[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-studies-list:{\"conditionNormalized\":\"hyperinsulinemia\",\"overallStatus\":[\"RECRUITING\",\"AVAILABLE\",\"NOT_YET_RECRUITING\"],\"orderBy\":\"LastUpdateSubmitDate:desc\",\"size\":25,\"offset\":0}":3,"health-study-condition:hyperinsulinemia":29},{"pageToken":4,"total":5,"offset":6,"count":5,"results":7},null,6,0,[8,50,74,105,129,153],{"id":9,"slug":10,"hasResults":11,"nctId":12,"briefTitle":13,"officialTitle":13,"acronym":4,"eligibilityCriteria":14,"healthyVolunteers":15,"sex":16,"minAge":17,"maxAge":18,"enrollmentInfo":19,"targetDuration":4,"studyType":22,"phases":4,"briefSummary":23,"conditions":24,"keywords":30,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":38,"lastUpdatePostDateStruct":39,"startDateStruct":42,"completionDateStruct":44,"leadSponsor":46,"locationsCount":49},"100314492","clinical-and-molecular-characteristics-of-primary-aldosteronism-in-blacks-100314492",false,"NCT03374215","Clinical and Molecular Characteristics of Primary Aldosteronism in Blacks","* INCLUSION CRITERIA:\n\nInclusion criteria for main study:\n\n* Age greater than or equal to 18y.\n* Self-described Black race. Those with reported other racial backgrounds may enroll in protocol 00-CH-0160 instead.\n* Evidence supportive of the diagnosis of PA (e.g. HTN, hypokalemia, known adrenal nodule, elevated ARR, etc).\n* Willing and able to return to the NIH for follow-up evaluation.\n\nInclusion criteria for blood (peripheral) DNA only study:\n\n* Age greater than or equal to 7y.\n* Relative of a patient that participates in the main study (above) (i) with family history of hypertension, ACTs, or both, or (ii) with a genetic mutation identified in the course of the genetic investigations described in the main study.\n\nEXCLUSION CRITERIA:\n\nExclusion criteria for main study:\n\n* Individuals over the age of 70 years will be excluded because of the possibility of comorbidities that may significantly affect appropriate initial work-up and post-operative management. In addition, research data may be compromised by the inability to interpret data collected from patients over the age of 70 years that may be on multiple medications for a variety for reasons.\n* Women who are pregnant or nursing will be excluded for safety concerns with hyperaldosteronism workup.\n* Individuals whose medical status will not allow them, for safety reasons, to participate in the provocative testing (e.g. NYHA Class III or IV heart failure, or CKD Stage 3b or worse), or who in the opinion of the investigators have unacceptably high risk for surgical morbidity and mortality (e.g. Revised Cardiac Risk Index Class IV or above, or American Society of Anesthesiologists Physical Status Class 3 or above) will be excluded from the protocol, as they will not be able to participate profitably in the research aspects of this protocol.\n* Individuals who have current substance abuse or a psychiatric disorder or any other condition that in the opinion of the investigators would impede competence, compliance, or participation in the study.\n* Individuals found to have a known inherited syndrome as the cause for hormone over-secretion will be excluded from participation in this protocol, as the mechanisms of hormone over-secretion and tumorigenesis is likely to be distinct in these individuals. Specific examples of syndromes that may be excluded from this protocol include individuals with Carney complex, McCune-Albright syndrome, and MEN-1. If inquiries are received from such patients, they will be referred to the appropriate ongoing protocols, if possible.\n* Family members who end up being diagnosed with PA will be referred to the 00-CH-0160 protocol, to avoid selection bias in genetic mutation analyses for PA.\n* Patients unwilling or unable to abide by procedures of the protocol.\n\n\\\u003CTAB\\>\n\nExclusion criteria for the DNA only study:\n\n-Patients unwilling or unable to provide peripheral blood for DNA studies.",true,"ALL","7 Years","70 Years",{"count":20,"type":21},1150,"ESTIMATED","OBSERVATIONAL","Background:\n\nThe adrenal gland makes the hormone aldosterone. This helps regulate blood pressure. An adrenal gland tumor that makes too much aldosterone can cause high blood pressure and low potassium. The cause of these tumors is unknown, but sometimes they are inherited.\n\nObjective:\n\nTo study the genes that may cause primary aldosteronism in Black individuals.\n\nEligibility:\n\nPeople ages 18-70 who:\n\nAre Black, African American, or of Caribbean descent\n\nAnd have difficult to control blood pressure or primary aldosteronism\n\nRelatives of people with primary aldosteronism\n\nDesign:\n\nParticipants who are relatives of people with primary aldosteronism will have only 1 visit, with medical history and blood tests.\n\nParticipants with primary aldosteronism or difficult to control blood pressure (suspected to possibly have primary aldosteronism) will be screened with a 1-2 hour visit. If they qualify, they will return for a hospital stay for 7-10 days. Tests may include:\n\nMedical history\n\nPhysical exam\n\nBlood tests: Participants will have a small tube (IV catheter) inserted in a vein in the arm. They may drink a glucose-containing liquid or get a salt solution. If medically indicated, they may have invasive blood tests with a separate consent.\n\nUrine tests: Some require a high-salt diet for 3 days.\n\nHeart tests\n\nScans: Participants lie in a machine that takes pictures of the body. A dye may be injected through a vein.\n\nSmall hair sample taken from near the scalp.\n\nKidney ultrasound\n\nBone density scan: Participants lie on a table while a camera passes over the body.\n\nIf the doctors feel it is medically necessary, they will offer participants treatment depending on their results. These treatments may cure the patient of their disease and may include:\n\n1. Having one adrenal gland removed by the Endocrine surgeon under anesthesia. Patients will have follow-up visits 2-4 weeks after surgery.\n2. Taking drugs to block the effects of aldosterone\n\nParticipants may return about 1 year later to repeat testing.",[25,26,27,28,29],"Adrenal Gland Neoplasm","Hypertension","Bone Diseases, Metabolic","Cardiovascular Disease","Hyperinsulinemia",[31,32,33,34,35,36],"Adrenal Adenoma","Molecular Genetics","African-American","Biomarkers","Primary Aldosteronism","Natural History","RECRUITING","2026-06-10",{"date":40,"type":41},"2026-06-11","ACTUAL",{"date":43,"type":41},"2017-12-14",{"date":45,"type":21},"2026-12-31",{"name":47,"class":48},"National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)","NIH",1,{"id":51,"slug":52,"hasResults":11,"nctId":53,"briefTitle":54,"officialTitle":54,"acronym":4,"eligibilityCriteria":55,"healthyVolunteers":15,"sex":16,"minAge":56,"maxAge":57,"enrollmentInfo":58,"targetDuration":4,"studyType":22,"phases":4,"briefSummary":60,"conditions":61,"keywords":4,"overallStatus":63,"whyStopped":4,"lastUpdateSubmitDate":64,"lastUpdatePostDateStruct":65,"startDateStruct":67,"completionDateStruct":69,"leadSponsor":71,"locationsCount":4},"100636348","application-of-freestyle-libre-2-for-evaluating-glycemic-variability-characteristics-in-patients-with-extreme-glucose-metabolism-phenotypes-100636348","NCT07564518","Application of FreeStyle Libre 2 for Evaluating Glycemic Variability Characteristics in Patients With Extreme Glucose Metabolism Phenotypes","1. Inclusion Criteria:\n\n   1. Group A1:\n\n      * Age ≥ 18 years;\n      * Patients with β cell dysfunction monogenic diabetes confirmed by DNA sequencing or other diagnostic testing.