Inflammation and Diabetes: Evaluating Antioxidant Levels (IDEAL)

July 24, 2026 updated by: Hande Seven Avuk, Istanbul Bilgi University

The Relationship Between Dietary Antioxidant Capacity, Inflammatory Response, and Nutritional Parameters in Type 2 Diabetes Management

The goal of this observational, cross-sectional study is to evaluate the relationships between dietary total antioxidant capacity, systemic inflammatory response markers, and nutritional parameters in adult patients with Type 2 Diabetes (T2DM). Participants will be classified into controlled (HbA1c < %7) and uncontrolled (HbA1c ≥ %7) diabetes groups based on their glycemic control. The main questions it aims to answer are: Does dietary antioxidant capacity affect systemic inflammation levels and metabolic parameters? Is there a relationship between nutritional risk status and inflammatory response in T2DM patients?

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Type 2 Diabetes Mellitus (T2DM) is defined not only as a carbohydrate metabolism disorder but also as a chronic, low-grade inflammatory condition. In this pathological process, the total capacity of dietary antioxidants is a determining factor in maintaining metabolic control. This study will evaluate dietary antioxidant intake using the Antioxidant Food Frequency Questionnaire to calculate the Dietary Antioxidant Index (DAI) and Composite Dietary Antioxidant Index (CDAI). Furthermore, systemic inflammation will be comprehensively evaluated using novel hematological and biochemical indices including the Systemic Immune-Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR), and C-reactive protein/albumin ratio (CAR). Nutritional status will be assessed using NRS-2002 and MUST screening tools.

Study Type

Observational

Enrollment (Estimated)

180

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Turkey (Türkiye)
      • Istanbul, Turkey (Türkiye)
        • Gaziosmanpasa Training and Research Hospital

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Outpatients applying to Internal Medicine and Family Medicine clinics of Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey.

Description

Inclusion Criteria:

  • Adults aged 18 and older diagnosed with Type 2 Diabetes.
  • Individuals whose biochemical analyses have been performed by a physician within the last 1 month.
  • Individuals willing to participate voluntarily.

Exclusion Criteria:

  • Missing required laboratory data in the last 1 month.
  • Presence of acute infection or inflammatory disease.
  • Advanced kidney or liver failure.
  • Active malignancy or receiving chemotherapy/radiotherapy.
  • Pregnant and lactating women.
  • Use of antioxidant/vitamin-mineral supplements.
  • Receiving special diet therapies (e.g., time-restricted, ketogenic, or elimination diet).
  • Advanced cognitive impairment or communication difficulties.

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

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Controlled Type 2 Diabetes
Adults diagnosed with Type 2 Diabetes with an HbA1c level of < 7%
Other: No Interventions
No interventions
Uncontrolled Type 2 Diabetes
Adults diagnosed with Type 2 Diabetes with an HbA1c level of ≥ 7%
Other: No Interventions
No interventions

