COMBINE trial: Glucose clamp technique as part of a new type 2 diabetes research trial

Researchers at Leicester Diabetes Centre (LDC) have successfully started using the glucose clamp technique as part of a new type 2 diabetes research trial. The gold-standard technique measures how sensitive a person is to the hormone insulin. In the COMBINE trial, the glucose clamp technique will determine how effective a low-energy diet is in improving insulin sensitivity in a South Asian population.

Research participant, Hanif, during the glucose clamp with Clinical Research Fellow, Dr Vaios Koutroukas and Dietitian, Frank Arsenyadis at Leicester Diabetes Centre

“In type 2 diabetes we see high blood sugar levels in the body which is often due to a resistance to insulin. Insulin acts to lower blood sugar concentrations. The glucose clamp technique is a way to accurately measure how resistant the body is to insulin. To do this, we give a fixed rate of insulin to the body and then see how much glucose we need to give the patient to maintain or “clamp” the glucose at a steady level,” explained Dr Gráinne Whelehan, Research Assistant at LDC. "The amount of glucose required to maintain stable blood sugar levels during the insulin infusion will tell us exactly how sensitive that person is to insulin. The more glucose we need to give the participant to keep the glucose stable, the less insulin resistant they are.”

Dietitian, Frank Arsenyadis, funded by the Wellcome Trust (Leicestershire Healthcare Inequalities Improvement Doctoral Training Programme) is leading the COMBINE trial that aims to see whether combining structured exercise and a high protein, low energy diet can minimise muscle loss while attempting to reverse type 2 diabetes. The team will also be looking to see if blood sugar control is improved during the 12-week trial.

“Being able to use innovative techniques like the glucose clamp in our research is instrumental in developing a deeper understanding of how interventions like low energy diets or exercise affect insulin sensitivity and resistance, providing vital insights that will shape the future of diabetes management,” added Pratik Choudhary, Professor of Diabetes for Leicester Diabetes Centre.

The National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre (BRC) funded COMBINE Trial is still looking for volunteers. Trial participants will be from the South Asian community, living with type 2 diabetes, aged between 40 – 65 years and have a body mass index (BMI) between 27 and 45.

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