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Women With Previous GDM and the Effects of HIIT. (GDM-HIIT)

28 de abril de 2026 actualizado por: Odense University Hospital

Deep Metabolic and Molecular Phenotyping of Women With Previous Gestational Diabetes Mellitus and the Responses to High-intensity Interval Training.

The goal of this clinical trial is to investigate if women with previous gestational diabetes (pGDM) are characterized with unique metabolic and molecular alterations compared to women without pGDM. Furthermore if 8 weeks of high-intensity interval training (HIIT) can improve these alterations. The main questions we aim to answer are:

  1. Women with pGDM have metabolic abnormalities compared with women without pGDM, and that these metabolic abnormalities are explained by unique molecular abnormalities in skeletal muscle and adipose tissue.
  2. Eight weeks of HIIT combining rowing and cycling can markedly improve these metabolic abnormalities in women with pGDM and these improvements are explained by beneficial cellular and molecular changes in skeletal muscle and adipose tissue.

Researchers will compare 20 women with pGDM to 20 glucosetolerant without pGDM, who are matched on age, BMI and times since last pregnancy.

Participants will undergo a screening visit and examinations on two separate days before (day 1 and day 2) and two separate days after (day 3 and day 4) 8-weeks of HIIT, in all cases after an overnight fast (≥ 12 h). Day 1 and day 3 will include assessment of body composition and VO2max. On day 2 and day 4, the insulin sensitivity, substrate metabolism, and β-cell function of the participants will be examined by a Botnia-clamp combined by indirect calorimetry. Skeletal muscle biopsies from m. vastus lateralis and subcutaneous abdominal adipose tissue biopsies are taken in the basal and insulin-stimulated states of each clamp.

Descripción general del estudio

Estado

Inscripción por invitación

Condiciones

Intervención / Tratamiento

Tipo de estudio

Intervencionista

Inscripción (Estimado)

40

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Dinamarca
    • Region Syddanmark
      • Odense, Region Syddanmark, Dinamarca, 5000
        • Steno Diabetes Center Odense, Odense University Hospital

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Adulto

Acepta Voluntarios Saludables

Sí

Descripción

Inclusion Criteria:

  • Age 25-45 years
  • BMI 20-35 kg/m2
  • 2-8 years since the last pregnancy
  • No known diabetes or PCOS
  • No previous bariatric surgery
  • No known disease
  • Be drug-naive
  • Have a regular menstrual cycle (23-35 days)
  • Not be pregnant or planning pregnancy during the study period
  • Low or moderate level of physical activity must be (max 2 hours of moderate exercise weekly).
  • All participants should be able to provide informed consent
  • Women without pGDM must not have known hypertension or first-degree relatives with diabetes.

Exclusion Criteria:

  • Abnormal cardiac stethoscopy, ECG or screening blood tests
  • Positive plasma GAD-65 antibodies
  • Positive plasma choriogonadotropine
  • Undiagnosed T2D based on fasting plasma glucose (≥ 7.0 mmol/mol), plasma HbA1c (≥ 48 mmol/mol), or 2-h plasma glucose during an oral glucose tolerance test (OGTT) (≥ 11.1 mmol/mol)
  • Dyslipidemia (plasma LDL-cholesterol > 5.0 mmol/l)
  • In women with pGDM: Undiagnosed severe hypertension (blood pressure > 160/100)
  • In women without pGDM: Undiagnosed hypertension (blood pressure >140/90 mmHg) or impaired glucose tolerance (fasting plasma glucose at 6.16.9 mmol/l, plasma HbA1c at 42-47 mmol/mol, or a 2-h glucose at 7.8-11.0 mmol/l during an OGTT).