\n   2. Group A2:\n\n      * Age ≥ 18 years;\n      * Patients with confirmed type 2 diabetes mellitus;\n      * Derived from this center's existing continuous glucose monitoring (CGM) database.\n   3. Group B1:\n\n      * Age ≥ 18 years;\n      * Normal fasting plasma glucose (≥ 3.6 and \\\u003C 6.1 mmol\u002FL) and normal 2-hour plasma glucose during OGTT (≥ 3 and \\\u003C 7.8 mmol\u002FL);\n      * Fasting insulin ≥ 25 µU\u002FmL and\u002For 2-hour insulin during OGTT greater than 10 times the fasting insulin level.\n   4. Group B2:\n\n      * Age ≥ 18 years;\n      * Normal glucose tolerance meeting the 2024 ADA criteria: fasting plasma glucose \\\u003C 5.6 mmol\u002FL, 2-hour plasma glucose during OGTT \\\u003C 7.8 mmol\u002FL;\n      * According to laboratory reference standards, fasting insulin ≥ 2.6 and \\\u003C 25 µU\u002FmL, and 2-hour insulin during OGTT 5-10 times the fasting insulin level.\n      * Derived from this center's existing continuous glucose monitoring (CGM) database.\n2. Exclusion Criteria:\n\n   1. Neonates younger than 4 months of age (congenital diabetes);\n   2. Pregnancy;\n   3. Patients with positive pancreatic autoantibody test results;\n   4. Patients with severe cardiovascular or cerebrovascular diseases, hepatic disease, or renal disease;\n   5. Patients who have participated in other clinical trials.","18 Years","75 Years",{"count":59,"type":21},120,"This cross-sectional study aims to further subdivide diabetes mellitus into more homogeneous subgroups by focusing on extreme glucose metabolism phenotypes, including monogenic diabetes with β cell dysfunction, hyperinsulinemia caused by excessive β cell secretion, and postprandial hypoglycemia phenotypes. By utilizing continuous glucose monitoring (CGM) technology and the FreeStyle Libre 2 glucose monitoring device, this study will evaluate glycemic variability patterns in patients with extreme glucose metabolism phenotypes and perform comparative analyses using existing CGM data from healthy populations and patients with type 2 diabetes in our center's database. The study aims to address current gaps in understanding glycemic variability characteristics under extreme β cell functional states, provide novel dynamic monitoring evidence to support early identification, precise classification, and personalized management of these special metabolic states, and simultaneously screen for biomarkers to enable more accurate disease identification, thereby offering potential avenues for improving personalized treatment of diabetes mellitus.",[62,29],"Monogenic Diabetes","NOT_YET_RECRUITING","2026-05-31",{"date":66,"type":41},"2026-06-02",{"date":68,"type":21},"2026-05-25",{"date":70,"type":21},"2027-01-09",{"name":72,"class":73},"Peking University People's Hospital","OTHER",{"id":75,"slug":76,"hasResults":11,"nctId":77,"briefTitle":78,"officialTitle":79,"acronym":80,"eligibilityCriteria":81,"healthyVolunteers":15,"sex":16,"minAge":56,"maxAge":82,"enrollmentInfo":83,"targetDuration":4,"studyType":85,"phases":86,"briefSummary":88,"conditions":89,"keywords":93,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":96,"lastUpdatePostDateStruct":97,"startDateStruct":99,"completionDateStruct":101,"leadSponsor":103,"locationsCount":49},"100561599","phase-1-graded-insulin-suppression-test-pf-100561599","NCT06592261","Graded Insulin Suppression Test P&F","Human Models of Selective Insulin Resistance: Graded Insulin Suppression Test (GIST) Pilot & Feasibility Study","GIST","Inclusion Criteria:\n\n* Body mass index of 18-25 and 30-45 kg\u002Fm2\n* Able to understand written and spoken English and\u002For Spanish\n* Fasting euinsulinemia (fasting serum insulin of 4-10 μU\u002FmL) for reference group or hyperinsulinemia (fasting serum insulin ≥ 13 μU\u002FmL) for hyperinsulinemic group on screening labs\n* Written informed consent (in English or Spanish) and any locally required authorization (e.g., Health Insurance Portability and Accountability Act) obtained from the participant prior to performing any protocol-related procedures, including screening evaluations.\n\nExclusion Criteria:\n\n* Unable to provide informed consent in English or Spanish\n* Unwillingness to use only bedpan or urinal to void or to refrain from non-emergent mobile device use during the GIST\n* Documented weight loss of ≥ 5% of baseline within the previous 6 months\n* Systolic blood pressure \\\u003C 90 mm Hg or \\> 160 mm Hg, and\u002For\n* Diastolic blood pressure \\\u003C 60 mm Hg or \\> 100 mm Hg\n* Abnormal resting heart rate: \\\u003C 60 or ≥ 110 bpm\n* Sinus brady or tachycardia that has been worked up and considered benign by the recruit's personal physician may be permitted at the PI's discretion\n* Abnormal screening electrocardiogram (or if on file, performed within previous 90 d):\n\n  * Non-sinus rhythm\n  * Heart conduction blocks\n  * Previously unknown ischaemic changes that persist on repeat EKG:\n  * ST elevations\n  * T-wave inversions in a vascular distribution\n* Hemoglobin A1c ≥ 5.7%, and\u002For\n* Fasting plasma glucose ≥ 100 mg\u002FdL\n* Positive qualitative β-hCG (i.e., pregnancy test) in women of childbearing potential\n* Positive urine drug screen, except for lawfully prescribed medications and\u002For marijuana, provided that participant agrees to refrain from marijuana use during the period that they refrain from alcohol.\n* Transaminases (AST or ALT) \\> 3.0 x the upper limit of normal\n* Total bilirubin \\> 1.25 x the upper limit of normal\n* Abnormal sodium, potassium, chloride, or bicarbonate levels that are considered potentially significant according to the clinical judgment of the PI.