- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01337362
Recurrent Hypoglycaemia in Type 1 Diabetes (HypoNeuro)
Recurrent Hypoglycaemia in Type 1 Diabetes: Effects on Cognitive Function, Cerebral Electrical Activity, and Skin Temperature
Patients with type 1 diabetes are at risk of very low blood sugar levels (hypoglycaemia) as a severe side effect to insulin therapy, in particular subjects who have lost warning of hypoglycaemia. During hypoglycaemia a low frequent activity can be seen with electroencephalography (EEG) as cognitive function declines.
The purpose of the study is to investigate the activity in the brain, the cognitive function, and the skin temperature when patients are exposed to repeated hypoglycaemia. The results will show whether the response to hypoglycaemia will change after repeated episodes.
It is our hope that results can contribute to improved understanding of hypoglycaemic EEG changes.
Study Overview
Detailed Description
Background:
Patients with type 1 diabetes are at risk of severe hypoglycaemia as a severe side effect to insulin therapy, in particular subjects who have lost warning of hypoglycaemia (hypoglycaemia unawareness). The episodes are associated with impaired quality of life and can lead to permanent brain damage and death.
During hypoglycaemia a low frequent activity can be seen with electroencephalography (EEG) as cognitive function declines. Repeated hypoglycaemic episodes result in down regulation of counter regulatory and symptomatic responses. It is not known whether a similar phenomenon is present for cerebral dysfunction as judged by EEG changes and cognitive function.
The purpose is to investigate the activity in the brain, the cognitive function, and the skin temperature when patients are exposed to repeated hypoglycaemia. The results will show whether the response to hypoglycaemia will change after repeated episodes.
The methods:
The investigators will recruit two groups of patients: Patients with hypoglycemia awareness and patients with hypoglycaemic unawareness.
The patients are exposed to hypoglycaemia on two concomitant days while the investigators record EEG and perform cognitive tests. Skin temperature is assessed by the use of thermography. If the patient has hypoglycaemic unawareness a 4 week period follows where the glycaemic control is loosened to avoid hypoglycaemia episodes and the patients is then exposed to hypoglycaemia again.
The prospect:
It is the investigators hope that results can contribute to improved understanding of hypoglycaemic EEG changes and skin temperature changes. This could be of potential benefit for patients with hypoglycaemic unawareness.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
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Hillerød, Denmark, 3400
- Hillerod Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Type 1 diabetes
- Age > 18 years
- - Have had diabetes for more than 5 years
- Negative pregnancy test
- Caucasian
- Signed written informed consent
Exclusion Criteria:
- Pregnant or breastfeeding
- Epilepsy
- Self-perceived impaired hearing
- Use of antiepileptic medicine
- Use of neuroleptics within the last 6 months
- Use of benzodiazepines within the last month
- Use of betablockers
- Previous stroke or other disease in the brain
- Cardiovascular disease
- Alcohol-, drug- or medicine abuse
- Previous allergic reaction to heparin
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Patients with hypoglycemia awareness
Patients who have symptoms when the blood sugar level is low
|
Patients will be exposed to low bloodsugar
Other Names:
|
Experimental: patients with hypoglycaemic unawareness.
Patients who do not feel any symptoms when the blood sugar levels are low
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Patients will be exposed to low bloodsugar
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
EEG
Time Frame: 2 years
|
EEG will be analysed in order to see whether there are any differences between aware and unaware patients during hypoglycaemia.
It is our hope that the result can help develop an alarm before the patient experiences severe hypoglycaemia.
|
2 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
QTc interval
Time Frame: 2 years
|
The investigators want to investigate whether the QTc complex gets wider during hypoglycaemia.
This is in order to see whether long QTc could be the explanation behind sudden dearth in diabetes patients.
|
2 years
|
Skin temperature
Time Frame: 2 years
|
Skin temperature will be measured by thermography.
The investigators want to see whether the skin can be used as a biomarker for hypoglycaemia.
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2 years
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Auditory evoked potentials
Time Frame: 2 years
|
The investigators what to see whether there is any difference in auditory evoked potentials (AEP) between aware and unaware diabetic patients.
The subject will hear a common and a rare sound in a 4:1 ratio while the EEG is recorded.
Afterwards the data is analyzed and the AEPs are addressed.
|
2 years
|
Cognitive function
Time Frame: 2 years
|
The investigators want to address whether there are any differences in the cognitive function between aware and unaware patients.
The cognitive function will be addressed by the use of cognitive function tests (CalCAP) and Stroops tests as well.
|
2 years
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Anne-Sophie Sejling, MD, Hillerod Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- H-1-2011-024
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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