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SNPMiner SNPMiner Trials (Home Page)


Report for Mutation E23K

Developed by Shray Alag, 2020-2021.
SNP Clinical Trial Gene

There are 4 clinical trials

Clinical Trials


1 Study of Sulphonylurea Synergy With DPP4 Inhibitors

The Study of Sulphonylurea Synergy with DPP4 Inhibitors (SSS Study) will establish whether a very low dose of sulphonylurea will have a synergistic role on augmentation of insulin secretion when given in combination with a DPP4 inhibitor as a primary outcome. The study will recruit 30 patients with type 2 diabetes mellitus controlled with no treatment or metformin monotherapy with an HbA1c <64mmol/mol (<8%). In this unblinded, randomised physiological study, participants will receive four 14-day intervention blocks: low dose sulphonylurea alone, DPP4 inhibitor alone, low dose sulphonylurea + DPP4 inhibitor or no treatment change. The primary outcome will be assessed through evaulation of insulin secretion and sensitivity at mixed meal test at the end of each treatment block. Glycaemic variability on continuous glucose monitoring for each intervention block will be evaluated as a secondary outcome. In addition, the primary outcome will be evaulated for KCNJ11 genotype as an additional secondary outcome.

NCT04192292
Conditions
  1. Type 2 Diabetes
Interventions
  1. Drug: Sulfonylurea
  2. Drug: DPP4 Inhibitor

insulin secretory response for E23K, E23E, K23K variants.. Variation in blood glucose during intervention blocks analysed by continuous glucose monitoring. --- E23K ---

Primary Outcomes

Description: Comparison of four mixed meal tests performed at the end of each intervention block. Meal tests will evaluate 1) No intervention 2) Low dose sulphonylurea alone 3) DPP4 inhibitor alone 4) Low dose sulphonylurea + DPP4 inhibitor. Measures of the incretin effect will be compared between the different blocks.

Measure: Difference in incretin effect between mixed meal tests

Time: Through four mixed meal tests which take place at the end of each 14 day intervention block. The four intervention blocks will be completed during an 8 week clinical phase of study.

Secondary Outcomes

Description: Difference in insulin secretory response to low dose gliclazide calculated by insulin/cpeptide levels in each meal test visit. Differences will then be compared by participants genotype e.g. insulin secretory response for E23K, E23E, K23K variants.

Measure: Insulin secretory response analysed by KCNJ11 genotype

Time: Through 4 meal test visits completed over an 8 week clinical phase of study. Outcome will also be evaluated through variability of glucose levels observed on continuous glucose monitoring worn for duration of 8 week clinical phase.

Description: Comparison time-in-range of blood sugars as low, target and high on continuous glucose monitoring between each intervention block

Measure: Variation in blood glucose during intervention blocks analysed by continuous glucose monitoring

Time: Meansurements taken via continuous glucose monitoring sensors worn by participants for duration of 8 week clinical phase

2 Sulphonylurea Receptor Mutation and Responsiveness to Gliclazide - a Pilot Proof of Concept, Randomised Cross-over Study

Gliclazide has greater glucose lowering efficacy than glibenclamide among type 2 diabetes mellitus patients with minor haplotype (K23/A1369) at the KCNJ11/ABCC gene locations.

NCT02201602
Conditions
  1. Diabetes
Interventions
  1. Drug: Gliclazide
  2. Drug: Glibenclamide

Interestingly, the KCNJ11 E23K (rs5219) variant was shown to confer susceptibility to T2DM and the ABCC8 S1369A (rs757110) variant was found to be in complete linkage disequilibrium with it i.e. inherited together as a genetic block (haplotype). --- E23K ---

Primary Outcomes

Measure: Mean blood glucose level

Time: 6 days

Secondary Outcomes

Description: Glycemic variability will be assessed using the EasyGV software (http://www.phc.ox.ac.uk/research/diabetes/software/easygv/) which is capable of calculating 10 different measures of glycemic variability from continuous glucose monitoring data, such as Standard Deviation (SD) and M-value, mean amplitude of glycemic excursions (MAGE).