\n* Creatinine equating to estimated glomerular filtration rate \\\u003C 60 mL min-1 1.73 m-2\n* Hemoglobin \\\u003C 10 g\u002FdL or hematocrit \\\u003C 30%\n* Platelet count \\\u003C 100,000\u002FμL\n* Women currently pregnant, measured by serum and\u002For urine β-hCG\n* Women currently breastfeeding\n* History of having met any of the American Diabetes Association's definitions of prediabetic state during adulthood or diabetes mellitus (i.e., overt diabetes) at any time:\n\n  * Hemoglobin A1c ≥ 5.7%, or rapid rise in documented HbA1c values causing clinical concern for evolving insulin deficiency\n  * Plasma glucose ≥ 100 mg\u002FdL after 8-h fast\n  * Plasma glucose of ≥ 140 mg\u002FdL at 2 h after ingestion of a 75-g glucose load\n  * Random plasma glucose ≥ 200 mg\u002FdL associated with typical hyperglycemic symptoms, diabetic ketoacidosis, or hyperglycemic-hyperosmolar state\n* History of gestational diabetes mellitus within the previous 5 years\n* Use of most antidiabetic medications within the 30 days prior to screening\n\n  * Excluded: thiazolidinediones, sulfonylureas, meglitinides, DPP4 inhibitors, GLP-1 receptor agonists, SGLT2 inhibitors, amylin mimetics, acarbose, insulin\n  * Metformin is acceptable provided that recruits meet all of the inclusion criteria at screening\n* Known, documented history, at the time of screening, of any of the following medical conditions:\n\n  * Pancreatic pathology, including but not limited to: Pancreatic neoplasia (unless appropriately evaluated and considered benign and not producing hormones), Chronic pancreatitis, History of acute pancreatitis within the past 5 years\n  * Cardiovascular diseases (N.B. uncomplicated hypertension is not exclusionary)\n  * Atherosclerotic cardiovascular disease\n  * Stable or unstable angina\n  * Myocardial infarction\n  * Ischaemic or hemorrhagic stroke\n  * Peripheral arterial disease (claudication)\n  * Use of dual antiplatelet therapy (aspirin + P2Y12 inhibitor)\n  * History of percutaneous coronary intervention\n  * Heart rhythm abnormalities (non-sinus)\n  * Congestive heart failure of any New York Heart Association class\n  * Severe valvular heart disease (e.g., aortic stenosis)\n  * Pulmonary hypertension\n* Chronic kidney disease, Stage 3 or higher (estimated glomerular filtration rate \\\u003C 60 mL\u002Fmin\u002F1.73 m2), of any cause\n* Advanced or severe liver disease, including but not limited to:\n\n  * Advanced liver fibrosis, as determined by non-invasive testing\n  * Cirrhosis of any etiology\n  * Autoimmune hepatitis or other rheumatologic disorder affecting the liver\n  * Biliopathy (e.g., progressive sclerosing cholangitis, primary biliary cholangitis)\n  * Hepatocellular carcinoma\n  * Infiltrative disorders (e.g., sarcoidosis, hemochromatosis, Wilson disease)\n* Gallstone disease, including:\n\n  * Biliary colic (active)\n  * History of acute cholecystitis not treated with cholecystectomy\n  * History of other gallstone complications (e.g., pancreatitis, cholangitis)\n* Chronic viral illness (N.B. diagnosis based only on medical history and not by laboratory confirmation)\n* Hepatitis B virus (HBV), unless previously successfully eradicated with antiviral drugs that have been discontinued for at least 30 d prior to screening\n* Hepatitis C virus (HCV) infection, unless previously successfully eradicated with antiviral drugs that have been discontinued for at least 30 d prior to screening\n* Human immunodeficiency virus (HIV) infection\n* Active seizure disorder (including controlled with antiepileptic drugs)\n* Psychiatric diseases causing functional impairment that:\n\n  * Are or have been decompensated within 1 year of screening, and\u002For\n  * Require use of anti-dopaminergic antipsychotic drugs associated with significant weight gain\u002Fmetabolic dysfunction (e.g., clozapine, olanzapine), monoamine oxidase inhibitors, tricyclic antidepressants, or lithium\n* Other endocrinopathies:\n\n  * Cushing syndrome (okay if considered in remission after treatment, provided that no exogenous corticosteroids or other ongoing treatment are required)\n  * Adrenal insufficiency\n  * Primary aldosteronism\n* Venous thromboembolic disease (deep vein thrombosis or pulmonary embolism) or any required use of therapeutic anticoagulation\n* Bleeding disorders, including due to anticoagulation, or significant anemia\n* Active malignancy, or hormonally active benign neoplasm, except allowances for:\n\n  * Non-melanoma skin cancer\n  * Differentiated thyroid cancer (AJCC Stage I only)\n* Clinical concern for increased risk of volume overload, including due to medications and\u002For heart\u002Fliver\u002Fkidney problems, as listed above\n* Clinical concern for increased risk of hypokalemia, including low potassium on screening labs (i.e., below lower limit of normal), use of certain medications, or any medical conditions listed above\n* Use of prescribed medications used for any of the indications in the preceding list of excluded conditions, or their use within 30 d prior to screening, except allowances for:\n\n  * Use of drugs prescribed for indications other than the exclusionary diagnoses\u002Fpurposes listed above (e.g., antiepileptic drugs used for non-seizure indications, ACEi\u002FARB used for uncomplicated hypertension rather than for congestive heart failure, etc.). Note, as above, that antidiabetic drugs except metformin within 30 d of screening are excluded.\n* Oral or parenteral corticosteroids (at greater than prednisone 5 mg daily, or equivalent) for more than 3 days within the previous 30 days; topical and inhaled formulations are permitted.\n* Beta blockers or non-dihydropyridine calcium channel blockers (verapamil or diltiazem)\n* History of certain weight-loss (bariatric) surgery, including:\n\n  * Roux-en-Y gastric bypass\n  * Biliopancreatic diversion\n  * Restrictive procedures (lap band, sleeve gastrectomy) performed within the past 6 months\n* Clinical concern for alcohol overuse, including recent documented history during screening and\u002For participant report of regularly consuming more than 2 drinks per day for males or 1 drink per day for females.\n* History of severe infection or ongoing febrile illness within 14 days of screening\n* Any other disease, condition, or laboratory value that, in the opinion of the investigator, would place the participant at an unacceptable risk and\u002For interfere with the analysis of study data.\n* Known allergy\u002Fhypersensitivity to any component of the medicinal product formulations, foods, IV infusion equipment, plastics, adhesive or silicone, history of infusion site reactions with IV administration of other medicines, or ongoing clinically important allergy\u002Fhypersensitivity as judged by the investigator.