Diabetes-Specific Formula on Long Term Glycemic Control

A Randomized Controlled Trial to Determine the Effects of a Diabetes-specific Formula on Long-term Glycemic Control and Short-term Glycemic Variability in Individuals With Type 2 Diabetes

The study aims to investigate the effect of a diabetes-specific formula (DSF) used as a (partial) meal replacement on long-term glycemic control and short-term glycemic variability in individuals with type 2 diabetes.

Study Overview

• Status: Completed
• Conditions: Diabetes Mellitus, Type 2
• Intervention / Treatment: Other: Diabetes-Specific Formula; Other: Standard Of Care

Detailed Description

This is a randomized, controlled, parallel study. Eligible participants will be randomly allocated (at 1 :1 ratio) to one of two groups: DSF group or control group.The total expected duration of the study is 97 days.

There are two periods in the study:

i) "Run-in Period" (Study Days -6 to -1): participants will wear the CGMS:Continuous Glucose Monitoring System (FreeStyle Libre Pro) and will be asked to follow and track their diet and physical activity on a daily basis.

ii) "Intervention Period" (Study Days 0 to 90): participants will be randomized into one of the two groups (n = 125 per group): DSF group or control group.

• Study Type: Interventional
• Enrollment (Actual): 251
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Malaysia
  • Kuala Lumpur, Malaysia, 57000
    • International Medical University
  • Kuala Lumpur, Malaysia, 59100
    • University of Malaya Medical Centre
  • Seremban, Malaysia, 70300
    • Klinik Kesihatan Seremban
• Thailand
  • Bangkok, Thailand, 10400
    • Phramongkutklao Hospital
  • Bangkok, Thailand, 10400
    • Rajavithi Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years to 65 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Adult participants (≥ 21 and ≤ 65 years of age)
2. Has type 2 diabetes as evidenced with oral anti-diabetic drug(s) at constant dose for at least two months prior to the study and is able to maintain number of medications, type and dose throughout the duration of the study
3. BMI ≥ 23 and < 35.0 kg/m2
4. Weight is stable (has maintained current body weight within 3 kg) for the two months prior to the Baseline Visit
5. Either a male or a non-pregnant, non-lactating female, at least 6 weeks postpartum prior to the Baseline Visit. A urine pregnancy test is required for all female participants unless she is not of childbearing potential, defined as postmenopausal for at least one year prior to the Baseline Visit or surgically sterile (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy).

6. If the female is of childbearing potential, she is practicing one of the following methods of birth control and will continue through the duration of the study:

   1. Condoms, sponge, diaphragm or intrauterine device;
   2. Oral or parenteral contraceptives for 3 months prior to Baseline Visit;
   3. Vasectomized partner;
   4. Total abstinence from sexual intercourse
7. If on a chronic medication such as an anti-hypertensive, lipid-lowering, thyroid medication or hormone therapy, the medication number, type and dose were constant for at least two months prior to the Baseline Visit and will continue through the duration of the study
8. Willingness to follow the protocol as described, including consumption of study product per the protocol and completing any forms/questionnaires needed throughout the study
9. At least a two-week washout period is needed between the completion of a previous research study that required ingestion of any study food or drug and their start in the current study
10. The participant is willing to refrain from taking non-study diabetes-specific formulas over the entire course of the study

Exclusion Criteria:

1. Screening HbA1c level <7% or ≥ 10%
2. Use of exogenous insulin for glucose control
3. Confirmed type 1 diabetes and/or had a history of diabetic ketoacidosis
4. Current infection (requiring medication), inpatient surgery or received systemic corticosteroid treatment [except for inhaled (includes nasal), topical, and ophthalmic steroids] in the last 3 months; or received antibiotics in the last 3 weeks
5. Active malignancy within the last 5 years
6. A significant cardiovascular event within 6 months prior to study entry or history of congestive heart failure
7. End-stage organ failure (such as end-stage renal disease) or is post-organ transplant
8. Current or history of renal disease or on dialysis or severe gastroparesis
9. Current hepatic disease
10. Has had bariatric surgery including gastric balloon; the history of gastrointestinal disease (e.g., Crohn's, colitis, celiac) or intestinal surgery that can interfere with consumption or digestion or absorption of study product
11. A chronic, contagious, infectious disease, such as active tuberculosis, Hepatitis A, B or C, or HIV
12. Has eating disorder, severe dementia or delirium, history of significant neurological or psychiatric disorder, alcoholism, substance abuse or other conditions that may interfere with study product consumption or compliance with study protocol procedures in the opinion of the principal investigator or study physician
13. Taking any herbals, dietary supplements, or medications during the past four weeks prior to Baseline Visit that could profoundly affect (in the opinion of the primary investigator) blood glucose or appetite (e.g. orlistat, contrive, qsymia, belviq, incretins, cannabis, glucocorticoids, nicotinic acid, etc.) per healthcare professional's opinion
14. Using diabetes-specific formula(s), (e.g. Glucerna, Nestle Nutren Diabetes, Kalbe Diabetasol, Appeton Nutrition Wellness 60+ Diabetic, ForSure, Penta Sure DM, Resurge DM, Diben, Diasip, etc.) defined as more than one eating occasion per week within the past 3 months (those users who have stopped using such products for more than 3 months may not be excluded)
15. Clotting or bleeding disorders (the use of Plavix® or a similar anticoagulant drug with no reported difficulty during blood draws will be allowed)
16. Has blood or blood-related diseases (e.g. hemophilia, thalassemia, sickle cell disease, hereditary spherocytosis, glucose-6-phosphate dehydrogenase deficiency)
17. Received a blood transfusion within the last 3 weeks
18. Allergic or intolerant to any ingredient found in the test meals
19. Participates in another study that has not been approved as a concomitant study by Abbott Nutrition
20. The participant has skin lesions hyperhidrosis, eczema, psoriasis, scarring, tattoos, redness, infection or edema at the application sites that in the opinion of the study investigator or study physician could interfere with device placement or the accuracy of interstitial glucose measurements.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: SUPPORTIVE_CARE
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: NONE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: Diabetes-Specific Formula; Diabetes-specific formula 1-2 servings a day and Standard of Care	Other: Diabetes-Specific Formula; Diabetes-Specific Formula and Standard of Care
OTHER: Standard of Care	Other: Standard Of Care; Standard of Care

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
HbA1c Level	Change in HbA1c level from Day 0 to Day 90	Study Days 0, 45 and 90

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Glycemic Excursion	Mean Amplitude of Glycemic Excursions (MAGE)	Study Day 1 to Day 7
Glucose	Mean and coefficient of variation (CV) of glucose during the intervention phase	Study Day 1 to Day 7
Time of glucose level	Time of glucose level in target, below and above range per day during intervention phase	Study Day 1 to Day 7
Hypoglycemic Episodes	Number of hypoglycemic episodes per day during the intervention phase	Study Day 1 to Day 7
Hyperglycemic Episodes	Number of hyperglycemic episodes per day during the intervention phase	Study Day 1 to Day 7

Collaborators and Investigators

• Sponsor: Abbott Nutrition

Study record dates

Study Major Dates

• Study Start (ACTUAL): August 26, 2020
• Primary Completion (ACTUAL): December 6, 2022
• Study Completion (ACTUAL): December 6, 2022

Study Registration Dates

• First Submitted: April 10, 2020
• First Submitted That Met QC Criteria: April 10, 2020
• First Posted (ACTUAL): April 14, 2020

Study Record Updates

• Last Update Posted (ESTIMATE): February 14, 2023
• Last Update Submitted That Met QC Criteria: February 13, 2023
• Last Verified: February 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Diabetes Mellitus; Diabetes Mellitus, Type 2
• Other Study ID Numbers: BL46

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.: Yes