Measure: Glycemic variability

Time: 6 days

3 Study of Sulphonylurea Synergy With Incretins

The Study of Sulphonylurea Synergy with Incretins (LOGIC) is a Proof-of-Concept Physiological study in the form of two matched isoglycaemic clamps. A matched clamp consists of an of oral glucose tolerance test followed by an isoglycaemic intravenous glucose infusion (IGII). The study will investigate whether there is synergy between a physiological sulphonylurea (SU) stimulus and the incretin effect, causing augmentation of insulin secretion in patients with type 2 diabetes mellitus (T2DM). The study will take place at The Clinical Research Centre at Ninewells Hospital in Dundee over five visits. It will evaluate 20 patients with T2DM on no diabetes therapy, or metformin monotherapy. All participants will undergo two matched clamps. The first matched clamp will be with no intervention. The second intervention matched clamp, low-dose liquid gliclazide will be administered 1-hour prior to each test. The sulphonylurea, Gliclazide, in this this instance will be used as a physiological stimulus and will only be given on two occasions as part of the second matched clamp. The first eight participants will participate in the dose-ranging phase. They will receive either 10mg or 20mg gliclazide as a stimulus to augment the incretin effect. A further twelve participants will then be recruited to complete the study utilising the dose which caused the greatest increment in insulin secretion. LOGIC will also evaluate the cohort for effect of KCNJ11 genotype on physiological response.

NCT03705195
Conditions
  1. Type 2 Diabetes Mellitus
Interventions
  1. Drug: Gliclazide
MeSH:Diabetes Mellitus, Type 2
HPO:Type II diabetes mellitus

Insulin secretory response analysed by KCNJ11 Genotype (E23K, E23E, K23K). --- E23K ---

insulin secretory response for E23K, E23E, K23K variants.. Inclusion Criteria: - Age 40 - 80, - Age of Diabetes Diagnoses ≥ 35 - T2DM on no treatment or metformin monotherapy - White British - HbA1c ≤ 8% (64mmol/mol) - eGFR ≥ 50ml/min-1 - ALT ≤ 2.5 x ULN - Able to consent Exclusion Criteria: - Type 1 Diabetes Mellitus - HbA1c > 8.0% (> 64mmol/mol) - eGFR <50ml/min-1 - ALT >2.5 x ULN - Anaemia (Haemoglobin <12.0 g/dL for women, <13.0 g/dL for men) - Pregnancy, lactation or a female planning to conceive within the study period - Established pancreatic disease - Participating in clinical phase of another interventional trial/study or have done so within the last 30 days - Any other significant medical reason for exclusion as determined by the investigator Inclusion Criteria: - Age 40 - 80, - Age of Diabetes Diagnoses ≥ 35 - T2DM on no treatment or metformin monotherapy - White British - HbA1c ≤ 8% (64mmol/mol) - eGFR ≥ 50ml/min-1 - ALT ≤ 2.5 x ULN - Able to consent Exclusion Criteria: - Type 1 Diabetes Mellitus - HbA1c > 8.0% (> 64mmol/mol) - eGFR <50ml/min-1 - ALT >2.5 x ULN - Anaemia (Haemoglobin <12.0 g/dL for women, <13.0 g/dL for men) - Pregnancy, lactation or a female planning to conceive within the study period - Established pancreatic disease - Participating in clinical phase of another interventional trial/study or have done so within the last 30 days - Any other significant medical reason for exclusion as determined by the investigator Type 2 Diabetes Mellitus Diabetes Mellitus, Type 2 The Study of Sulphonylurea Synergy with Incretins (LOGIC) is a Proof-of-Concept Physiological study in the form of two matched isoglycaemic clamps. --- E23K ---

Primary Outcomes

Description: Comparison of two matched clamps (oral glucose tolerance test + isoglycaemic intravenous glucose infusion). Matched clamp 1 - control. Matched clamp 2 - low dose gliclazide. Levels of insulin/c-peptide, incretin hormones and plasma glucose will be compared in the presence and absence of low dose gliclazide

Measure: Difference in insulin secretion and incretin effect between two matched clamps (presence and absence of low dose gliclazide)

Time: Through four study visits completed over 4 weeks

Secondary Outcomes

Description: Difference in insulin secretory response to low dose gliclazide calculated by insulin/cpeptide levels in matched clamp(gliclazide). Differences will then be compared by participants genotype e.g. insulin secretory response for E23K, E23E, K23K variants.

Measure: Insulin secretory response analysed by KCNJ11 Genotype (E23K, E23E, K23K)

Time: Through four study visits completed over 4 weeks

4 Study to Understand the Genetics of the Acute Response to Metformin and Glipizide in Humans

The SUGAR-MGH investigators are studying the influence of inherited gene variants on the response to two commonly prescribed type 2 diabetes medications, metformin and glipizide. They hypothesize that variants in genes that are associated with type 2 diabetes or related traits may impact the effect of anti-diabetic medications. In addition, physiological responses to an insulin secretagogue or an insulin sensitizer may shed light on the mechanism of action of reported genetic associations.