\n* Concurrent enrollment in another clinical study of any investigational drug therapy within 30 days prior to screening or within 5 half-lives of an investigational agent, whichever is longer.","65 Years",{"count":84,"type":21},15,"INTERVENTIONAL",[87],"PHASE1","The goal of this study is to learn about how the hormone insulin controls blood sugar in a variety of people. The main question it aims to answer is about how much insulin the body actually needs to maintain a normal blood sugar level. Participants will be asked to come in for a one-day study visit in which they will undergo a \"graded insulin suppression test\" (\"GIST\"). The GIST involves intravenous (into the vein) infusions of octreotide, a medication that turns off the body's own production of insulin, as well as replacement of insulin at two different levels (low and high), with or without replacement of glucagon, and glucose (sugar). The study investigators will check blood sugar levels every few minutes during the procedure to determine the effect of the two different insulin levels. This study will evaluate the GIST in both healthy volunteers and those at higher risk for type 2 diabetes.",[90,29,91,92],"Insulin Resistance","Obesity","Healthy",[94,29,95,91],"Insulin resistance","Type 2 diabetes","2026-05-26",{"date":98,"type":41},"2026-05-28",{"date":100,"type":41},"2024-09-16",{"date":102,"type":21},"2026-08",{"name":104,"class":73},"Columbia University",{"id":106,"slug":107,"hasResults":11,"nctId":108,"briefTitle":109,"officialTitle":110,"acronym":4,"eligibilityCriteria":111,"healthyVolunteers":11,"sex":16,"minAge":56,"maxAge":82,"enrollmentInfo":112,"targetDuration":4,"studyType":85,"phases":114,"briefSummary":115,"conditions":116,"keywords":119,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":122,"lastUpdatePostDateStruct":123,"startDateStruct":125,"completionDateStruct":126,"leadSponsor":128,"locationsCount":49},"100623974","phase-1-effect-of-insulin-lowering-on-lipogenesis-100623974","NCT07403604","Effect of Insulin Lowering on Lipogenesis","Human Models of Selective Insulin Resistance: Diazoxide, Part I","Inclusion Criteria:\n\n* Adults aged 18-65 years\n* Body mass index of 30-45 kg\u002Fm2\n* Able to understand written and spoken English and\u002For Spanish\n* Able to have pre-randomization screening labs drawn and study protocol initiated within 60 days of eligibility determination\n* Presence of uncomplicated metabolic dysfunction-associated steatotic liver disease (MASLD) by vibration-controlled transient elastography (VCTE)\n\n  * Steatosis score of S1-S3\n  * Fibrosis score of F0-F2 (Note that if VCTE result is available from within past 6 months, then do not have to repeat VCTE for study purposes)\n* Evidence of insulin resistance, represented by any or all of the following criteria:\n\n  * Meeting either of the American Diabetes Association's definitions for prediabetes or impaired fasting glucose (IFG) on screening labs:\n\n    * Prediabetes: Hemoglobin A1c 5.7-6.4%\n    * IFG: plasma glucose of 100-125 mg dL-1 after ≥ 8-h fast\n  * Homeostasis Model of Insulin Resistance (HOMA-IR) score ≥ 2.73\n* Fasting hyperinsulinemia (fasting insulin level ≥ 13 μU\u002FmL) on screening labs\n* Written informed consent (in English or Spanish) and any locally required authorization (e.g., Health Insurance Portability and Accountability Act) obtained from the participant prior to performing any protocol-related procedures, including screening evaluations.\n\nExclusion Criteria:\n\n* Unable to provide informed consent in English or Spanish\n* Concerns arising at screening visit (any of the following):\n\n  * Documented weight loss of ≥ 5.0% of baseline within the previous 3 months\n  * Abnormal blood pressure (including on treatment, if prescribed)\n\n    * Systolic blood pressure (SBP) \\\u003C 90 mm Hg or \\> 160 mm Hg, and\u002For\n    * Diastolic blood pressure (DBP) \\\u003C 60 mm Hg or \\> 100 mm Hg\n  * Resting heart rate \\\u003C 55 bpm or ≥ 110 bpm\n  * Abnormal screening electrocardiogram (or if on file, performed within previous 90 days)\n  * Laboratory evidence of diabetes mellitus:\n\n    * Hemoglobin A1c ≥ 6.5%, and\u002For\n    * Fasting plasma glucose ≥ 126 mg\u002FdL\n  * Positive qualitative serum β-human chorionic gonadotropin (β-hCG, i.e., pregnancy test) in women of childbearing potential\n  * Liver function abnormalities: transaminases (aspartate aminotransferase or alanine aminotransferase) \\> 3.0 x the upper limit of normal, and\u002For total bilirubin \\> 1.25 x the upper limit of normal\n  * Abnormal screening fasting triglycerides \\> 500 mg\u002FdL\n  * Abnormal screening serum electrolytes that are considered clinically significant according to the clinical judgment of the PI\n  * Creatinine equating to estimated glomerular filtration rate \\\u003C 60 mL\u002Fmin\u002F1.73 m2\n  * Abnormal screening blood counts (any of the following):\n\n    * Hemoglobin \\\u003C 10 g\u002FdL\n    * White blood cell count below the lower limit of normal for sex\n    * Platelet count below the lower limit of normal for sex\n  * Uric acid level above the upper limit of normal\n* Reproductive concerns\n\n  * Women currently pregnant (tested by serum and\u002For urine β-hCG)\n  * Women currently breastfeeding\n* Concerns related to glucose metabolism\n\n  * History of having met any of the American Diabetes Association's definitions of diabetes mellitus (i.e., overt diabetes):\n\n    * Hemoglobin A1c ≥ 6.5%\n    * Plasma glucose ≥ 126 mg\u002FdL after 8-h fast\n    * Plasma glucose of ≥ 200 mg\u002FdL at 2 h after ingestion of a 75-g glucose load\n    * Random plasma glucose ≥ 200 mg\u002FdL associated with typical hyperglycemic symptoms, diabetic ketoacidosis, or hyperglycemic-hyperosmolar state\n  * History of gestational diabetes mellitus within the previous 5 years\n  * Use of antidiabetic medications except metformin within the 90 days prior to screening\n  * Clinical concern for absolute insulin deficiency (e.g., type 1 diabetes, pancreatic disease)\n* Concerns related to lipid metabolism\n\n  * Known diagnoses of familial hypercholesterolemia, familial combined hyperlipidemia, or familial hyperchylomicronemia\n  * Use of fibrates, prescription-strength omega-3 fatty acids, or high-dose niacin within the 90 days prior to screening:\n* Known, documented history (i.e., not to be newly screened\u002Ftested for study purposes), at the time of screening, of any of the following medical conditions:\n\n  * Pancreatic pathology, including but not limited to neoplasia, pancreatitis, pancreatectomy\n  * Cardiovascular disease (N.B. uncomplicated hypertension is not exclusionary)\n\n    * Atherosclerotic cardiovascular disease: stable or unstable angina, myocardial infarction, ischaemic or hemorrhagic stroke, or transient ischaemic attack, peripheral arterial disease (claudication), use of dual antiplatelet therapy (aspirin + P2Y12 inhibitor), history of percutaneous coronary intervention\n    * Heart rhythm abnormalities\n    * Congestive heart failure of any New York Heart Association class\n    * Symptomatic valvular heart disease (e.g., aortic stenosis)\n    * Pulmonary hypertension\n  * Chronic kidney disease, Stage 3 or higher (estimated glomerular filtration rate \\\u003C 60 mL\u002Fmin\u002F 1.73 m2), of any cause\n  * Chronic liver disease other than uncomplicated MASLD, including but not limited to:\n\n    * Advanced liver