Exocrine-Endocrine Pancreatic Crosstalk: Precision Pathways to Reframe Diabetes Pathophysiology
- Sponsor
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Study ID
- NCT07670871
- Status
- Not Yet Recruiting
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Conditions
- Chronic Pancreatitis
- Pancreatic Neoplasms
- Prediabetes
- Type 2 Diabetes Mellitus (T2DM)
Eligibility Criteria
- Sex
- ALL
- Age
- 20 Years - 78 Years
- Healthy Volunteers
- Not accepted
Study Details
The EXPAND study is a prospective observational study designed to investigate the biological mechanisms underlying the heterogeneity of type 2 diabetes and related metabolic disorders. The study will enroll adults with and without pancreatic disease, including patients undergoing pancreatic surgery, individuals with chronic pancreatitis, subjects at high risk of type 2 diabetes, and patients with newly diagnosed type 2 diabetes. Clinical, metabolic, imaging, genetic, microbiome, and molecular data will be integrated to identify distinct metabolic endotypes and to investigate the interactions between the exocrine pancreas, endocrine pancreas, and adipose tissue. The ultimate goal is to improve the understanding of diabetes pathophysiology and support the development of precision medicine approaches.
Key Dates
- First listed
- Jun 26, 2026
- Start date
- Sep 30, 2026
- Status verified
- Jun 2026
- Primary completion
- Nov 30, 2029
- Completion
- Sep 30, 2031
Study Design
- Enrollment
- 440 participants (estimated)
Arms
- Arm: Pancreatic Surgery for Non-Endocrine Pancreatic DiseaseAdults undergoing partial or total pancreatectomy for non-endocrine pancreatic disease. Participants will undergo clinical evaluation, metabolic phenotyping, imaging assessments, biomarker measurements, gut microbiome profiling from stool samples, and Genetic Risk Score determination. Pancreatic and adipose tissue specimens obtained during clinically indicated surgery may be analyzed for histopathological, molecular, and multi-omic studies.
- Arm: Pancreatic Ductal Adenocarcinoma Undergoing PancreatectomyAdults with pancreatic ductal adenocarcinoma undergoing partial or total pancreatectomy. Participants will undergo clinical evaluation, metabolic phenotyping, imaging assessments, biomarker measurements, gut microbiome profiling from stool samples, and Genetic Risk Score determination. Pancreatic and adipose tissue specimens obtained during clinically indicated surgery may be analyzed for histopathological, molecular, and multi-omic studies.
- Arm: Chronic or Previous PancreatitisAdults with chronic pancreatitis or a previous episode of acute pancreatitis. Participants will undergo clinical evaluation, metabolic phenotyping, imaging assessments, biomarker measurements, gut microbiome profiling from stool samples, and Genetic Risk Score determination.
- Arm: Individuals at Risk for Type 2 DiabetesAdults at increased risk of type 2 diabetes, including individuals with impaired fasting glucose and/or impaired glucose tolerance, without exocrine pancreatic disease. Participants will undergo clinical evaluation, metabolic phenotyping, imaging assessments, biomarker measurements, gut microbiome profiling from stool samples, and Genetic Risk Score determination.
- Arm: Newly Diagnosed Type 2 DiabetesAdults with newly diagnosed type 2 diabetes mellitus. Participants will undergo clinical evaluation, metabolic phenotyping, imaging assessments, biomarker measurements, gut microbiome profiling from stool samples, and Genetic Risk Score determination.
Primary Outcome Measure
Identification and Characterization of Metabolic Endotypes [ Time Frame: At baseline and during study assessments up to 60 months ]
Central Contacts
- Teresa Mezza, MD, PhD+390630156664
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