Effect of Medium Chain Fatty Acids on Cognitive Function During Acute Hypoglycemia in Patients With Type 1 Diabetes
Effect of Medium Chain Fatty Acids on Cognitive Function During Acute Hypoglycemia in Patients With Type 1 Diabetes
At present, there are no therapeutic agents that can minimize severe hypoglycemia (low blood
 sugar) and its effects on long-term brain function. The aim of this study is to determine
 whether the human brain is able to use medium chain fatty acids (MCFA) and/or their
 metabolites as an alternative fuel source during acute hypoglycemia in patients with Type 1
 Diabetes Mellitus (T1DM). The hypothesis is that medium chain fatty acids will provide a
 rapidly absorbed, non-carbohydrate fuel that will improve cognitive performance during
 episodes of hypoglycemia (low blood sugar.)
Twelve subjects between the ages of 18 years and 55 years who have had Type 1 Diabetes
 Mellitus for more than five years and have had tight control of their diabetes as determined
 by screening blood work will be invited to participate. Each study subject will undergo two
 hypoglycemic clamp studies (a procedure where the blood sugar is closely regulated with
 intravenous insulin and glucose.) In these hypoglycemic clamp studies, cognitive testing will
 be performed during 90 minutes of normal blood glucose followed by 90 minutes of
 hypoglycemia. During the hypoglycemic period, either the MCFA or a placebo will be
 administered. Each subject will experience both conditions. The order in which the MCFA is
 given will be randomized.
Inclusion Criteria:

 -  Type 1 Diabetes Mellitus for greater than 5 years (C-peptide negative)

 -  Age 18-55 years

 -  Subject is on intensive insulin therapy resulting in a Hemoglobin A1c of less than
 7.5%

 -  History of frequent hypoglycemic events as defined as having at least one blood
 glucose of less than 60 mg/dl in the last four weeks

 Exclusion Criteria:

 -  History of hypoglycemia induced seizures

 -  Pregnancy

 -  Significant baseline anemia (hemoglobin < 11.0g/dl or hematocrit < 33%)

 -  A history of liver cirrhosis or porto-caval shunt surgery