NCT01762046
Conditions
  1. Diabetes Mellitus, Type 2
Interventions
  1. Drug: Glipizide
  2. Drug: Metformin
  3. Other: Oral Glucose Tolerance Test
MeSH:Diabetes Mellitus Diabetes Mellitus, Type 2
HPO:Diabetes mellitus Type II diabetes mellitus

In particular, sulfonylureas may have differential effects on individuals depending on the allelic variant they carry at KCNJ11 E23K; conversely, because TCF7L2 is postulated to influence insulin secretion by regulating the action of glucagon-like peptide 1 (GLP-1), and sulfonylureas act at a different step in the insulin secretion pathway, the effect of sulfonylureas on insulin secretion could be independent of genetic variation at TCF7L2. --- E23K ---

Primary Outcomes

Description: Investigators will measure insulin and glucose levels for 240 minutes after Glipizide administration on Visit 1, and compare them by genotype at selected loci.

Measure: Glipizide response

Time: Between 0-240 minutes, Visit 1

Description: Investigators will measure the change in glycemic measures between Visit 1 and Visit 2 as an index of Metformin response, and compare them by genotype at selected loci.

Measure: Metformin response

Time: 7 days

Secondary Outcomes

Description: Investigators will measure GLP-1 and GIP during the 120 minutes of Visit 2, and compare them by genotype at selected loci.

Measure: Incretin levels

Time: 120 minutes, Visit 2

Description: Investigators will measure proinsulin and glucagon levels at regular intervals during Visits 1 and 2, and compare them by genotype at selected loci.

Measure: Proinsulin, glucagon

Time: 7 days

Description: Investigators will perform metabolomic profiling of plasma samples at regular intervals in Visits 1 and 2, by using initially a targeted approach on an existing platform that measures ~400 metabolites (both polar and non-polar); they will compare their relative concentrations by genotype at selected loci before and after the interventions.

Measure: Metabolomics

Time: 7 days

Description: Investigators will measure 25-hydroxy vitamin D levels at baseline, and examine its effects on glycemic measures during Visits 1 and 2.

