- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02810691
The Effect of Soluble Fiber to Reduce Post-prandial Glycemic Excursion in Adults With Cystic Fibrosis (SOFI)
July 16, 2018 updated by: Rémi Rabasa-Lhoret, Institut de Recherches Cliniques de Montreal
With improved survival, the clinical spectrum of cystic fibrosis (CF), a complex multi systemic disease, continue to evolve.
A major emerging complication is CF related diabetes (CFRD) which is occurring in 40-50% of adults.
Patients who develop CFRD are at increase risk of morbidity and mortality and they are also facing an increased medical burden with insulin therapy, the only recommended treatment.
Accelerated decline in weight and/or pulmonary function start 2 to 4 years before CFRD onset and this period is characterized by frequent Post-Prandial Glycemic (PPG) excursions.
Higher PPG excursions are associated with lower pulmonary function and it predicts future CFRD risk.
To the improved nutritional status, lung function and survival of patients, the nutritional approach for patients with CF focuses on high-energy high-fat diet and a pancreatic enzyme supplementation.
However, such diet also contributes to increased PPG excursions.
Based on the beneficial effects of nutrition therapy to improve PPG in other forms of pre-diabetes and diabetes, extending such benefits to patients with CF is important.
The investigators aim to test the feasibility and the effectiveness of a viscous fiber supplement to reduce PPG in adult patients with CF.
Using a randomized crossover design, the investigators will study the impact of two doses of a viscous fiber supplement as compared to a placebo.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
With improved survival, the clinical spectrum of cystic fibrosis (CF), a complex multi systemic disease, continue to evolve.
A major emerging complication is CF related diabetes (CFRD).
CFRD is a major co-morbidity occurring in 20% of adolescents and 40-50% of adults and is mainly due to reduced insulin secretion.
Patients who develop CFRD are at increase risk of morbidity and mortality and they are also facing an increased medical burden with insulin therapy, the only recommended treatment.
Because accelerated decline in weight and/or pulmonary function start 2 to 4 years before CFRD onset and that this period is characterized by frequent Post-Prandial Glycemic (PPG) excursions, the role of these PPG excursions in clinical deterioration have been investigated.
The investigators have shown that higher PPG excursions are associated with lower pulmonary function and others have shown that PPG excursions predicts future CFRD risk.
Food overconsumption is discouraged in other forms of diabetes to avoid overweight or obesity, but also to prevent an increase in insulin demand.
In contrast, nutritional approach for patients with CF focuses on high-energy high-fat diet to meet increased energy requirements.
In combination with an appropriate pancreatic enzyme supplementation, this approach contributes significantly to the improved nutritional status, lung function and survival of patients.
However, such diet also contributes to increased PPG excursions.
Based on the beneficial effects of nutrition therapy to improve PPG in other forms of pre-diabetes and diabetes, extending such benefits to patients with CF is important.
In the context of high CF treatment burden, such approach should however be simple and not inducing weight loss.
The investigators aim to test the feasibility and the effectiveness of a viscous fiber supplement to reduce PPG in adult patients with CF.
Using a randomized crossover design, the investigators will study the impact of two doses of a viscous fiber supplement as compared to a placebo in controlled conditions, in 22 patients, over 8 hours, at the research center with 2 standardized mixed-meals: breakfast and lunch on PPG excursions.
Study Type
Interventional
Enrollment (Actual)
14
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Quebec
-
Montréal, Quebec, Canada, H2W 1R7
- Institut de Recherches Cliniques de Montreal
-
-
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
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Diagnosed with CF
- Aged above 18 years
- CF-Impaired glucose tolerance, CF-indeterminate glucose tolerance (INDET), de-novo diabetes not requiring immediate treatment and diabetes without pharmacological treatment, based on the oral glucose tolerance test (OGTT) performed within three months of the first visit
Exclusion Criteria:
- Treated or longstanding CFRD
- Subjects taking medication or affected by conditions that could interfere with glucose metabolism in the last 6 weeks: hemoptysis, fever, IV antibiotic treatment, pregnancy and oral steroids. If a patient presents any sign of infection confirmed by a trained CF pneumologist, OGTT testing is postponed to the next medical appointment 1 months later.
- Subjects with severe gastrointestinal disease (Crohn disease, coeliac disease and recent (<1 year) history of intestinal occlusion).
- Subjects with intestinal obstruction history.
- Allergy to an ingredient in the menu.
- Corrector or potentiator prescribed within the last 6 months prior to the first visit.
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
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Soluble fiber, dose #1
Soluble fiber supplementation with dose #1 (smaller dose) of psyllium fiber.
|
Two different doses of psyllium powder will be diluted in 250 ml of orange-flavored water and drink in 5 minutes before breakfast.
|
Active Comparator: Soluble fiber, dose #2
Soluble fiber supplementation with dose #2 (bigger dose) of psyllium fiber.
|
Two different doses of psyllium powder will be diluted in 250 ml of orange-flavored water and drink in 5 minutes before breakfast.
|
Placebo Comparator: Placebo
A 250 ml placebo solution of orange-flavored water will be drink at breakfast.
|
Placebo will consist of 250 ml of orange-flavored water to be drink in 5 minutes before breakfast.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Plasma glucose area under the curve
Time Frame: 3 hours
|
3 hours
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Plasma insulin area under the curve
Time Frame: 3 hours
|
3 hours
|
|
Incretin hormones
Time Frame: Each 30 minutes, up to 510 minutes, from 8h30 am to 5h00 pm
|
Glucagon-like peptide, gastric inhibitory polypeptide
|
Each 30 minutes, up to 510 minutes, from 8h30 am to 5h00 pm
|
Side effects of the supplement
Time Frame: 60, 180, 300, 420 and 540 minutes after the beginning of the test
|
It will be measure with gastro-intestinal symptoms visual analog scale.
There will be 3 continuous scales for gastrointestinal symptoms and 5 continuous scales to evaluate the satiety.
Each scale will measure 100 mm.
The score is the distance measured in millimeters from the "no pain" anchor to the participant's mark.
|
60, 180, 300, 420 and 540 minutes after the beginning of the test
|
Positive incremental area under the curve for post-prandial glucose and insulin excursions
Time Frame: 3 hours
|
3 hours
|
|
Mean plasma glucose
Time Frame: 9 hours (over study period)
|
9 hours (over study period)
|
|
Percentage of time with plasma glucose concentration a. >8.0 mmol/L, b. >10.0 mmol/L, c. >11.0 mmol/L, and d. <4.0 mmol/L
Time Frame: 9 hours (over study period)
|
9 hours (over study period)
|
|
Post-meal peak plasma glucose
Time Frame: 3 hours after each meal
|
For the breakfast and lunch
|
3 hours after each meal
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Rémi Rabasa-Lhoret, MD,PhD, IRCM
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
July 1, 2016
Primary Completion (Actual)
April 1, 2018
Study Completion (Actual)
April 1, 2018
Study Registration Dates
First Submitted
June 14, 2016
First Submitted That Met QC Criteria
June 22, 2016
First Posted (Estimate)
June 23, 2016
Study Record Updates
Last Update Posted (Actual)
July 17, 2018
Last Update Submitted That Met QC Criteria
July 16, 2018
Last Verified
July 1, 2018
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SOFI
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
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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