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Effekt af ændringer i kulhydratindtag på glukosekontrol hos patienter med type 1-diabetes

7. september 2026 opdateret af: Yang Tao

Effekt af ændringer i kulhydratindtag på glukosekontrol hos patienter med type 1-diabetes.

Blodsukkeret svinger meget hos T1DM-patienter, især i de midterste og sene stadier af sygdommen, og kulhydrat (CHO) er hoveddeterminanten for postprandial glukoserespons (PGR). Baseret på den tidligere undersøgelse for at forstå, hvordan ernæringsvaner påvirker blodsukkerkontrol, vil vi udføre diætinterventionsundersøgelser i T1DM-patienter for at undersøge, om justeringen af ​​kostmønsteret er gavnligt for blodsukkerkontrol, og yderligere udforske den relevante mekanisme gennem påvisning af relaterede metaboliske indikatorer.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

1. Hovedformål: At evaluere effekten af ​​ændringer i kulhydratindtaget på glukosekontrol hos patienter med type 1-diabetes.

  1. Primært endepunkt: tidsforskel (TIR) ​​mellem de 2 grupper.
  2. Sekundært endepunkt:

1) forskel i variationskoefficient (CV), gennemsnitlig amplitude af glykæmiske udsving (MAGE), stor amplitude af glykæmiske udsving (LAGE) mellem de 2 grupper; 2) forskel i ændring i HbA1c, GA, 1,5-anhydroglucitol (1,5-AG) fra baseline mellem de 2 grupper; 3) forskel i ændring i forekomst af hypoglykæmiske hændelser (%), svær hypoglykæmi og natlig hypoglykæmi fra baseline mellem de 2 grupper; 4) forskel på ændring i insulindosis (IE/kg/dag) fra baseline mellem de 2 grupper.

2. Sekundært mål: At udforske den mulige mekanisme for diætintervention for at forbedre blodsukkerkontrollen hos patienter med type 1-diabetes.

  1. Effekter af diætintervention på tarmmikromiljø og mikroflora hos type 1-diabetespatienter;
  2. Effekter af diætintervention på immunfunktionen hos type 1-diabetespatienter;
  3. Effekter af diætintervention på metabolomik hos type 1-diabetespatienter.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

80

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

  • Navn: Tao Yang, MD/PhD
  • Telefonnummer: 6466 86-25-83718836
  • E-mail: yangt@njmu.edu.cn

Studiesteder

    • Jiangsu
      • Nanjing, Jiangsu, Kina, 210029
        • Rekruttering
        • First Affiliated Hospital, Nanjing Medical University
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inklusionskriterier:

  1. De, der accepterer at deltage i undersøgelsen og underskriver informeret samtykke;
  2. Diagnose af type 1 diabetes mellitus (ADA2024);
  3. Alder 18~65 år;
  4. Afhængig af eksogen insulinbehandling (CSII) forbliver behandlingsplanen uændret inden for 2 måneder (insulintypen kan ikke ændres, og dosis kan justeres i henhold til plasmaglukose);
  5. Kropsmasseindeks (BMI) på 18~24 kg/m2;
  6. HbA1c ≤9,5%;
  7. Tilfældigt C-peptid ≥200 pmol/L.

Ekskluderingskriterier:

  1. Bryllupsrejsende med type 1-diabetes mellitus;
  2. Kvinder, der er gravide eller planlægger at blive gravide;
  3. Patienter, der er vegetarer;
  4. Patienter, der bruger orale hypoglykæmiske lægemidler (alfa-glucosidasehæmmere, DPP-IV-hæmmere osv.);
  5. Patienter, der er brugere af glukokortikoider inden for 30 dage;
  6. Anamnese med alvorlig fødevareallergi;
  7. Patienter med akutte komplikationer såsom DKA;
  8. Patienter med gastroparese, inflammatorisk tarmsygdom og andre komplikationer;
  9. Patienter med stor albuminuri og nyreinsufficiens;
  10. Patienter med ukontrolleret hyperthyroidisme og hypothyroidisme;
  11. Anamnese med hjertesygdomme, koronar hjertesygdom og arytmi;
  12. Alvorlig leverdysfunktion (ALT eller AST>1,5 gange den øvre normalgrænse);
  13. Anamnese med maligne tumorer, ukontrollerede andre immunsystemsygdomme, ukontrollerede infektioner;
  14. Alkoholmisbrug, psykiske lidelser eller andre forhold, der er uegnede til at være observatør i stoftests;
  15. Patienter med enhver sygdom, der sandsynligvis vil forstyrre undersøgelsesdeltagelse eller evaluering.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: diverse carbohydrate diet

Carbohydrate, protein, and fat provide 45-55%, 15-20%, and 25-35% of total dietary energy, respectively. Of the staple carbohydrate sources, 45-50% are derived from refined grains and 45-50% from whole grains and legumes.

