Targeting Beta-cell Failure in Lean Patients With Type 2 Diabetes
Status:
Not yet recruiting
Trial end date:
2023-10-01
Target enrollment:
Participant gender:
Summary
The majority of people with type 2 diabetes (T2D) are overweight, and while weight gain is a
major contributor to diabetes, a minority of patients with T2D are not overweight or obese.
The reasons why lean or normal body weight individuals develop T2D (lean-T2D) are not yet
understood. T2D occurs when the body does not produce enough insulin, or becomes less
sensitive to its effects. Insulin acts like a key to allow sugar into cells and if someone is
overweight that key works less well. Recent research suggests that T2D in lean people should
be considered a different disease from the diabetes associated with obesity and the main
problem in lean-T2D patients may be a reduced capacity of insulin secretion. However, some
researchers argue that many seemingly thin people carry more fat than muscle, making them
trim on the outside, but fat on the inside, and they are in fact not truly lean. This implies
that just like overweight diabetics, lean diabetics also have high resistance to insulin. The
main aim of this research is to better understand the main driver of T2D in lean individuals,
as this will determine how best to treat these individuals.
There are many different types of drugs for treating T2D. Liraglutide improves insulin
secretion capacity of the pancreas. Pioglitazone reduces resistance to insulin action. The
investigators will compare the actions of these diabetes drugs on the blood supply and the
heart's energy levels in lean-T2D and obese-T2D patients. This will allow the investigators
to determine the ideal treatment strategies for improving cardiovascular health in lean-T2D
patients, and better understand the role of impaired insulin secretory capacity, insulin
resistance and excess fat deposition specifically in this group.