Glutamine and Insulin Sensitivity in Type I Diabetes
Condition: Type I Diabetes Mellitus
MeSH terms: Diabetes Mellitus; Insulin Resistance; Diabetes Mellitus, Type 1
Study type: Interventional

Summary: 
      Insulin is crucial to help the body metabolize ('burn') sugar (glucose). Even though juvenile
      (type 1) diabetes (T1D) is primarily due to the lack of insulin, patients with T1D tend to
      become less sensitive to insulin, particularly during adolescence.

      The overall objective of this project is to gain further insight into the possible benefits
      of supplementation with glutamine (GLN), a natural dietary amino acid, enhancing insulin
      sensitivity in adolescents with T1D. To elucidate the impact of glutamine, the investigators
      will use a method called the 'euglycemic, hyperinsulinemic clamp': it consists of giving an
      IV drip of insulin, while the drop in blood sugar is prevented by giving variable, precisely
      measured amounts of glucose by vein: the amount of glucose required to prevent a drop in
      blood sugar reflects the body's sensitivity to insulin. The investigators will also give an
      IV drip of glucose and arginine (a building block of protein) 'tagged' with non-radioactive
      isotopes to better understand how glutamine may work. This procedure will be performed in 2
      groups of 10 adolescents in the morning either after a strenuous exercise performed the
      previous afternoon (group 1; n=10), or after a sedentary day (group 2; n=10). Each subject
      will be studied twice, once after taking oral GLN, once after placebo, in separate clinical
      research center (CRC) admissions a few weeks apart, in random order.

      Should the investigators hypothesis prove to be true, it would warrant long term studies to
      determine whether sustained dietary GLN supplementation can decrease insulin requirements and
      ultimately improve diabetes control in teenagers with T1DM, If successful, this approach
      could potentially have a significant positive impact in terms of adolescent health.
    


Intervention name(s): Glutamine; Placebo
Intervention type(s): Dietary Supplement; Dietary Supplement
Intervention description(s): Participants will keep a diary of food intake and activity as well as wear an accelerometer (to measure overall movement) for 2-3 days prior to the admission. Subject will come to the Clinical Research Center for approximately 24 hours. They will receive a drink containing Glutamine (0.25 g/kg/dose). Afterwards they will have an afternoon exercise session consisting of 15-min bouts of exercise, interspersed with 5-min rest periods in between for a total of 75min. Blood glucose will be checked during rest intervals. They will be served a controlled dinner. Before bedtime another dose of the same drink will be given. Overnight blood glucose will be monitored closely. In the morning, another dose of the same drink will be given. Subjects will have two isotope infusions (non-radioactive) running concomitantly and a hyperinsulinemic-euglycemic clamp will be performed. Afterwards lunch will be served and subject discharged home.; Participants will keep a diary of food intake and activity as well as wear an accelerometer (to measure overall movement) for 2-3 days prior to the admission. Subject will come to the Clinical Research Center for approximately 24 hours. They will receive a PLACEBO drink. Afterwards they will have an afternoon exercise session consisting of 15-min bouts of exercise, interspersed with 5-min rest periods in between for a total of 75min. Blood glucose will be checked during rest intervals. They will be served a controlled dinner. Before bedtime another dose of the same drink will be given. Overnight blood glucose will be monitored closely. In the morning, another dose of the same drink will be given. Subjects will have two isotope infusions (non-radioactive) running concomitantly and a hyperinsulinemic-euglycemic clamp will be performed. Afterwards lunch will be served and subject discharged home.
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Treatment
Keywords: Type I Diabetes; Insulin Resistance; Glutamine; Amino Acids; Glucagon like peptide 1; Glutathione; Citrulline; Arginine; Nitric Oxide