Total daily energy intake is divided among three meals, with breakfast providing 25-30% of total energy, lunch 30-40%, and dinner 30-35%.

Carbohydrate, protein, and fat provide 45-55%, 15-20%, and 25-35% of total dietary energy, respectively. Of the staple carbohydrate sources, 45-50% are derived from refined grains and 45-50% from whole grains and legumes. Total daily energy intake is divided among three meals, with breakfast providing 25-30% of total energy, lunch 30-40%, and dinner 30-35%.
Andet: moderate carbohydrate diet

Carbohydrate, protein, and fat provide 45-55%, 15-20%, and 25-35% of total dietary energy, respectively. Of the staple carbohydrate sources, 90-95% are derived from refined grains.

Total daily energy intake is divided among three meals, with breakfast providing 25-30% of total energy, lunch 30-40%, and dinner 30-35%.

Carbohydrate, protein, and fat provide 45-55%, 15-20%, and 25-35% of total dietary energy, respectively. Of the staple carbohydrate sources, 90-95% are derived from refined grains. Total daily energy intake is divided among three meals, with breakfast providing 25-30% of total energy, lunch 30-40%, and dinner 30-35%.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Time in range (TIR)
Tidsramme: 4 weeks (2 weeks after randomization)
TIR is defined as the percentage of time that glucose levels are between 3.9 and 10.0 mmol/L, as measured by continuous glucose monitoring (CGM). TIR at the end of the 2-week dietary intervention will be compared between the two groups.
4 weeks (2 weeks after randomization)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Time above range(TAR)
Tidsramme: 4 weeks (2 weeks after randomization)
TAR is defined as the percentage of time that glucose levels are above 10.0 mmol/L, as measured using continuous glucose monitoring (CGM). TAR at the end of the 2-week dietary intervention will be compared between the two groups.
4 weeks (2 weeks after randomization)
Time below range(TBR)
Tidsramme: 4 weeks (2 weeks after randomization)
TBR is defined as the percentage of time that glucose levels are below 3.9 mmol/L, as measured using continuous glucose monitoring (CGM). TBR at the end of the 2-week dietary intervention will be compared between the two groups.
4 weeks (2 weeks after randomization)
Mean glucose (MG)
Tidsramme: 4 weeks (2 weeks after randomization)
Mean glucose is defined as the arithmetic mean of all valid glucose values recorded during the 2-week continuous glucose monitoring (CGM) period. Mean glucose at the end of the 2-week dietary intervention will be compared between the two groups.
4 weeks (2 weeks after randomization)
Standard deviation of glucose (SD)
Tidsramme: 4 weeks (2 weeks after randomization)
SD is a continuous glucose monitoring (CGM)-derived measure of glycemic variability. SD at the end of the 2-week dietary intervention will be compared between the two groups.
4 weeks (2 weeks after randomization)
Glucose coefficient of variation (CV)
Tidsramme: 4 weeks (2 weeks after randomization)
CV is a continuous glucose monitoring (CGM)-derived measure of glycemic variability. CV at the end of the 2-week dietary intervention will be compared between the two groups.
4 weeks (2 weeks after randomization)
Mean amplitude of glycemic excursions (MAGE)
Tidsramme: 4 weeks (2 weeks after randomization)
MAGE is a continuous glucose monitoring (CGM)-derived measure of glycemic variability. MAGE at the end of the 2-week dietary intervention will be compared between the two groups.
4 weeks (2 weeks after randomization)
Largest amplitude of glycemic excursions (LAGE)
Tidsramme: 4 weeks (2 weeks after randomization)
LAGE is a continuous glucose monitoring (CGM)-derived measure of glycemic variability. LAGE at the end of the 2-week dietary intervention will be compared between the two groups.
4 weeks (2 weeks after randomization)
Glycated albumin (GA)
Tidsramme: 4 weeks (2 weeks after randomization)
Glycated albumin will be measured at the end of the 2-week dietary intervention and compared between the two groups.
4 weeks (2 weeks after randomization)
Glycated hemoglobin A1c (HbA1c)
Tidsramme: 16 weeks (14 weeks after randomization)
HbA1c will be measured at the end of the follow-up period and compared between the two groups.
16 weeks (14 weeks after randomization)
C-peptide area under the curve (AUC C-peptide)
Tidsramme: 16 weeks (14 weeks after randomization)
C-peptide area under the curve will be assessed during a 3-hour mixed-meal tolerance test and calculated using the trapezoidal rule. The assessment will be performed in participants with fasting C-peptide >80 pmol/L.
16 weeks (14 weeks after randomization)
Glucagon area under the curve (AUC glucagon)
Tidsramme: 16 weeks (14 weeks after randomization)
Glucagon area under the curve will be assessed during a 3-hour mixed-meal tolerance test and calculated using the trapezoidal rule. The assessment will be performed in participants with fasting C-peptide >80 pmol/L.
16 weeks (14 weeks after randomization)
Fasting blood glucose (FBG)
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Fasting blood glucose will be measured at the end of the dietary intervention and at the end of the follow-up period and compared between the two groups.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Total cholesterol (TC)
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Total cholesterol will be measured at the end of the dietary intervention and at the end of the follow-up period and compared between the two groups.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Triglycerides (TG)
