Glucose Response, Excursions And Treatment (GREAT) Study
Status:
Completed
Trial end date:
2015-11-01
Target enrollment:
Participant gender:
Summary
Patients with type 2 diabetes have very variable endogenous insulin secretion. While some
patients have relatively preserved endogenous insulin with marked insulin resistance others
may develop the very severe insulin deficiency seen in type 1 diabetes. The impact of this
variation on hypoglycaemia risk and treatment response in type 2 diabetes is unclear. This
project aims to determine the impact of residual endogenous insulin secretion on glucose
variability, hypoglycaemia risk and treatment response in insulin-treated participants with a
clinical diagnosis of type 2 diabetes. The investigators will recruit participants from
existing cohorts known to have severe insulin deficiency despite classical clinical
characteristics of type 2 diabetes. The investigators will recruit other participants with
insulin-treated type 2 diabetes and retained endogenous insulin secretion matched for
glycemia and gender. The investigators will assess glucose variability (using continuous
glucose monitoring system (CGMS)) and treatment response to a single dose of the glucose
lowering therapy vildagliptin and compare responses between groups. This study will allow us
to assess the potential utility of measuring endogenous insulin secretion in insulin-treated
type 2 diabetes as a marker of hypoglycaemia risk and in determining likely response to oral
therapy.