- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03045250
Corneal Confocal Microscopy in Patients With Type 1 Diabetes (CCM)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Rationale: Poorly controlled diabetes mellitus is associated with microvascular complications, which includes peripheral neuropathy. Peripheral neuropathy associated with diabetes is a painful condition. Its diagnosis is hampered by painful and long nerve conduction studies which fail to diagnose small nerve neuropathy. It is important to study methods of noninvasive methods of early detection, which are sensitive and specific in diagnosing early neuropathy and we propose a novel study that this can be detected in the cornea of the eye.
Aims:
- Estimate corneal small nerve fiber damage in young T1DM subjects (corneal fiber density, nerve branch density, and fiber length) and compare the results to healthy controls using corneal confocal microscopy (CCM).
- Estimate corneal nerve fiber damage in subjects with diabetes, with peripheral neuropathy and subjects with diabetes without peripheral neuropathy, diagnosed by skin biopsies and nerve conduction studies
- Obtain much needed normative values for CCM in adolescents and intraepidermal nerve fiber density from skin biopsies in subjects with type 1 diabetes.
- As a secondary outcome measure, to compare serum biomarkers including leptin, TNF alpha, and fibrinogen in patients with diabetes in those with neuropathy Vs. without neuropathy.
Study Type
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion:
- Subjects with diabetes:
- 18-30 years (cohort 1), adolescents ages 13-17 years (cohort 2).
- Type 1 Diabetes diagnosed via standard ADA criteria
Matched Controls:
- Match for age and gender
- Hemoglobin A1c <6.5%
Exclusion:
For all subjects:
- Contact lens wearers
- Diseases that could damage the cornea, other than diabetes.
- Neurologic disease
- Psychiatric disease
- Amputation
- Foot ulcers
- Pain not of neuropathic origin.
- Presence of Lupus, Sjogren's syndrome and Celiac disease
- Hyperlipidemia requiring lipid-lowering medications
- Peripheral vascular disease
- Neuropathy due to anything besides diabetes
- Presence of any medical condition that may affect nerve conduction (e.g., radiculopathy).
For healthy controls
- Family history of Type 1 Diabetes
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Screening
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Type 1 Diabetes
Subjects with known Type 1 diabetes
|
Confocal miscroscopy will be used to assess corneal nerve changes due to hyperglycemia.
Skin biopsy will be used to assess the appearance of nerve fibers in subjects with type 1 diabetes.
Nerve conduction studies will be use to assess for neuropathy.
Subjects will undergo a one time blood draw for biomarkers.
|
Placebo Comparator: Healthy Controls
Healthy controls
|
Confocal miscroscopy will be used to assess corneal nerve changes due to hyperglycemia.
Nerve conduction studies will be use to assess for neuropathy.
Subjects will undergo a one time blood draw for biomarkers.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Corneal small nerve fiber damage
Time Frame: Assessed one time per subject during study (study completed over 3 years)
|
Estimate corneal small nerve fiber damage in young T1DM subjects and compare the results to healthy controls using corneal confocal microscopy (CCM).
This will be done by examining the cornea via confocal microscopy and obtaining images.
These images will be evaluated looking at how many nerves there are, how they branch, and how long they are).
|
Assessed one time per subject during study (study completed over 3 years)
|
Normative values for corneal confocal microscopy (CCM)
Time Frame: Assessed one time per subject during study (study completed over 3 years)
|
Obtain much needed normative values for CCM in adolescents and intraepidermal nerve fiber density from skin biopsies in subjects with type 1 diabetes.
This will be done by obtaining a small biopsy of skin and looking at the number of nerve fibers in the outer layer of the skin.
|
Assessed one time per subject during study (study completed over 3 years)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Serum biomarkers - leptin
Time Frame: Assessed one time per subject during study (study completed over 3 years)
|
Measuring serum biomarkers (blood levels) leptin.
In participants with diabetes, comparing the blood level measurements of those with neuropathy vs. those without neuropathy.
|
Assessed one time per subject during study (study completed over 3 years)
|
Serum biomarkers - TNF Alpha
Time Frame: Assessed one time per subject during study (study completed over 3 years)
|
Measuring serum biomarkers (blood levels) Tumor Necrosis Factor (TNF) Alpha.
In participants with diabetes, comparing the blood level measurements of those with neuropathy vs. those without neuropathy.
|
Assessed one time per subject during study (study completed over 3 years)
|
Serum biomarkers - fibrinogen
Time Frame: Assessed one time per subject during study (study completed over 3 years)
|
Measuring serum biomarkers (blood levels) fibrinogen.
In participants with diabetes, comparing the blood level measurements of those with neuropathy vs. those without neuropathy.
|
Assessed one time per subject during study (study completed over 3 years)
|
Collaborators and Investigators
Investigators
- Principal Investigator: Lisa Underland, MD, Montefiore Medical Center at Albert Einstein College of Medicine
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2016-6962
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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