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Triglycerides will be measured at the end of the dietary intervention and at the end of the follow-up period and compared between the two groups.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Low-density lipoprotein cholesterol (LDL-C)
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
LDL-C will be measured at the end of the dietary intervention and at the end of the follow-up period and compared between the two groups.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
High-density lipoprotein cholesterol (HDL-C)
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
HDL-C will be measured at the end of the dietary intervention and at the end of the follow-up period and compared between the two groups.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
1,5-Anhydroglucitol (1,5-AG)
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
1,5-AG will be measured at the end of the dietary intervention and at the end of the follow-up period and compared between the two groups.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Total daily insulin dose
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Total daily insulin dose, expressed as IU/kg/day, will be assessed at the end of the dietary intervention and at the end of the follow-up period.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Basal insulin dose
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Basal insulin dose, expressed as IU/kg/day, will be assessed at the end of the dietary intervention and at the end of the follow-up period.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Prandial insulin dose
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Prandial insulin dose, expressed as IU/kg/day, will be assessed at the end of the dietary intervention and at the end of the follow-up period.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Body weight
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Body weight will be measured at the end of the dietary intervention and at the end of the follow-up period.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Waist circumference
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Waist circumference will be measured at the end of the dietary intervention and at the end of the follow-up period.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Hip circumference
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Hip circumference will be measured at the end of the dietary intervention and at the end of the follow-up period.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Waist-to-hip ratio (WHR)
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Waist-to-hip ratio will be calculated from waist and hip circumference measurements at the end of the dietary intervention and at the end of the follow-up period.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Body composition
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Body composition will be assessed using a body composition analyzer at the end of the dietary intervention and at the end of the follow-up period.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Hypoglycemic events
Tidsramme: From randomization to the end of follow-up at 16 weeks
Hypoglycemic events will be assessed by the number of events per participant, the proportion of participants experiencing at least one hypoglycemic event, and the incidence rate of hypoglycemic events.
From randomization to the end of follow-up at 16 weeks
Diabetic ketoacidosis (DKA)
Tidsramme: From randomization to the end of follow-up at 16 weeks
The number and proportion of participants experiencing diabetic ketoacidosis will be assessed and compared between the two groups.
From randomization to the end of follow-up at 16 weeks

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Gut microbiota profile
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Gut microbiota profiles will be assessed from fecal samples at the end of the dietary intervention and at the end of the follow-up period to evaluate differences between the two groups.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Metabolomic profile
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Metabolomic profiles will be assessed at the end of the dietary intervention and at the end of the follow-up period to evaluate differences between the two groups.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
T-cell subset proportions
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
The proportions of T-cell subsets will be assessed by flow cytometry at the end of the dietary intervention and at the end of the follow-up period.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Tao Yang, MD/PhD, First Affiliated Hospital, Nanjing Medical University, China

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. august 2024

Primær færdiggørelse (Anslået)

31. december 2027

Studieafslutning (Anslået)

31. december 2027

Datoer for studieregistrering

Først indsendt

23. februar 2023

Først indsendt, der opfyldte QC-kriterier

16. februar 2024

Først opslået (Faktiske)

22. februar 2024

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

10. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

7. september 2026

Sidst verificeret

1. september 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 2022-SR-481.A3

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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