Neurovascular Coupling and Autonomic Neuropathy in Type 2 Diabetes

April 11, 2024 updated by: Hartwig R. Siebner

Unravelling the Association Between Neurovascular Uncoupling and Autonomic Neuropathy in Patients With Type 2 Diabetes

Diabetes is a growing global health care challenge. Diabetes patients may also suffer from cardiovascular autonomic neuropathy (CAN) which may affect cerebral perfusion. The main purpose of this project is to investigate the association between CAN and disturbances in the neurovascular coupling in type 2 diabetes patients. Moreover, the purpose is also to investigate coherence between CAN and the enteric nervous system. Finally, this project aims at delineating microstructural changes in the brain tissues as a consequence of CAN.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Estimated)

90

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

      • Gentofte, Denmark, 2820
        • Steno Diabetes Center Copenhagen
      • Hvidovre, Denmark, 2650
        • Danish Research Centre for Magnetic Resonance

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

50 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Patients with type 2 diabetes and cardiovascular autonomic neuropathy. Patients with type 2 diabetes but no cardiovascular autonomic neuropathy Healthy controls.

Description

Inclusion Criteria:

  • A diagnosis of type 2 diabetes (Patients)
  • Age between 50-70 years (All)
  • Presence of CAN as diagnosed by cardiovascular reflex tests with two or three pathological results (Patients with CAN only)
  • Exclusion of CAN as diagnosed by cardiovascular reflex tests with no pathological results (Patients without CAN and HC only)

Exclusion Criteria:

  • Participants receiving treatment with direct effects on noradrenergic or cholinergic signaling (for example beta-blockers, tricyclic antidepressants, SSRI's) (All)
  • Acute infections (All)
  • Thyroid disease (All)
  • Substance or alcohol abuse (All)
  • Atrial fibrillation or flutter (All)
  • Respiratory failure (All)
  • Participants in active laser treatment for retinopathy, will be excluded from the Valsalva test (Patients)
  • Non-diabetic causes of neuropathy including a medical history of vitamin B12 deficiency, folic acid deficiency, rheumatoid arthritics, amyloidosis, HIV, syphilis, Borreliosis, drug induced neuropathy and neuropathy caused by toxins (All)
  • Claustrophobia (All)
  • Implanted pacemakers or remaining pacemaker electrodes (All)
  • Previous heart or brain surgery with use of metal clips (All)
  • Any form of non-MR-compatible implants
  • Non-compliance with the study protocol as judged by the investigators (All)
  • Concurrent participation in an intervention study (Patients)
  • Participants who by judgments of the investigator, is incapable of participating (All)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Healthy control
To assess cardiovascular reactivity
Meal response test to assess changes in splanchnic blood flow.
T2DM +CAN
To assess cardiovascular reactivity
Meal response test to assess changes in splanchnic blood flow.
T2DM -CAN
To assess cardiovascular reactivity
Meal response test to assess changes in splanchnic blood flow.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Neurovascular coupling
Time Frame: 1 hour
Ratio between oxygen delivery/oxygen consumption by MRI during visual and hypercapnic stimulation
1 hour
Cerebrovascular reactivity
Time Frame: 1 hour
Change in CBF between normocapnia and hypercapnia
1 hour
Structural differences in brain tissue
Time Frame: 1 hour
1 hour
Regional splanchnic blood (superior mesenteric artery) flow increase in response to meal test
Time Frame: 3 hours
3 hours
Change in blood levels of gastrointestinal hormones and markers of metabolism following meal test
Time Frame: 3 hours
3 hours

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Hartwig R. Siebner, MD, Prof, Danish Research Centre for Magnetic Resonance

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 7, 2021

Primary Completion (Estimated)

December 31, 2024

Study Completion (Estimated)

July 31, 2025

Study Registration Dates

First Submitted

November 6, 2020

First Submitted That Met QC Criteria

November 6, 2020

First Posted (Actual)

November 12, 2020

Study Record Updates

Last Update Posted (Actual)

April 12, 2024

Last Update Submitted That Met QC Criteria

April 11, 2024

Last Verified

April 1, 2024

More Information

Terms related to this study

Other Study ID Numbers

  • H-20031245

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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