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Composite Dietary Antioxidant Index (CDAI)
Time Frame: Baseline
The Composite Dietary Antioxidant Index (CDAI) will be calculated to evaluate the total and synergistic effect of dietary antioxidants. It is based on the standardized daily intake of six main antioxidant components: Vitamin A, Vitamin C, Vitamin E, Magnesium, Selenium, and Zinc. Nutrient data will be obtained from food consumption records using the BeBiS 9 nutritional software. For each antioxidant nutrient, a unitless Z-score will be calculated by subtracting the population's mean intake from the individual's intake and dividing by the standard deviation.
Baseline
The Dietary Antioxidant Index
Time Frame: Baseline
The Dietary Antioxidant Index (DAI) will be calculated based on the daily antioxidant intake obtained from the participants' food frequency questionnaire data. The main dietary antioxidant components (Vitamin C, Vitamin E, $\beta$-carotene, flavonoids, and other polyphenols) will be quantitatively determined using the BeBiS 9 nutritional software. For each antioxidant component, the obtained values will be standardized into a Z-score by subtracting the mean intake of the study population from the individual's intake and dividing by the standard deviation. The individual's final DAI score will then be calculated by summing the Z-scores of all these components.
Baseline
Systemic Immune-Inflammation Index (SII)
Time Frame: Baseline
Calculated from peripheral blood parameters using the formula: Platelet count × Neutrophil count / Lymphocyte count.
Baseline
Systemic Inflammation Response Index (SIRI)
Time Frame: Baseline
Calculated using the formula: Neutrophil count × Monocyte count / Lymphocyte count.
Baseline
Triglyceride-Glucose (TyG) Index
Time Frame: Baseline
Calculated using fasting plasma glucose and fasting triglyceride levels as an indirect marker of insulin resistance.
Baseline
Nutritional Assessment - Nutritional Risk Screening 2002 (NRS-2002)
Time Frame: Baseline
The nutritional risk of the participants will be evaluated using the Nutritional Risk Screening 2002 (NRS-2002) tool. The NRS-2002 assesses impaired nutritional status and disease severity. The total score ranges from 0 to 7. A total score of 3 or higher indicates that the patient is at nutritional risk, while a score less than 3 indicates no immediate nutritional risk. The assessment will be administered by the researcher at the beginning of the study.
Baseline
Nutritional Assessment - Malnutrition Universal Screening Tool (MUST)
Time Frame: Baseline
The nutritional risk of the participants will be evaluated using the Malnutrition Universal Screening Tool (MUST). MUST is a validated screening tool used to identify adults who are malnourished or at risk of malnutrition. The score is calculated based on three parameters: current body mass index (BMI), unintentional weight loss, and the effect of acute disease. The total score ranges from 0 to 6. A score of 0 indicates low risk, a score of 1 indicates medium risk, and a score of 2 or higher indicates a high risk of malnutrition. The assessment will be administered by the researcher at the beginning of the study.
Baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Anthropometric Measurements - Body weight (kg)
Time Frame: Baseline
At the beginning and end of the study, body weights (kg) will be measured using a weighing scales with a sensitivity of 50 grams in accordance with the measurement standards.
Baseline
Anthropometric Measurements - Height
Time Frame: Baseline
Height (cm) will be measured with a stadiometer in the Frankfort plane, standing and with the head upright.
Baseline
Body Mass Index
Time Frame: Baseline
The body mass index (BMI) of the participants will calculated according to the body weight (kg) / height (m)2 form.
Baseline
Anthropometric Measurements - Fat Mass
Time Frame: Baseline
At the beginning and end of the study, body fat mass (kg) analysis will be performed using a bioelectrical impedanc device, paying attention to measurement standards.
Baseline
Body Mass Index Classification
Time Frame: Baseline
The body mass index (BMI) of the participants is classiOed according to the World Health Organization (WHO) crite ≤ 18.5 kg/m2 is underweight, between 18.5-24.99 kg/m2 is normal, ≥ 25 kg/m2 is overweight, and ≥ 30 kg/m2 is obesity.
Baseline
Anthropometric Measurements - Fat ratio calculation
Time Frame: Baseline
At the beginning and end of the study, body composition analyses will be performed using a bioelectrical impedanc device with measurement standards. According to the BIA analysis, fat percentage (%) will be calculated as the rati total body fat weight to total body weight.
Baseline
Anthropometric Measurements - Fat-free mass
Time Frame: Baseline
At the beginning and end of the study, fat-free mass (kg) will be analyzed using a bioelectrical impedance (BIA) dev paying attention to measurement standards.
Baseline
Anthropometric Measurements - Muscle mass
Time Frame: Baseline
At the beginning and end of the study, lean muscle mass (kg) will be analyzed using a bioelectrical impedance (BIA paying attention to measurement standards.
Baseline
Anthropometric Measurements - Total body water
Time Frame: Baseline
At the beginning and end of the study, total body water (kg) will be analyzed using a bioelectrical impedance (BIA) paying attention to measurement standards.
Baseline
Biochemical Measurements - Platelet count (PLT)
Time Frame: Baseline
The platelet levels (mcL) will be analyzed in the hospital biochemistry laboratory using routine methods from blood samples taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurements - Monocyte count
Time Frame: Baseline
