- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03821753
The Effect of the Glycemic Variability on Macular Retinal Microcirculation and Cognitive Functions in Patient With Type 1 Diabetes (REVADIAB)
Revadiab is case-control study aimed to demonstrate that retinal capillary density is altered in patients with type 1 diabetes with glycemic variability compared to those with comparable glycemic control without glycemic variability. An OCT angiography will be used to precisely evaluate retinal capillary density.
A secondary objective will be to evaluate if glycemic variability is associated with cognitive dysfunction, using a neuro psychologic evaluation.
Study Overview
Status
Intervention / Treatment
Detailed Description
HbA1c doesn't explain all the microvascular complications of diabetes, especially microvascular complications. Glycemic variability is associated with increased oxidative stress, free radicals and endothelial dysfunction; it contributes to the pathogenesis of diabetic complications.
The relationship between glycemic variability and microangiopathic complications especially retinal but also neurological, needs to be studied.
The principal objective of Revadiab study is to demonstrate a correlation between glycemic variability and macular retinal microcirculation in patient with type 1 diabetes.
The secondary objective is to search a correlation between glycemic variability and :
- Alteration of cognitive functions.
- Severity of peripheral diabetic retinopathy and retinal neuronal damage.
- Other micro and macro angiopathic complications.
- Oxidative stress and inflammation.
Two groups of type 1 diabetic patients will be compared:
- Case: Patient with significant glycemic variability.
- Control: Patients without glycemic variability.
The severity of diabetic retinopathy will be evaluated by the degree of occlusion of small vessels in the central retinal region as measured by OCT angiography.
Acts or Product necessary to research :
- Non-invasive retinal imaging (OCT and OCT- Angiography, retinophotography)
- Neuropsychological tests.
- Blood test.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Jean Pierre RIVELINE, Professor
- Phone Number: +33(0) 1 49 95 83 79
- Email: jeanpierre.riveline@aphp.fr
Study Locations
-
-
Ile-de-France
-
Paris, Ile-de-France, France, 75475
- Recruiting
- Hopital Lariboisiere
-
Contact:
- Jean-Pierre RIVELINE, Professor
- Phone Number: +33(0) 1 49 95 83 79
- Email: jeanpierre.riveline@aphp.fr
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Inclusion of adult patients with T1D with more than 10 years of diabetes and users of the FreeStyle Free continuous measurement system.
Case: Patients with glycemic variability, defined by a coefficient of variation (CV) > 36%, calculated from continuous glucose measurements data by Free Style Libre® (Abbott).
Controls: Patients without glycemic variability, defined by a coefficient of variation (CV) ≤ 36%, calculated from Free Style Libre® data and matched to patients in the Case group for HbA1c (+/- 0.5%).
Description
Inclusion Criteria:
- Patients ≥ 18 years
- Type 1 diabetes (T1D)
- Using Free FreeStyle
- Diabete evolving for 10 years or more
- Case: Patients with glycemic variability, defined by a coefficient of variation (CV) > 36%, calculated from continuous glucose measurements data by Free Style Libre® (Abbott)
- Controls: Patients without glycemic variability, defined by a coefficient of variation (CV) ≤ 36%, calculated from Free Style Libre® data and matched to patients in the Case group for HbA1c (+/- 0.5%)
Exclusion Criteria:
- Type 2 diabetic patient
- Corticotherapy
- Comorbidity like cancer
- Antecedent of vitreoretinal pathology
- Antecedent of vitreoretinal surgery
- Important cataract, with an important opacity that prevents a reliable evaluation of capillary density in OCT angio
- Pregnant or lactating woman
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Case
Patients with glycemic variability, defined by a coefficient of variation (CV)> 36%, calculated from continuous glucose measurements data by Free Style Libre® (Abbott)
|
|
Control
Patients without glycemic variability, defined by a coefficient of variation (CV) ≤ 36%, calculated from Free Style Libre® data and matched to patients in the Case group for HbA1c (+/- 0.5%)
|
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Macular capillary density in the external deep capillary network
Time Frame: 3 months
|
Macular capillary density in the external deep capillary network measured by OCT-Angiography (no later than 3 months after inclusion)
|
3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Macular capillary density in the deep capillary and deep capillary network
Time Frame: 3 months
|
Macular capillary density in the deep capillary and deep capillary network measured by OCT-angiography (no later than 3 months after inclusion)
|
3 months
|
Area of the central avascular zone
Time Frame: 3 months
|
Area of the central avascular zone by OCT-Angiography (no later than 3 months after inclusion)
|
3 months
|
Macular edema presence
Time Frame: 3 months
|
Macular edema presence by OCT (no later than 3 months after inclusion)
|
3 months
|
Layer thickness reduction of the ganglion cells
Time Frame: 3 months
|
Layer thickness reduction of the ganglion cells measured by OCT (no later than 3 months after inclusion)
|
3 months
|
Diabetic retinopathy stage
Time Frame: 3 months
|
Diabetic retinopathy stage evaluated with retinographies (no later than 3 months after inclusion)
|
3 months
|
Development of pre-retinal neovascular vessels and/or pre-papillary
Time Frame: 3 months
|
Development of pre-retinal neovascular vessels and/or pre-papillary (no later than 3 months after inclusion)
|
3 months
|
Occurrence of neovascular complications
Time Frame: 3 months
|
Occurrence of neovascular complications: vitreous
|
3 months
|
Haemorrhage, retina tractional detachment, neovascular glaucoma
Time Frame: 3 months
|
Haemorrhage, retina tractional detachment, neovascular glaucoma (no later than 3 months after inclusion)
|
3 months
|
Renal function evaluation
Time Frame: 3 months
|
Renal function evaluation: microalbuminuria and creatinine determination (no later than 3 months after inclusion)
|
3 months
|
Evaluation of peripheral neuropathy
Time Frame: 3 months
|
Evaluation of peripheral neuropathy : monofilament test (no later than 3 months after inclusion)
|
3 months
|
Ischemic cardiopathy
Time Frame: 3 months
|
Measurement method: treatment with angioplasty or coronary artery bypass graft, Assessment of vascular risk by measuring the coronal calcium score, and determination of BNP and troponin.
(no later than 3 months after inclusion)
|
3 months
|
Number of severe hypoglycemia
Time Frame: 3 months
|
Number of severe hypoglycemia since 1 year, threshold for hypoglycemia no later than 3 months after inclusion)
|
3 months
|
Markers of inflammation
Time Frame: 3 months
|
characterization of circulating inflammatory and endothelial cells and CRP-US assay
|
3 months
|
Oxidative stress markers
Time Frame: 3 months
|
Oxidative stress markers: Measurements of 8-iso-prostaglandin F2 alpha urinary and 1,5-anhydroglucitol sanguine.
(no later than 3 months after inclusion)
|
3 months
|
Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
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
- K170406J
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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