fibrosis, as determined by non-invasive testing, including fibrosis scores of F3-F4 on VCTE\n    * Cirrhosis of any etiology\n    * Autoimmune hepatitis or other rheumatologic disorder affecting the liver\n    * Biliopathy (e.g., progressive sclerosing cholangitis, primary biliary cholangitis)\n    * Chronic liver infection (e.g., viral hepatitis, parasitic infestation)\n    * Hepatocellular carcinoma\n    * Infiltrative disorders (e.g., sarcoidosis, hemochromatosis, Wilson disease)\n  * Gout\n  * Chronic infection with hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV)\n  * Malabsorptive conditions\n  * Active seizure disorder (including controlled with antiepileptic drugs)\n  * Psychiatric diseases that are or have been decompensated within 1 year of screening, and\u002For require use of antipsychotic drugs associated with significant weight gain\u002Fmetabolic dysfunction (e.g., clozapine, olanzapine), monoamine oxidase inhibitors, tricyclic antidepressants, or lithium\n  * Known glucose-6-phosphate dehydrogenase (G6PD) deficiency\n  * Other clinically significant endocrinopathies\n  * Venous thromboembolic disease (deep vein thrombosis or pulmonary embolism) or any required use of therapeutic anticoagulation\n  * Active malignancy, or hormonally active benign neoplasm, except allowances for non-melanoma skin cancer and differentiated thyroid cancer (Stage I only)\n  * Clinical concern for increased risk of volume overload or hypotension (SBP \\\u003C90 and\u002For DBP \\\u003C60 mm Hg), including due to medications and\u002For heart\u002Fliver\u002Fkidney problems, as listed above\n* Clinical concern for increased risk of volume overload or hypotension (SBP \\\u003C90 and\u002For DBP \\\u003C60 mm Hg), including due to medications and\u002For heart\u002Fliver\u002Fkidney problems, as listed above\n* Use of certain medications currently or within 90 d prior to screening:\n\n  * Prescribed medications used for any of the indications in the preceding list of excluded conditions, or their use within 90 d prior to screening, except allowances for:\n\n    * Statins for primary prevention of cardiovascular disease\n    * Use of drugs prescribed for indications other than the exclusionary diagnoses\u002Fpurposes listed above (e.g., non-hydantoin antiepileptic drugs used for non-seizure indications, angiotensin converting enzyme inhibitor\u002Fangiotensin receptor blocker used for uncomplicated hypertension rather than for congestive heart failure, etc.)\n    * Vasodilating drugs for any indication: hydralazine, nitrates, phosphodiesterase-5 inhibitors (e.g., sildenafil, tadalafil), minoxidil (oral)\n    * Phenytoin or fosphenytoin for any indication\n    * Oral or parenteral corticosteroids (at greater than prednisone 5 mg daily, or equivalent) for more than 3 days within the previous 90 days; topical and inhaled formulations are permitted\n* History of certain weight-loss (bariatric) surgeries, including:\n\n  * Roux-en-Y gastric bypass\n  * Biliopancreatic diversion\n  * Restrictive procedures (lap band, sleeve gastrectomy) performed within past year\n* Clinical concern for alcohol overuse, including based on chart review and\u002For by participant's report of consuming more than 14 standard drinks per week for males or more than 7 standard drinks per week for females\n* Regular use of tobacco, either daily or an average of at least 1 cigarette per day, and\u002For nicotine vaping more than 1 day per week\n* Positive urine drug screen, except for lawfully prescribed medications or marijuana\u002Ftetrahydrocannabinol positivity, provided that the participant agrees not to use it during the same period that they will abstain from alcohol)\n* Atypical circadian rhythm, such as due to night shift work, within 30 days of screening or expected within 30 days of each treatment period\n* History of severe infection or ongoing febrile illness within 14 days of screening\n* Any other disease or condition or laboratory value that, in the opinion of the investigator, would place the participant at an unacceptable risk and\u002For interfere with the analysis of study data.\n* Known allergy\u002Fhypersensitivity to any component of the medicinal product formulations (including sulfa drugs), other biologics, intravenous (IV) infusion equipment, plastics, adhesive or silicone, history of infusion site reactions with IV administration of other medicines, or ongoing clinically important allergy\u002Fhypersensitivity as judged by the investigator.\n* Concurrent enrollment in another clinical study of any investigational drug therapy or use of any biologicals within 5 half-lives of an investigational agent or biologic",{"count":113,"type":21},25,[87],"The goal of this clinical trial is to compare a one-week course of diazoxide (2 mg\u002Fkg per dose x 14 doses) and placebo in people with obesity and insulin resistance (IR) with metabolic dysfunction-associated steatotic liver disease (MASLD). The main question it aims to answer are how mitigation of compensatory hyperinsulinemia with diazoxide affects hepatic de novo lipogenesis, a major contributor to MASLD pathophysiology.\n\nParticipants will:\n\n* Take 14 doses of placebo over 7 days, followed 4-12 weeks later by either 14 doses of diazoxide (at 2 mg per kg of body weight per dose \\[mpk\\]) or another 14 doses of placebo, over 7 days\n* Take 18 doses of heavy (deuterated) water (50 mL each) over 7 days, twice\n* Have blood drawn and saliva collected after an overnight fast on four mornings over the course of the study\n* Undergo insulin suppression tests (IST) to assess the degree of insulin resistance at the end of each 1-week study period\n* Consume their total calculated daily caloric needs as divided into three meals per day\n\nResearchers will compare blood tests at the beginning and end of each 1-week study period in participants randomized (like the flip of a coin) to receive either placebo followed by diazoxide or placebo followed by placebo, to see how the drug treatment affects de novo lipogenesis, serum insulin, plasma glucose, and other serum lipid parameters (triglycerides, free fatty acids), among others.",[29,90,117,118,91],"Non-Alcoholic Fatty Liver Disease","Prediabetic State",[29,90,120,117,121],"Metabolic Dysfunction-Associated Steatotic Liver Disease","Triglycerides","2026-04-06",{"date":124,"type":41},"2026-04-09",{"date":64,"type":21},{"date":127,"type":21},"2029-09-30",{"name":104,"class":73},{"id":130,"slug":131,"hasResults":11,"nctId":132,"briefTitle":133,"officialTitle":133,"acronym":4,"eligibilityCriteria":134,"healthyVolunteers":11,"sex":16,"minAge":56,"maxAge":82,"enrollmentInfo":135,"targetDuration":4,"studyType":85,"phases":137,"briefSummary":138,"conditions":139,"keywords":141,"overallStatus":63,"whyStopped":4,"lastUpdateSubmitDate":145,"lastUpdatePostDateStruct":146,"startDateStruct":148,"completionDateStruct":150,"leadSponsor":152,"locationsCount":49},"100558999","phase-1-human-models-of-selective-insulin-resistance-pancreatic-clamp-100558999","NCT06558422","Human