A Study of LY2608204 in Patients With Type 2 Diabetes
Condition: Diabetes Mellitus, Type 2
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Intervention: LY2608204
Intervention description: Administered orally.
Intervention MeSH terms: Globalagliatin
Phase: Phase 1
Study type: Interventional
Primary purpose: Other
Intervention model: Single Group Assignment
Masking: None (Open Label)
Enrollment: 20.0
Sex: All
Minimum age: 18 Years
Maximum age: 70 Years
Healthy volunteers: No
Keywords: Diabetes glucokinase safety

Summary:

      Safety study with multiple oral doses of LY2608204 given to patients with type 2 diabetes.
      Study subjects will receive once daily doses of LY2608204 for a total treatment duration of
      up to 28 days. In this study, each patient will receive increasing doses of LY2608204 until
      reaching the highest dose that they can tolerate.

      Continuous glucose monitoring devices will be employed for each patient to monitor for
      hypoglycemia during study treatment. Dose titration and dose reduction is determined for each
      individual patient based on their safety and glycemic data.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Patients diagnosed with Type 2 diabetes mellitus (T2DM) who are currently treated with
             diet/lifestyle measures alone or in combination with anti-diabetic agents, including
             insulins

          -  Have fasting blood glucose (FBG) greater than or equal to 160 milligram/deciliter
             (mg/dL), with a subset of patients with FBG greater than or equal to 190 mg/dL in at
             least 2 measurements on separate days

          -  Have a glycated haemoglobin (HbA1c) level of greater than or equal to 8% and less than
             or equal to 11% at screening

          -  If female, are not of child-bearing potential due to surgical sterilisation
             (hysterectomy or bilateral oophorectomy or tubal ligation) or menopause

          -  Are males or females who are at least 18 years old (for sites outside of Singapore) or
             at least 21 years old (for sites within Singapore) but no more than 70 years old (for
             all sites)

          -  Body mass index (BMI) greater than 18.5 kilogram/square meter (kg/m²) and less than
             40.0 kg/m²

          -  Have clinical laboratory test results within the normal range for the population or
             investigator site, or with abnormalities deemed clinically insignificant by the
             investigator

          -  Have supine systolic blood pressure (SBP) greater than 160 millimeters of mercury
             (mmHg) and supine diastolic blood pressure (DBP) less than 100 mmHg

          -  Have venous access sufficient to allow blood sampling as per the protocol

          -  Are willing and able to comply with requirements for continuous glucose monitoring
             (CGM)

          -  Are reliable and willing to make themselves available for the duration of the study
             and who will abide by the Clinical Research Unit (CRU) policy and procedure and study
             restrictions. This includes staying in-patient at the CRU for a total duration of up
             to 31 days

          -  Have given written informed consent approved by Lilly and the ethical review board
             governing the site

        Exclusion Criteria:

          -  Are currently enrolled in, or discontinued within the last 30 days from, a clinical
             trial involving an investigational drug or device or use of a drug or device other
             than the study drug used in this study, or are concurrently enrolled in any other type
             of medical research judged not to be scientifically or medically compatible with this
             study

          -  Have significant history of past or current cardiovascular, respiratory, hepatic,
             renal, gastrointestinal, endocrine (other than diabetes), hematological, or
             neurological disorders capable of significantly altering the absorption, metabolism or
             elimination of drugs or of constituting a risk when taking the study drug formulations
             or interfering with the interpretation of data

          -  Have a history of a seizure disorder

          -  A corrected QT interval greater than 450 milliseconds (msec) at screening or any
             personal history of ventricular tachycardia or unexplained syncope, or other
             abnormality in the 12-lead Electrocardiogram (ECG) that, in the opinion of the
             investigator, increases the risks associated with participating in the study

          -  Have family history of long QT syndrome or family history of sudden unexplained death

          -  Use medications known to prolong the QT interval.

          -  Have type 1 diabetes mellitus or a history of ketoacidosis or any other type of
             diabetes mellitus other than type 2

          -  Use of any known inducers or inhibitors of CYP3A within 14 days prior to the first
             dosing with study drug or intended use during the study

          -  History of a hypoglycemic event with acute mental status alteration that was not
             preceded by prodromal symptoms recognizable to the patient

          -  Fasting serum triglycerides greater than 500mg/dl

          -  Serum creatinine greater than 1.3 mg/dL in women, greater than 1.5 mg/dL in men

          -  Clinical evidence of active diabetic proliferative retinopathy

          -  Known clinically significant autonomic neuropathy as evidenced by urinary retention,
             orthostatic hypotension, diabetic diarrhea or gastroparesis

          -  Clinically significant coronary events or symptoms within 6 months prior to study
             entry

          -  Clinically significant peripheral vascular disease

          -  Have known allergies to LY2608204 or related compounds

          -  Evidence of human immunodeficiency virus (HIV) infection and/or positive human HIV
             antibodies/antigen

          -  Evidence of hepatitis B and/or positive hepatitis B surface antigen (HBsAg)

          -  Donation or loss of blood equal to or exceeding 450 milliliter (mL) during the 3
             months before the first administration of study drug

          -  Patients who have an average weekly alcohol intake that exceeds 21 units per week
             (males) and 14 units per week (females) (1 unit equal to 12 oz or 360 mL of beer; 5 oz
             or 150 mL of wine; 1.5 oz or 45 mL of distilled spirits) or patients unwilling to stop
             alcohol consumption 24 hours prior to admission until the completion of each
             in-patient study period

          -  Patients who smoke more than 10 cigarettes or other tobacco products per day before
             study entry. Patients will not be allowed to smoke while in the study Unit

          -  Have a history of drug or alcohol abuse

          -  Intended use of over-the counter or prescription medications 7 and 14 days,
             respectively, prior to dosing. If this situation arises, inclusion of an otherwise
             suitable volunteer may be at the discretion of the investigator. Use of anti-diabetic
             medication [metformin, sulphonylureas, glinides, thiazolidinediones, acarbose, DPPIV
             inhibitors, Byetta (but not liraglutide)] by patients with type 2 diabetes mellitus is
             acceptable for this study

          -  Have repeated alanine transaminase levels greater than 2.5 times the upper limit of
             the reference range at screening, as determined by the central laboratory

          -  Have previously been enrolled in this clinical study or any other study of LY2608204.

        Exclusion Criteria for EU/UK/US Site(s) only --

          -  Evidence of hepatitis C and/or positive hepatitis C antibodies, at screening

          -  Use of known drugs of abuse and/or positive findings on urinary drug screening, other
             than findings consistent with medication prescribed by the patient's physician or
             over-the-counter medications