Measure: Vitamin D

Time: Baseline


HPO Nodes


HP:0000819: Diabetes mellitus
Genes 567
LHX1 BLK MERTK PROK2 UBR1 MTHFR MAGEL2 UBR1 NODAL ND6 NDUFS4 RETN TRNL1 MAGEL2 TRNK POLA1 GTF2IRD1 TRNC SLC7A14 RP1 HNF1A CTRC CAVIN1 BRAF RTL1 BBS1 FGFR1 PDE6A CNGB1 LIPE ZNF408 HNF1B TRNS2 GCK HNF4A SHH CTNNB1 BMP2 HYMAI DCAF17 PTF1A TOPORS CFTR KCNJ11 OCA2 SPINK1 ENPP1 AMACR MTNR1B ND1 TCF4 RBP3 ELMO2 PRSS1 SAG MAPK8IP1 PAX4 TP53 NDN FUZ DLL1 PROKR2 RTL1 PCNT SIM1 CLIP2 ABCC8 ELN KCTD1 PIK3R1 TTC7A IRS2 IGF1R GNAS EDA2R ABCC8 PIK3R1 OFD1 PLIN1 CNBP PEX10 COX1 ELN KLF11 SLC19A2 TULP1 LMNB2 PEX6 AKT2 NDUFV2 NDUFAF5 HFE GLIS3 SNRNP200 INS FOXP3 HMGA1 LIPE TRMT10A XRCC4 NEUROD1 HESX1 PTRH2 MTHFR PDE4D NSMCE2 GLRX5 HAMP HNF1B TRNW NPAP1 PPARG SUFU RP9 IFT88 IRS1 RHO PLAGL1 BLM TDGF1 PRSS1 AKT2 PDX1 TRNW ARL3 RPGR HNF4A GPD2 LMNA PDE6B USB1 MEG3 NDUFB10 SNORD115-1 ZNF513 DNAJC21 WFS1 XRCC4 SOX3 SLC25A4 IL2RA RLBP1 NDUFA11 MKRN3-AS1 PRKAR1A NDUFS3 HJV TKT FAM161A GCK LIG4 ROM1 GJA1 TRNS1 TRNH BLM COX1 SNRPN TTC8 PDE8B AGPAT2 TREX1 TINF2 LMNA AIP DCAF17 ND2 IFIH1 BRCA1 IDH3B DNM1L PDE4D GJB4 USP8 BEST1 PWRN1 GATA6 IPW RP2 ND1 GATA6 ARNT2 SLC19A2 APPL1 ND4 PDX1 FOXRED1 TRNF STAT1 INSR IMPDH1 GATA3 SLC2A2 DHDDS EIF2S3 IL6 CNOT1 HLA-DRB1 GPR101 PPARG TRNQ GCK RPE65 ATP6 SNRPN ZBTB20 CISD2 TRNS1 INS CAT SPATA7 RAC1 NDUFB11 HNF4A PALLD RNASEH2B TRNE XRCC4 NDUFAF8 ARHGEF18 STAT1 CYTB LIPC GCK EDA HBB MMP2 OCA2 ZFYVE26 FOXP3 TRNF KLHL7 ALMS1 CP SEMA4A USH2A FGF8 SBDS HBB CERKL INS CYP19A1 APPL1 RNASEH2A TRNS2 ZFP57 GJA1 CDON TIMMDC1 FGFR1 POLR3A AGPAT2 MAGEL2 HNF4A ZFP57 ND1 FOXH1 PRPF8 IARS1 SPINK1 PAX4 HNF1A NDUFAF3 GAS1 CDHR1 NPM1 STUB1 PWAR1 CPA1 KCNJ11 EYS HNF1A IL18BP DISP1 PDX1 VANGL1 CEP19 POLG2 CARS1 CLRN1 HNF1B NDN MKRN3 KCNJ11 BSCL2 OCA2 ZIC2 SRP54 CAV1 CFTR DHX38 IFT172 PPARG FXN WRN PLIN1 INSR WRN NDUFB9 WFS1 DLK1 MMP14 LEP PTPN1 ARL2BP PRCD EIF2AK3 CIDEC ITCH PRPH2 CDH23 NEK2 ATM PTRH2 TTPA SLC29A3 NDN NKX2-5 PDE11A NDUFS8 REEP6 AGBL5 ZMPSTE24 PROM1 NDUFS6 TRNK AEBP1 PRSS2 LEPR TBL2 BBS2 COL2A1 LRP6 GCK POC1A PDX1 CTNS CORIN PNPLA2 IFT140 PPP1R15B FOXP1 RFC2 CTRC NDUFS1 LMNA PTPN22 SNORD116-1 LEPR RNASEH2C RRM2B LIMK1 BLK NOTCH3 HMGA2 TWNK CNOT1 FLT1 NEUROD1 KCNJ11 ABCA4 IDH3A CDKN2A NDUFA6 KIZ ABCC8 ATM BRCA2 ND6 NDUFS2 LMNA ND3 IMPG2 MST1 TGIF1 PAX4 WFS1 KCNJ11 FXN NOP10 KDSR MEG3 OPA1 TRNQ TUB HYMAI CISD2 DNAJC3 STOX1 IL2RA NDUFS7 NDUFA1 NUBPL BSCL2 PEX1 COX2 SPINK1 PAX4 RTEL1 INS NDUFB3 COX3 CASR SMAD4 GCK ITPR3 SNRPN HBB POLG NDP OTX2 SLC12A3 TRNE PNPLA6 APOA5 LMNA GCK STAT3 POMGNT1 PDE6G WFS1 GLI2 CLCNKB ALMS1 AHI1 LEMD3 HNF1A BBS2 GJB3 ABCC8 TP53 ITCH RP1L1 PLAGL1 LMNA PALB2 NDUFAF2 CRB1 CNGA1 DMPK PPP1R3A PNPLA2 PTCH1 WRAP53 STAT3 SAMHD1 HYMAI NDUFV1 HGSNAT HNF1B HNF4A SLC29A3 ARMC5 CCDC28B KRAS GTF2I MAGEL2 TWNK HNF1A PRPF3 VANGL2 GUCA1B TMEM126B EIF2AK3 TRNV TERT KCNJ11 PTF1A FBN1 IGF2BP2 ARL6 COX2 HFE AIP NR2E3 PCARE MAK KCNJ11 HLA-DQB1 ABCC8 NDN PLCD1 NDUFAF4 POLD1 CEL VANGL2 NSMCE2 PSTPIP1 SOX2 SIX3 ND5 TCF7L2 NEUROG3 MKKS CAV1 SMPD4 SLC16A2 PDX1 FSCN2 PRKACA CA4 MC4R TRNL1 PRKACA CTC1 ADA2 PRSS2 SNRPN RGR AHR DMXL2 PRPF4 KLF11 ADAR SARS2 MOG MEN1 HERC2 CP ND5 INSR LRAT MAFA EFL1 HNF1A TERC FOXC2 SCAPER FOS CRX DLK1 KIAA1549 MAGEL2 MLXIPL DNAJC3 PRPF31 AIRE PRPF6 PARN DKC1 NEUROD1 APOE PPARG WFS1 ABCC8 LRBA AR NRL NHP2 GPR35 BAZ1B RDH12 ERGIC1 ARL6 NDUFAF1 SLC30A8 PDX1 COX3 ABCC8 INS C8ORF37 IER3IP1 PRKAR1A KCNJ11 CEL INS TRNL1