The monocyte levels (mcL) will be analyzed in the hospital biochemistry laboratory using routine methods from blood samples taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurements - Lymphocyte count (LYM)
Time Frame: Baseline
Lymphocyte count (LYM) (mcL) will be analyzed in the hospital biochemistry laboratory using routine methods from samples taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurements - Neutrophil count (NEU)
Time Frame: Baseline
Neutrophil count (NEU) (mcL) will be analyzed in the hospital biochemistry laboratory using routine methods from samples taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurements - White blood cell (WBC)
Time Frame: Baseline
The white blood cell levels (mcL) will be analyzed in the hospital biochemistry laboratory using routine methods fro samples taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurements - CRP
Time Frame: Baseline
Participants' c-reactive protein tests (CRP) (mg/L) will be analyzed in the hospital biochemistry laboratory using ro methods at the beginning of the study from blood samples taken by a nurse after at least 12 hours of fasting and w consuming alcohol for 24 hours before.
Baseline
Physical Activity Level
Time Frame: Baseline
Assessed using the International Physical Activity Questionnaire Short Form (IPAQ-Short Form) in MET-min/week.
Baseline
Biochemical Measurements - Fasting blood glucose
Time Frame: Baseline
Fasting blood sugar (mg/dL) will be analyzed in the hospital biochemistry laboratory using routine methods from bl samples taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurement - Lipid Profile
Time Frame: Baseline
Participants' biochemical tests (total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, (mg/dL) will be ana the hospital biochemistry laboratory using routine methods at the beginning of the study from blood samples taken nurse after at least 12 hours of fasting and without consuming alcohol for 24 hours before.
Baseline
Biochemical Measurements - Liver Enzymes
Time Frame: Baseline
Participants' liver enzymes tests (ALT, AST, and ALP) (IU) will be analyzed in the hospital biochemistry laboratory us routine methods at the beginning of the study from blood samples taken by a nurse after at least 12 hours of fastin without consuming alcohol for 24 hours before.
Baseline
Biochemical Measurements - HbA1c
Time Frame: Baseline
HbA1C will be analyzed in the hospital biochemistry laboratory using routine methods from blood samples taken b nurse at the beginning of the study.
Baseline
Biochemical Measurements - Urea
Time Frame: Baseline
The blood urea (mg/dL) will be analyzed in the hospital biochemistry laboratory using routine methods from blood taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurements - Serum Albumine
Time Frame: Baseline
Serum Albumine (mg/dL) will be analyzed in the hospital biochemistry laboratory using routine methods from bloo samples taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurements - Hemoglobin (Hb)
Time Frame: Baseline
The hemoglobin levels (g/dL) will be analyzed in the hospital biochemistry laboratory using routine methods from blood samples taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurements - Hematocrit (Hct)
Time Frame: Baseline
The hematocrit levels (%) will be analyzed in the hospital biochemistry laboratory using routine methods from blood samples taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurements - Red blood cell count (RBC)
Time Frame: Baseline
The red blood cell levels (millions/mcL) will be analyzed in the hospital biochemistry laboratory using routine methods from blood samples taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurements - Creatinine
Time Frame: Baseline
The creatinine levels (mg/dL) will be analyzed in the hospital biochemistry laboratory using routine methods from blood samples taken by a nurse at the beginning of the study.
Baseline
Biochemical Measurements - Glomerular Filtration Rate (GFR)
Time Frame: Baseline
The glomerular filtration rate (mL/min/1.73m²) will be analyzed in the hospital biochemistry laboratory using routine methods from blood samples taken by a nurse at the beginning of the study.
Baseline
Anthropometric Measurements - Circumferences
Time Frame: Baseline
Waist, hip, neck, upper middle arm, and calf circumference measurements of the participants were measured in light clothing on an empty stomach, following anthropometric measurement standards.
Baseline
Anthropometric Measurements - Waist/Height Ratio
Time Frame: Baseline
Waist/height ratio will be obtained by dividing waist circumference by height at the beginning and end of the study.
Baseline
Anthropometric Measurements - Waist/Hip Ratio
Time Frame: Baseline
Waist/hip ratio will be obtained by dividing waist circumference by hip at the beginning and end of the study.
Baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul Bilgi University

Collaborators

İstanbul Gaziosmanpaşa Training and Research Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

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 (Estimated)

July 15, 2026

Primary Completion (Estimated)

December 30, 2026

Study Completion (Estimated)

December 30, 2026

Study Registration Dates

First Submitted

July 13, 2026

First Submitted That Met QC Criteria

July 24, 2026

First Posted (Actual)

July 29, 2026

Study Record Updates

Last Update Posted (Actual)

July 29, 2026

Last Update Submitted That Met QC Criteria

July 24, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IDEAL (Lupus Research Alliance)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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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