CPDPC16-04: Evaluation of a mixed meal test for Diagnosis and characterization of Type 3c diabeTes mellitus secondary to pancreatic cancer and chronic pancreatitis (DETECT)
Study to Develop a Test for Identifying Causes of Diabetes
Brief description of study.
Detailed description of study
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: pancreatic disease,pancreatic cancer,pancreatitis,diabetes mellitus
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Age: 40 years - 85 years
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Gender: All
Inclusion Criteria
Patients must have a diagnosis of one of the following based on study definitions
-New Onset Diabetes in subjects with Pancreatic Cancer (PDAC)
-New Onset Diabetes in subjects with Chronic Pancreatitis
-New Onset Diabetes in subjects without Pancreatic disease (i.e., T2DM)
-Long standing T2DM without Pancreatic disease
-Long standing diabetes in subjects with PDAC
-Long standing diabetes subjects with chronic pancreatitis
-non-diabetic subjects with PDAC
-non-diabetic subjects with chronic pancreatitis
-non-diabetic controls without Pancreatic disease
Exclusion Criteria
Patients must not have any significant medical illnesses (including diabetes) that in the investigator's opinion cannot be adequately controlled with appropriate therapy or would compromise the patient's ability to tolerate study interventions. Specifically, diabetes must be stable enough to permit holding diabetes medications following the criteria below: The following oral anti-diabetic agents will be held on the day of the meal tolerance test but may resume once test is completed: metformin, sulfonylureas, repaglinide or nateglinide, alpha-glucosidase inhibitors (acarbose, miglitol), pramlintide, colesevelam, bromocriptine Those on low doses of insulin (< 0.5 U/kg/day) will not take insulin on the day of study procedures. Subjects taking higher doses of insulin (≥0.5 unit/kg/day) will be excluded from this study. Subjects taking, DPP-4 inhibitors, SGLT2 inhibitors, or short acting GLP-1 analogs (Byetta [exenatide], Victoza [liraglutide], Adlyxin [lixisenatide]) will be asked not to take these medications on the day of the meal tolerance test (they can be taken the day before if taken in the morning; for those taking these medications in the afternoon or evening, they will be asked to withhold such dosing on the day prior to testing). Subjects on longer acting agents, including thiazolidinediones and once-weekly GLP-1 agonists (Bydureon [exenatide], Tanzeum [albiglutide], Trulicity [dulaglutide]) will be excluded from the study.
Patients currently receiving oral steroid medications
Hospitalization for acute pancreatitis within 2 months before study visit
Presence of one or more pancreatic cysts ≥2 cm in size
Any subject with a pancreatic cancer histologic subtype other than adenocarcinoma (e.g., subjects with pancreatic neuroendocrine tumors are excluded)
Previous pancreatic surgery (including total pancreatectomy, pancreaticoduodenectomy, distal pancreatectomy, pancreaticojejunostomy, enucleation, or Frey procedure)
Previous treatment for pancreatic cancer, including chemotherapy or radiation
Previous vagotomy or gastric surgery, including endoscopic gastric reduction procedures
Previous diagnosis of gastroparesis
Patients on treatment for any cancer (except non-melanoma skin cancer or carcinoma in-situ of the cervix)
Allergy or intolerance to ingredients in Boost drink
This study investigates the causes of diabetes related to the pancreas, such as chronic pancreatitis or pancreatic cancer, compared to type 2 diabetes. Diabetes mellitus is a condition characterized by high blood sugar levels. This study aims to develop a test to distinguish between diabetes caused by pancreatic issues and type 2 diabetes.
Participants will undergo various procedures to help develop this test. These procedures may involve holding certain diabetes medications on the day of a meal tolerance test. The study will include different study arms to compare participants with new onset diabetes, long-standing diabetes, and those without diabetes.
- Who can participate: Adults who have been diagnosed with either new onset diabetes or long-standing diabetes, with or without pancreatic disease, are eligible. Non-diabetic individuals with or without pancreatic disease may also participate.
- Study details: Participants will be involved in a meal tolerance test where some diabetes medications may need to be paused. Those on low doses of insulin may not take it on the day of the test. Participants will be compensated for their involvement.