions
- Type 1 Diabetes
- Keywords
- Continuous subcutaneous insulin infusion, Multiple daily injections of insulin
- Study type
- Interventional
- Recruitment status
- WithdrawnReason stopped: Changed IRB number
- Enrolment
- 0 participants (actual)
- Lead sponsor
- Mayo ClinicUniversity, hospital or other
- Study start
- 1 Jun 2026 (estimated)
- Primary completion
- 31 Jul 2026 (actual)
- Study completion
- 31 Jul 2026 (actual)
- First posted
- 14 Aug 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This research is being done to better understand how insulin effects muscle, blood, and the body in people with Type 1 Diabetes.
Detailed description
Insulin's contribution in controlling glucose homeostasis has been well appreciated but, its role in maintaining proteome homeostasis is less understood. Some animal and human studies have demonstrated that insulin signaling regulates protein synthesis and degradation as well as posttranslational modifications at the tissue level. Insulin's effect on the muscle's mitochondrial proteo-stasis has also been elucidated. Insulin deprivation increases global synthesis of splanchnic proteins based on isotope dilution studies across splanchnic bed. Most plasma proteins are derived from liver and preliminary studies suggest that synthesis rates of some plasma proteins increase while others decrease. Fractional rates of synthesis of various plasma proteins from the liver have been demonstrated in insulin deprivation state. These proteins might be implicated in the development of some of the complications from diabetes mellitus type 1. (T1DM) especially of macrovascular. Researchers have recently developed an isotope-based methodology to simultaneously measure in vivo synthesis rates of multiple plasma proteins in human.
In order to further investigate the effects of insulin deprivation researchers will apply the novel non-radioactive stable isotope-based approach on the rate of different plasma protein synthesis in T1DM and Diabetes after total pancreatectomy (DATP) in comparison with non-diabetic controls. Researchers will study pancreatectomized people because like T1DM they also are insulin deficient but unlike pancreatectomized people also are deficient in glucagon. Some tantalizing data from many studies indicate that glucagon also have catabolic effect not only on liver derived proteins but also on skeletal muscle-based proteins. Since skeletal muscle has no glucagon receptors, researchers hypothesize that unknown factors are released to the circulation that act on skeletal muscle to release amino acids for consumption in liver. Researchers will measure amino metabolites, acyl carnitines, organic acids, and ceramides in plasma and determine the blood exosome cargo by mass spectrometry-proteins and lipids and miRNA by PCR.
Researchers have previously shown reduced muscle mitochondrial ATP production during insulin deprivation in both T1D humans and diabetic mice and here researchers will measure mitochondrial energy dynamics in all study participants by the established techniques available in our lab.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 6
| Arm | Type | Receives |
|---|---|---|
| Type 1 Diabetes Mellitus (T1DM) Insulin Deprived | Experimental | Procedure: Muscle Biopsy, Other: Jell-O with Amino acidsSubjects will have their insulin infusions replaced with saline and have blood draws to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. |
| Type 1 Diabetes Mellitus (T1DM) Insulin Treated | Experimental | Procedure: Muscle Biopsy, Other: Jell-O with Amino acidsSubjects will continue their baseline insulin infusion while maintaining a target blood glucose range. Blood draws will be obtained to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. |
| Type 1 Diabetes Mellitus (T1DM) Insulin-Treated with Hyperglycemia | Experimental | Procedure: Muscle Biopsy, Other: Jell-O with Amino acids, Dietary Supplement: DextroseSubjects will be continue their baseline insulin infusion for 2 hours and then receive an intravenous dextrose infusion to maintain elevated blood sugar levels. Blood draws will be obtained to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. |
| Non-Diabetic Controls | Other | Procedure: Muscle Biopsy, Other: Jell-O with Amino acidsSubjects will have blood draws to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. |
| Diabetes after Total Pancreatectomized (DATP) Insulin Treated | Experimental | Procedure: Muscle Biopsy, Other: Jell-O with Amino acidsSubjects will continue their baseline insulin infusion while maintaining a target blood glucose range. Blood draws will be obtained to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. |
| Diabetes after Total Pancreatectomized (DATP) Insulin Deprived | Experimental | Procedure: Muscle Biopsy, Other: Jell-O with Amino acidsSubjects will have their insulin infusions replaced with saline and have blood draws to monitor glucose levels along with a muscle biopsy following consumption of a Jell-O with Amino acids. |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Able to provide written consent.
- Able to provide written consent.
- T1DM treated with continuous subcutaneous insulin infusion (CSII) or multiple daily injections (MDI) (not Degludec).
Key exclusion criteria (30 listed)
- BMI < 20 or > 32 kg/m^2.
- Celiac disease.
- Pregnancy.
- Smoking.
- Reported history of illicit substance use.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Muscle BiopsyNeedle muscle biopsy of the outer thigh muscle | Procedure or surgery | Diabetes after Total Pancreatectomized (DATP) Insulin Deprived, Diabetes after Total Pancreatectomized (DATP) Insulin Treated, Non-Diabetic Controls, Type 1 Diabetes Mellitus (T1DM) Insulin Deprived, Type 1 Diabetes Mellitus (T1DM) Insulin Treated, Type 1 Diabetes Mellitus (T1DM) Insulin-Treated with Hyperglycemia |
| Jell-O with Amino acidsAn amino acid mixture containing 13C6 Lysine isotope label | Other | Diabetes after Total Pancreatectomized (DATP) Insulin Deprived, Diabetes after Total Pancreatectomized (DATP) Insulin Treated, Non-Diabetic Controls, Type 1 Diabetes Mellitus (T1DM) Insulin Deprived, Type 1 Diabetes Mellitus (T1DM) Insulin Treated, Type 1 Diabetes Mellitus (T1DM) Insulin-Treated with Hyperglycemia |
| DextroseIntravenous form of sugar | Dietary supplement | Type 1 Diabetes Mellitus (T1DM) Insulin-Treated with Hyperglycemia |
Primary outcome
Protein synthesis
Time frame: Approximately 7 hours
Measurement of isotope abundance in peptides derived from the digested proteins
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Aug 2026.
- Mayo Clinic Clinical TrialsLink provided by the sponsor.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
K. Sreekumaran Nair, MD principal investigator
Mayo Clinic
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Muscle Biopsy, Jell-O with Amino acids and Dextrose in people with Type 1 Diabetes, run by Mayo Clinic 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 3 inclusion and 30 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: withdrawn, as of the sponsor's last update on 5 Aug 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.
Are results available for this study?
The study was withdrawn before enrolling participants, so there are no results.
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?
Protein synthesis (time frame: Approximately 7 hours). 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 5 Aug 2026.