Models of Selective Insulin Resistance: Pancreatic Clamp","Inclusion Criteria:\n\n* Men and women, ages 18-65 years\n* Body mass index of 27-50 kg\u002Fm2\n* Able to understand written and spoken English and\u002For Spanish\n* Evidence of insulin resistance, represented by any or all of the following criteria:\n\n  * Meeting either of the American Diabetes Association's definitions for prediabetes or Impaired fasting glucose (IFG) within the previous year and on screening labs:\n\n    1. Prediabetes: Hemoglobin A1c 5.7-6.4%\n    2. IFG: plasma glucose of 100-125 mg\u002FdL after 8-h fast\n* Homeostasis Model of Insulin Resistance (HOMA-IR) score ≥ 2.73\n* Fasting hyperinsulinemia (fasting insulin level ≥ 13 µU\u002FmL) on screening labs\n* Presence of uncomplicated MASLD, defined by vibration-controlled transient elastography (VCTE) as a steatosis score S1-S3 + fibrosis score F0-F2\n* Written informed consent (in English or Spanish) and any locally required authorization (e.g., Health Insurance Portability and Accountability Act) obtained from the participant prior to performing any protocol-related procedures, including screening evaluations.\n\nExclusion Criteria:\n\n* Unable to provide informed consent in English or Spanish\n* Unwillingness to use only bedpan or urinal to void or to refrain from non-emergent mobile device use during the clamp\n* Documented weight loss of ≥ 5% of baseline within the previous 3 months\n* Abnormal blood pressure (including on treatment, if prescribed)\n\n  * Systolic blood pressure \\\u003C 90 mm Hg or \\> 160 mm Hg, and\u002For\n  * Diastolic blood pressure \\\u003C 60 mm Hg or \\> 100 mm Hg\n* Abnormal resting heart rate: \\\u003C 60 or ≥ 110 bpm\n\n  * Sinus brady- or tachycardia that has been worked up and considered benign by the recruit's personal physician may be permitted at the PI's discretion\n* Abnormal screening electrocardiogram (or if on file, performed within previous 90 days)\n* Laboratory evidence of diabetes mellitus:\n\n  * Hemoglobin A1c ≥ 6.5%, and\u002For\n  * Fasting plasma glucose ≥ 126 mg\u002FdL\n* Positive qualitative β-hCG (Human chorionic gonadotropin, β subunit) (i.e., pregnancy test) in women of childbearing potential\n* Positive urine drug screen, except for lawfully prescribed medications and\u002For marijuana\n* Liver function abnormalities (either of the following)\n\n  * Transaminases (AST or ALT) \\> 3.0 x the upper limit of normal\n  * Total bilirubin \\> 1.25 x the upper limit of normal\n* Fasting serum triglycerides at screening ≥ 400 mg\u002FdL\n* Abnormal screening serum electrolytes that are considered potentially significant according to the clinical judgment of the PI\n* Abnormal complete blood count (CBC) (any of the following)\n\n  * Hemoglobin \\\u003C 10 g\u002FdL or hematocrit \\\u003C 30%\n  * Platelet count \\\u003C 100,000\u002FµL\n* Women currently pregnant, measured by serum and\u002For urine β-hCG, or trying to become pregnant\n* Women currently breastfeeding\n* History of having met any of the American Diabetes Association's definitions of diabetes mellitus (i.e., overt diabetes):\n\n  * Hemoglobin A1c ≥ 6.5%, or rapid rise in documented HbA1c values causing clinical concern for evolving insulin deficiency\n  * Plasma glucose ≥ 126 mg\u002FdL after 8-h fast\n  * Plasma glucose of ≥ 200 mg\u002FdL at 2 h after ingestion of a 75-g glucose load\n  * Random plasma glucose ≥ 200 mg\u002FdL associated with typical hyperglycemic symptoms, diabetic ketoacidosis, or hyperglycemic-hyperosmolar state\n* History of gestational diabetes mellitus within the previous 5 years\n* Use of most antidiabetic medications within the 30 days prior to screening\n\n  * Excluded: thiazolidinediones, sulfonylureas, meglitinides, DPP4 inhibitors, GLP-1 receptor agonists, SGLT2 inhibitors, amylin mimetics, acarbose, insulin\n  * Metformin is acceptable provided that recruits meet all of the inclusion criteria at screening\n* Clinical concern for absolute insulin deficiency (e.g., type 1 diabetes, pancreatic disease)\n* Known diagnoses of familial combined hyperlipidemia or familial chylomicronemia syndrome\n* Use of certain lipid-lowering drugs within 30 d prior to screening visit:\n\n  * Fibrates (e.g., fenofibrate, clofibrate, gemfibrozil)\n  * Prescription-strength omega-3 fatty acids (e.g., Lovaza®, Vascepa®)\n* Known, documented history, at the time of screening, of any of the following medical conditions:\n\n  * Pancreatic pathology\n  * Cardiovascular diseases (N.B. uncomplicated hypertension is not exclusionary)\n  * Chronic kidney disease, Stage 3 or higher (estimated glomerular filtration rate \\\u003C 60 mL min-1 1.73 m-2), of any cause\n  * Advanced or severe liver disease (including fibrosis scores of F3-F4 on screening VCTE)\n  * Gallstone disease\n  * Chronic viral illness\n  * Malabsorptive conditions (active)\n  * Active seizure disorder (including controlled with antiepileptic drugs)\n  * Psychiatric diseases causing functional impairment and\u002For requiring use of anti-dopaminergic antipsychotic drugs associated with significant weight gain\u002Fmetabolic dysfunction (e.g., clozapine, olanzapine), monoamine oxidase inhibitors, tricyclic antidepressants, or lithium\n  * Known adrenal disease\n  * Venous thromboembolic disease (deep vein thrombosis or pulmonary embolism) or any required use of therapeutic anticoagulation\n  * Bleeding disorders, including due to anticoagulation, or significant anemia (see above)\n  * Active malignancy, or hormonally active benign neoplasm\n* Clinical concern for increased risk of volume overload, including due to medications and\u002For heart\u002Fliver\u002Fkidney problems, as listed above\n* Clinical concern for increased risk of hypokalemia, including low potassium on screening labs (i.e., below lower limit of normal), use of certain medications, or any medical conditions listed above\n* Use of certain medications currently or within 30 d prior to screening:\n\n  * Prescribed medications used for any of the indications in the preceding list of excluded conditions, or their use within 30 d prior to screening, except allowances for:\n  * Use of drugs prescribed for indications other than the exclusionary diagnoses\u002Fpurposes listed above, e.g., antiepileptic drugs used for non-seizure indications, ACEi (angiotensin-converting enzyme inhibitor) \u002F ARB (angiotensin receptor blocker) used for uncomplicated hypertension rather than for congestive heart failure, etc. Note, as above, that antidiabetic drugs except metformin within 30 days of screening are excluded.