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Prevención
  • Asignación: No aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Women with previous gestational diabetes mellitus
Women with previous gestational diabetes mellitus, aged 25-45, who gave birth 2-8 years ago.
Otro: High-intensity interval training
The training intervention consists of 8-weeks of HIIT combining rowing and cycling on ergometers with two supervised sessions weekly in small groups of up to 10 participants. All HIIT sessions will start with a 10-min warm-up period followed by training blocks of 5 x 1 min high-intensity intervals (100-110% of Wattmax corresponding to ≥ 85% of maximum heart rate (HRmax)) each interspersed by 1 min active or resting recovery. Between the training blocks, the participants will have a 4-min break in which they shift from cycling to rowing or vice versa. The number of training blocks will gradually increase from two to five blocks during the 8-week intervention period with one block being added every second week. Halfway through the HIIT-protocol the workload will be adjusted according to a midway VO2max test. Participants will wear a heart monitor during training sessions.
Comparador activo: Women without previous gestational diabetes
Women without previous gestational diabetes mellitus, aged 25-45, who gave birth 2-8 years ago.
Otro: High-intensity interval training
The training intervention consists of 8-weeks of HIIT combining rowing and cycling on ergometers with two supervised sessions weekly in small groups of up to 10 participants. All HIIT sessions will start with a 10-min warm-up period followed by training blocks of 5 x 1 min high-intensity intervals (100-110% of Wattmax corresponding to ≥ 85% of maximum heart rate (HRmax)) each interspersed by 1 min active or resting recovery. Between the training blocks, the participants will have a 4-min break in which they shift from cycling to rowing or vice versa. The number of training blocks will gradually increase from two to five blocks during the 8-week intervention period with one block being added every second week. Halfway through the HIIT-protocol the workload will be adjusted according to a midway VO2max test. Participants will wear a heart monitor during training sessions.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
β-cell function by OGTT
Periodo de tiempo: At screening visit.
Will be estimated as the disposition index (DI) by oral glucose tolerance test (OGTT) derived indices of insulin sensitivity and insulin secretion, after a 2-hour OGTT (75g) with measurement of plasma glucose, serum insulin and serum C-peptide at 0, 30 and 120 min.
At screening visit.
β-cell function by Botnia-clamp
Periodo de tiempo: At examination day 2 and 4.
β-cell function adjusted for insulin sensitivity will be determined by calculating the DI as a product of the acute insulin response to glucose (AIRg) and insulin-stimulated glucose infusion rate (GIR).
At examination day 2 and 4.
Whole body composition (lean body mass and fat mass)
Periodo de tiempo: At examination day 1 and 3.
Will be obtained by a dual-energy X-ray absorptiometry (DXA) scanning (Prodigy Advance, GE Healthcare, CHI, US)
At examination day 1 and 3.
Lean body mass
Periodo de tiempo: At examination day 1 and 3.
Will be obtained by a dual-energy X-ray absorptiometry (DXA) scanning (Prodigy Advance, GE Healthcare, CHI, US)
At examination day 1 and 3.
Fat mass
Periodo de tiempo: At examination day 1 and 3.
Will be obtained by a dual-energy X-ray absorptiometry (DXA) scanning (Prodigy Advance, GE Healthcare, CHI, US)
At examination day 1 and 3.
Cardiorespiratory fitness (maximal oxygen consumptions (VO2-max))
Periodo de tiempo: At examination day 1 and 3.
Will be determined by an incremental exercise test on a cycle ergometer (SRM Ergometer System, Jülich, DE) combined with mixed chamber cardiopulmonary exercise analyzer (Oxigraf, Model O2CPX, California, US)
At examination day 1 and 3.
Insulin sensitivity by Botnia-clamp
Periodo de tiempo: At examination day 2 and 4.
Consisting of a hyperinsulinemic-euglycemic clamp (insulin 40mU/min/m2 for 3 h) combined with a 60 min intravenous glucose tolerance test (IVGGT) using a glucose bolus (0.3 kg per kg body weight with a maximum of 25 g glucose).
At examination day 2 and 4.

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Plasma-specific metabolomics by LC- and GC-MS
Periodo de tiempo: At examination day 2 and 4.
Liquid chromatography (LC)- and gas chromatography (GS)-based mass spectrometry (MS) will be used to detection, identification, and quantitation of very large numbers of metabolites in the micro- and nano-molar range in body fluids, such as blood.
At examination day 2 and 4.
Tissue-specific metabolomics by LC- and GC-MS
Periodo de tiempo: At examination day 2 and 4.
Liquid chromatography (LC)- and gas chromatography (GS)-based mass spectrometry (MS) will be used to detection, identification, and quantitation of very large numbers of metabolites in the micro- and nano-molar range in body tissues.
At examination day 2 and 4.
Proteomics
Periodo de tiempo: At examination day 2 and 4.
To identify biological processes and signaling networks altered in women with pGDM and changed in response to HIIT, we will apply unbiased mass-spectrometry based proteome analysis of the skeletal muscle and adipose tissue biopsies.
At examination day 2 and 4.
Phosphoproteomics
Periodo de tiempo: At examination day 2 and 4.
To identify biological processes and signaling networks altered in women with pGDM and changed in response to HIIT, we will apply unbiased mass-spectrometry based phosphoproteome analysis of the skeletal muscle and adipose tissue biopsies.
At examination day 2 and 4.
Transcriptional profiling and gene expression
Periodo de tiempo: At examination day 2 and 4.

