Normal-weight Diabetes: Adipocyte-directed Therapy With Pioglitazone or Tirzepatide
Stanford University
Summary
This study is to investigate how adipocyte (fat cell) function and fat distribution differ between individuals with normal-weight type 2 diabetes (NWD), those with overweight type 2 diabetes (OWD), and normal-weight controls without diabetes (NWC). The study will assess whether adipocyte-directed therapies, specifically pioglitazone and tirzepatide, can improve insulin resistance, adipocyte function, and fat distribution in individuals with NWD. By analyzing the biological mechanisms underlying adipocyte dysfunction, the study aims to provide insights into novel treatment strategies for improving metabolic health in normal-weight individuals with type 2 diabetes.
Description
The investigators aim to learn how adipocyte dysfunction and disordered fat distribution contribute to the development of type 2 diabetes in normal-weight individuals. The investigators hope to determine whether adipocyte-directed therapies, such as pioglitazone and tirzepatide, can improve insulin sensitivity, fat distribution, and metabolic health in this population. This study is important because most diabetes research focuses on overweight or obese individuals, and very little is known about how diabetes affects those with normal body weight. Understanding the unique biology of normal-wei…
Eligibility
- Age range
- 30–70 years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: Normal-Weight Diabetes (NWD) Group: 1. Age: 30 to 70 years old. 2. Diagnosis of Type 2 Diabetes (T2D): Based on a previous diagnosis or confirmed by laboratory testing at screening (A1c \> 5.7% or fasting glucose \> 100 mg/dL). 3. HbA1c Range: Between 5.7% and 8%, with a stable medication or lifestyle regimen for at least 3 months. 4. BMI: Between 19 and 24.9 kg/m². 5. Diabetes Medications: All diabetes medications are allowed, except insulin and pioglitazone. GLP-1 receptor agonists are permitted if the dose has been stable for 3 months. 6. Stable Body Weight: Body weigh…
Interventions
- ProcedureInsulin resistance testing
Steady state Plasma Glucose test
- ProcedureOGTT
Will collect 5 blood draws during the test to measure insulin secretion
- ProcedureFat biopsy
Needle biopsy to gather a sample of abdominal subcutaneous fat
- RadiationDXA scan
Whole body DXA scan
- ProcedureMRI
Abdominal MRI
- Procedure1H-MRS
Spectroscopy of the abdominal region
- DrugTirzepatide
16 weeks started at 2.5mg/week and increased to 5mg/week dose
Locations (2)
- Stanford UniversityPalo Alto, California
- Stanford University, Clinical and Translational Research Unit (CTRU)Stanford, California