\n  * Loop diuretics (furosemide, torsemide, ethacrynic acid)\n  * Oral or parenteral corticosteroids (at greater than prednisone 5 mg daily, or equivalent) for more than 3 days within the previous 30 days; topical and inhaled formulations are permitted\n  * Fludrocortisone\n  * Beta blockers or non-dihydropyridine calcium channel blockers (verapamil or diltiazem)\n* History of certain weight-loss (bariatric) surgery, including:\n\n  * Roux-en-Y gastric bypass\n  * Biliopancreatic diversion\n  * Restrictive procedures (lap band, sleeve gastrectomy) performed within the past 6 months\n* Clinical concern for alcohol overuse, including recent documented history during screening and\u002For participant report of regularly consuming more than 2 drinks per day for males or 1 drink per day for females.\n* Positive urine drug screen, with exceptions for:\n\n  * Lawfully prescribed medications\n  * Marijuana\u002FTHC positivity, provided that the participant agrees not to use it during the same period that they will abstain from alcohol\n* History of severe infection or ongoing febrile illness within 14 days of screening\n* Any other disease, condition, or laboratory value that, in the opinion of the investigator, would place the participant at an unacceptable risk and\u002For interfere with the analysis of study data.\n* Known allergy\u002Fhypersensitivity to any component of the medicinal product formulations, foods (including soy, dairy, peanuts, tree nuts, or egg), IV infusion equipment, plastics, adhesive or silicone, history of infusion site reactions with IV administration of other medicines, or ongoing clinically important allergy\u002Fhypersensitivity as judged by the investigator.\n* Concurrent enrollment in another clinical study of any investigational drug therapy within 30 days prior to screening or within 5 half-lives of an investigational agent, whichever is longer.",{"count":136,"type":21},36,[87],"This is a single-center, prospective, randomized, controlled (crossover) clinical study designed to investigate the impact of lowering insulin levels on hepatic glucose production (HGP) vs de novo lipogenesis (DNL) in people with insulin resistance. The investigators will recruit participants with a history of overweight\u002Fobesity and evidence of insulin resistance (i.e., fasting hyperinsulinemia plus prediabetes and\u002For impaired fasting glucose and\u002For Homeostasis Model Assessment of Insulin Resistance \\[HOMA-IR\\] score \\>=2.73), and with evidence of metabolic dysfunction-associated steatotic liver disease (MASLD). Participants will undergo two pancreatic clamp procedures -- one in which serum insulin levels are maintained near hyperinsulinemic baseline (Maintenance Hyperinsulinemia or \"MH\" Protocol) and the other in which serum insulin levels are lowered by 50% (Reduction toward Euinsulinemia or \"RE\" Protocol). In both clamps the investigators will use stable-isotope tracers to monitor hepatic glucose and triglyceride metabolism. The primary outcome will be the impact of steady-state clamp insulinemia on HGP vs DNL.",[90,29,140,117,118,91],"Metabolic Dysfunction Associated Steatotic Liver Disease",[94,29,142,143,144],"Diabetes","Non-alcoholic fatty liver disease","Metabolic dysfunction associated steatotic liver disease","2026-02-04",{"date":147,"type":41},"2026-02-06",{"date":149,"type":21},"2027-01-01",{"date":151,"type":21},"2029-02-28",{"name":104,"class":73},{"id":154,"slug":155,"hasResults":11,"nctId":156,"briefTitle":157,"officialTitle":158,"acronym":159,"eligibilityCriteria":160,"healthyVolunteers":11,"sex":16,"minAge":56,"maxAge":82,"enrollmentInfo":161,"targetDuration":4,"studyType":85,"phases":163,"briefSummary":164,"conditions":165,"keywords":166,"overallStatus":37,"whyStopped":4,"lastUpdateSubmitDate":167,"lastUpdatePostDateStruct":168,"startDateStruct":170,"completionDateStruct":172,"leadSponsor":174,"locationsCount":49},"100562681","phase-1-diazoxide-suppression-test-pf-study-100562681","NCT06606327","Diazoxide Suppression Test P&F Study","Human Models of Primary Hyperinsulinemia: Diazoxide Suppression Test (DzST) Pilot & Feasibility Study","DzST","Inclusion Criteria:\n\n* Men and women, aged 18-65 years\n* Body mass index of 30-45 kg\u002Fm2\n* Able to understand written and spoken English and\u002For Spanish\n* Fasting hyperinsulinemia (fasting serum insulin ≥ 13 μU\u002FmL)\n* Completion of the graded insulin suppression test (GIST) protocol (Group H)\n* Written informed consent (in English or Spanish) and any locally required authorization (e.g., Health Insurance Portability and Accountability Act) obtained from the participant prior to performing any protocol-related procedures, including screening evaluations.\n\nExclusion Criteria:\n\n* Unable to provide informed consent in English or Spanish\n* Documented weight loss of ≥ 5% of baseline within the previous 3 months\n* Abnormal blood pressure (including on treatment, if prescribed): Systolic blood pressure \\\u003C 90 mm Hg or \\> 160 mm Hg, and\u002For Diastolic blood pressure \\\u003C 60 mm Hg or \\> 100 mm Hg\n* Abnormal resting heart rate: \\\u003C 60 or ≥ 110 bpm\n* Sinus brady- or tachycardia that has been worked up and considered benign by the recruit's personal physician may be permitted at the PI's discretion\n* Abnormal screening electrocardiogram on GIST screening (or if on file, performed within previous 90 d):\n\n  * Non-sinus rhythm\n  * Heart conduction blocks\n  * Previously unknown ischaemic changes that persist on repeat EKG:\n  * ST elevations\n  * T-wave inversions in a vascular distribution\n* Laboratory evidence of dysglycemia on GIST screening:\n\n  * Hemoglobin A1c ≥ 5.7%, and\u002For\n  * Fasting plasma glucose ≥ 100 mg\u002FdL\n* Positive qualitative β-hCG (i.e., pregnancy test) in women of childbearing potential (both on the day of screening and on the first day of the DzST, prior to receipt of diazoxide doses)\n* Positive urine drug screen during GIST screening or on first day of DzST, except for lawfully prescribed medications and\u002For marijuana, provided that participant agrees to refrain from marijuana use during the period that they refrain from alcohol.\n* Liver function abnormalities (either of the following) on GIST screening:\n\n  * Transaminases (AST or ALT) \\> 3.0 x the upper limit of normal\n  * Total bilirubin \\> 1.25 x the upper limit of normal\n  * These exclusion criteria may be waived if the recruit's personal hepatologist approves an exception\n* Abnormal screening serum electrolytes (any of the following) on GIST screening:\n\n  * Abnormal sodium, potassium, chloride, or bicarbonate levels that are considered potentially significant according to the clinical judgment of the PI.