High-resolution transcriptional profiling of abdominal adipose tissue and skeletal muscle biopsies will be performed using total RNA sequencing with next generation sequencing (TruSeq® Stranded Total RNA Library Prep Gold; Illumina).

Gene expressions are quantified using Targeted quantitative real-time PCR (qRT-PCR) and Western Blotting.
At examination day 2 and 4.
Mitochondrial respiration
Periodo de tiempo: At examination day 2 and 4.
Will be measured on permeabilized muscle fibers, and analyzed by measuring oxygen consumption when adding substrates, uncouplers, and inhibitors to the chambers of a high-resolution oxygraphy.
At examination day 2 and 4.
Lipid droplets by TEM
Periodo de tiempo: At examination day 2 and 4.
The morphology, volume, and localization of lipid droplets in muscle biopsies from the study cohorts will be determined by Transmission Electron Microscopy (TEM).
At examination day 2 and 4.
Mitochondria by TEM
Periodo de tiempo: At examination day 2 and 4.
The morphology, volume, and localization of mitochondria in muscle biopsies from the study cohorts will be determined by Transmission Electron Microscopy (TEM).
At examination day 2 and 4.
Lipid droplet interaction with mitochondria by TEM
Periodo de tiempo: At examination day 2 and 4.
The the physical interaction between lipid droplets and mitochondria in muscle biopsies from the study cohorts will be determined by Transmission Electron Microscopy (TEM).
At examination day 2 and 4.
Protein abundance
Periodo de tiempo: At examination day 2 and 4.
Protein abundance will be studied in skeletal muscle and adipose tissue biopsies by Western blotting procedures.
At examination day 2 and 4.
Phosphorylation of enzymes
Periodo de tiempo: At examination day 2 and 4.
Phosphorylation of enzymes will be studied in skeletal muscle and adipose tissue biopsies by Western blotting procedures.
At examination day 2 and 4.

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
Lipid profile
Periodo de tiempo: At examination day 2 and 4.
Plasma total cholesterol, HDL-cholesterol, LDL-cholesterol, non-HDL-cholesterol and triglycerides determined by blood tests.
At examination day 2 and 4.
HbA1c
Periodo de tiempo: At examination day 2 and 4.
Determined by blood tests.
At examination day 2 and 4.
Insulin
Periodo de tiempo: At examination day 2 and 4.
Determined by blood tests.
At examination day 2 and 4.
Glucose
Periodo de tiempo: At examination day 2 and 4.
Determined by blood tests.
At examination day 2 and 4.
C-peptide
Periodo de tiempo: At examination day 2 and 4.
Determined by blood tests.
At examination day 2 and 4.
Levels of systemic low-grade inflammation
Periodo de tiempo: At examination day 2 and 4.
Circulating levels of adiponectin, leptin, interleukin-6 (IL-6), fibroblast growth factor 21 (FGF21), angiopoietin-like 4 (ANGPTL4) and growth differentiation factor 15 (GDF15) will be measured in bloodsamples.
At examination day 2 and 4.

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Odense University Hospital

Colaboradores

University of Southern Denmark

Investigadores

  • Investigador principal: Kurt Højlund, Prof. Dr. med., Steno Diabetes Center Odense, Odense University Hospital

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

13 de marzo de 2026

Finalización primaria (Estimado)

1 de enero de 2028

Finalización del estudio (Estimado)

1 de noviembre de 2028

Fechas de registro del estudio

Enviado por primera vez

26 de febrero de 2026

Primero enviado que cumplió con los criterios de control de calidad

28 de abril de 2026

Publicado por primera vez (Actual)

5 de mayo de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

5 de mayo de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

28 de abril de 2026

Última verificación

1 de abril de 2026

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • 25/55674

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

SÍ

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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