\n  * Creatinine equating to estimated glomerular filtration rate \\\u003C 60 mL\u002Fmin\u002F1.73 m2\n* Uric acid level above the upper limit of normal\n* Women currently pregnant, measured by serum and\u002For urine β-hCG at DzST screening (and on first study visit of DzST)\n* Women currently breastfeeding\n* History of having met any of the American Diabetes Association's definitions of prediabetic state or diabetes mellitus (i.e., overt diabetes):\n\n  * Hemoglobin A1c ≥ 5.7%, or rapid rise in documented HbA1c values causing clinical concern for evolving insulin deficiency\n  * Plasma glucose ≥ 100 mg\u002FdL after 8-h fast\n  * Plasma glucose of ≥ 140 mg\u002FdL at 2 h after ingestion of a 75-g glucose load\n  * Random plasma glucose ≥ 200 mg\u002FdL associated with typical hyperglycemic symptoms, diabetic ketoacidosis, or hyperglycemic-hyperosmolar state\n* History of gestational diabetes mellitus within the previous 5 years\n* Use of most antidiabetic medications within the 30 days prior to screening\n\n  * Excluded: thiazolidinediones, sulfonylureas, meglitinides, dipeptidyl peptidase-4 (DPP4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, sodium-glucose cotransporter-2 (SGLT2) inhibitors, amylin mimetics, acarbose, insulin\n  * Metformin is acceptable provided that recruits meet all of the inclusion criteria at screening\n* Pancreatic pathology, including but not limited to:\n\n  * Pancreatic neoplasia, unless appropriately evaluated and considered benign and not producing hormones\n  * Chronic pancreatitis\n  * History of acute pancreatitis within the past 5 years\n* Cardiovascular diseases (N.B. uncomplicated hypertension is not exclusionary)\n* Atherosclerotic cardiovascular disease\n* Stable or unstable angina\n* Myocardial infarction\n* Ischaemic or hemorrhagic stroke\n* Peripheral arterial disease (claudication)\n* Use of dual antiplatelet therapy\n* History of percutaneous coronary intervention\n* Heart rhythm abnormalities (non-sinus)\n* Congestive heart failure of any New York Heart Association class\n* Severe valvular heart disease (e.g., aortic stenosis)\n* Pulmonary hypertension\n* Chronic kidney disease, Stage 3 or higher (estimated glomerular filtration rate \\\u003C 60 mL\u002Fmin\u002F1.73 m2), of any cause\n* Advanced or severe liver disease, including but not limited to:\n\n  * Advanced liver fibrosis, as determined by non-invasive testing\n  * Cirrhosis of any etiology\n  * Autoimmune hepatitis or other rheumatologic disorder affecting the liver\n  * Biliopathy (e.g., progressive sclerosing cholangitis, primary biliary cholangitis)\n  * Hepatocellular carcinoma\n  * Infiltrative disorders (e.g., sarcoidosis, hemochromatosis, Wilson disease)\n  * Gout\n  * Chronic viral illness (N.B. diagnosis based only on medical history; investigators will not test for any of these viruses at any point in this study)\n  * Hepatitis B virus (HBV), unless previously successfully eradicated with antiviral drugs that have been discontinued for at least 30 d prior to screening\n  * Hepatitis C virus (HCV) infection, unless previously successfully eradicated with antiviral drugs that have been discontinued for at least 30 d prior to screening\n  * Human immunodeficiency virus (HIV) infection\n* Active seizure disorder (including controlled with antiepileptic drugs)\n* Psychiatric diseases causing functional impairment that:\n\n  * Are or have been decompensated within 1 year of screening, and\u002For\n  * Require use of anti-dopaminergic antipsychotic drugs associated with significant weight gain\u002Fmetabolic dysfunction (e.g., clozapine, olanzapine), monoamine oxidase inhibitors, tricyclic antidepressants, or lithium\n* Cushing syndrome (okay if considered in remission after treatment, provided that no exogenous corticosteroids or other ongoing treatment are required)\n* Adrenal insufficiency\n* Active malignancy, or hormonally active benign neoplasm, except allowances for:\n\n  * Non-melanoma skin cancer\n  * Differentiated thyroid cancer (AJCC Stage I only)\n* Clinical concern for increased risk of volume overload, including due to medications and\u002For heart\u002Fliver\u002Fkidney problems, as listed above\n* Use of certain medications currently or within 30 d prior to screening:\n\n  * Prescribed medications used for any of the indications in the preceding list of excluded conditions, or their use within 30 d prior to screening, except allowances for use of drugs prescribed for indications other than the exclusionary diagnoses\u002Fpurposes listed above (e.g., antiepileptic drugs used for non-seizure indications, angiotensin converting enzyme inhibitors or angiotensin receptor blockers used for uncomplicated hypertension rather than for congestive heart failure, etc.)\n  * Oral or parenteral corticosteroids (at greater than prednisone 5 mg daily, or equivalent) for more than 3 days within the previous 30 days; topical and inhaled formulations are permitted\n* History of certain weight-loss (bariatric) surgery, including:\n\n  * Roux-en-Y gastric bypass\n  * Biliopancreatic diversion\n  * Restrictive procedures (lap band, sleeve gastrectomy) performed within the past 6 months\n* Clinical concern for alcohol overuse, including recent documented history during screening and\u002For participant report of regularly consuming more than 2 drinks per day for males or 1 drink per day for females.\n* Positive urine drug screen, with exceptions for:\n\n  * Lawfully prescribed medications\n  * Marijuana\u002FTHC positivity, provided that the participant agrees not to use it during the same period that they will abstain from alcohol\n* History of severe infection or ongoing febrile illness within 14 days of screening\n* Any other disease, condition, or laboratory value that, in the opinion of the investigator, would place the participant at an unacceptable risk and\u002For interfere with the analysis of study data.\n* Known allergy\u002Fhypersensitivity to any component of the medicinal product formulations (including sulfa drugs) or ongoing clinically important allergy\u002Fhypersensitivity as judged by the investigator.\n* Concurrent enrollment in another clinical study of any investigational drug therapy within 30 days prior to screening or within 5 half-lives of an investigational agent, whichever is longer. This restriction does not apply to participants who have participated in other studies performed by the PI (Dr. Cook).",{"count":162,"type":21},10,[87],"The goal of this study is to learn about how the hormone insulin controls blood sugar. The main question it aims to answer is about how much insulin the body actually needs to maintain a normal blood sugar level. People with obesity and high insulin levels will receive eight doses of diazoxide, a drug that suppresses the pancreas's production of insulin, and will have their fasting blood sugar and insulin levels checked daily while taking the drug.",[90,29,91],[94,29,95,91],"2025-12-06",{"date":169,"type":41},"2025-12-11",{"date":171,"type":41},"2024-10-23",{"date":173,"type":21},"2028-01",{"name":104,"class":73}]