Hiilihydraattien saannin muutosten vaikutus glukoosin hallintaan tyypin 1 diabetesta sairastavilla potilailla
Hiilihydraattien saannin muutosten vaikutus glukoosin hallintaan potilailla, joilla on tyypin 1 diabetes.
Tutkimuksen yleiskatsaus
Tila
Tila
Ehdot
Ehdot
Interventio / Hoito
Interventio / Hoito
Yksityiskohtainen kuvaus
1. Päätavoite: Arvioida hiilihydraattien saannin muutosten vaikutusta verensokerin hallintaan tyypin 1 diabetesta sairastavilla potilailla.
- Ensisijainen päätepiste: aikaero kahden ryhmän välillä (TIR).
- Toissijainen päätepiste:
1) variaatiokertoimen ero (CV), glykeemisten poikkeamien keskimääräinen amplitudi (MAGE), glykeemisten muutosten suuri amplitudi (LAGE) kahden ryhmän välillä; 2) HbA1c,GA,1,5-anhydroglusitolin (1,5-AG) muutoksen ero perustasosta näiden kahden ryhmän välillä; 3) ero hypoglykeemisten tapahtumien (%), vakavan hypoglykemian ja yöllisen hypoglykemiatapahtumien esiintyvyyden muutoksissa lähtötasosta kahden ryhmän välillä; 4) insuliiniannoksen muutoksen ero (IU/kg/vrk) lähtötasosta kahden ryhmän välillä.
2. Toissijainen tavoite: Tutkia tyypin 1 diabetesta sairastavien potilaiden verensokerin hallinnan parantamiseksi mahdollista ruokavaliointerventiomekanismia.
- Ruokavalion vaikutukset tyypin 1 diabetespotilaiden suoliston mikroympäristöön ja mikroflooraan;
- Ruokavalion vaikutukset tyypin 1 diabetespotilaiden immuunitoimintoihin;
- Ruokavalion vaikutukset tyypin 1 diabetespotilaiden metabolomiikkaan.
Opintotyyppi
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Ilmoittautuminen
Vaihe
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskeluyhteys
Opiskeluyhteys
- Nimi: Tao Yang, MD/PhD
- Puhelinnumero: 6466 86-25-83718836
- Sähköposti: yangt@njmu.edu.cn
Opiskelupaikat
-
-
Jiangsu
-
Nanjing, Jiangsu, Kiina, 210029
- Rekrytointi
- First Affiliated Hospital, Nanjing Medical University
-
Ottaa yhteyttä:
- Tao Yang, PhD
- Puhelinnumero: 6466 86-25-83718836
- Sähköposti: yangt@njmu.edu.cn
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Kuvaus
Sisällyttämiskriteerit:
- Ne, jotka suostuvat osallistumaan tutkimukseen ja allekirjoittavat tietoisen suostumuksen;
- tyypin 1 diabetes mellituksen diagnoosi (ADA2024);
- Ikä 18-65 vuotta;
- Riippuen eksogeenisesta insuliinihoidosta (CSII), hoitosuunnitelma pysyy muuttumattomana 2 kuukauden sisällä (insuliinin tyyppiä ei voi muuttaa, ja annosta voidaan säätää plasman glukoosin mukaan);
- painoindeksi (BMI) 18-24 kg/m2;
- HbA1c < 9,5 %;
- Satunnainen C-peptidi ≥ 200 pmol/l.
Poissulkemiskriteerit:
- Häämatkalaiset, joilla on tyypin 1 diabetes mellitus;
- Naiset, jotka ovat raskaana tai suunnittelevat raskautta;
- Potilaat, jotka ovat kasvissyöjiä;
- Potilaat, jotka käyttävät suun kautta otettavia hypoglykeemisiä lääkkeitä (alfa-glukosidaasin estäjät, DPP-IV:n estäjät jne.);
- Potilaat, jotka käyttävät glukokortikoideja 30 päivän sisällä;
- Aiempi vakava ruoka-aineallergia;
- Potilaat, joilla on akuutteja komplikaatioita, kuten DKA;
- Potilaat, joilla on gastropareesi, tulehduksellinen suolistosairaus ja muita komplikaatioita;
- Potilaat, joilla on laaja albuminuria ja munuaisten vajaatoiminta;
- Potilaat, joilla on hallitsematon hypertyreoosi ja kilpirauhasen vajaatoiminta;
- Aiemmat sydänsairaudet, sepelvaltimotaudit ja rytmihäiriöt;
- Vakava maksan toimintahäiriö (ALT tai ASAT > 1,5 kertaa normaalin yläraja);
- Pahanlaatuiset kasvaimet, hallitsemattomat muut immuunijärjestelmän sairaudet, hallitsemattomat infektiot;
- Alkoholin väärinkäyttö, mielenterveyshäiriöt tai muut sairaudet, jotka eivät sovellu tarkkailijaksi huumetesteissä;
- Potilaat, joilla on jokin sairaus, joka todennäköisesti häiritsee tutkimukseen osallistumista tai arviointia.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Yksittäinen
Aseiden lukumäärä
Aseet ja interventiot
Osallistujaryhmä / ArmOsallistujaryhmä / Arm |
Interventio / HoitoInterventio / Hoito |
|---|---|
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Kokeellinen: 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%.
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|
Muut: 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%.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Time in range (TIR)
Aikaikkuna: 4 weeks (2 weeks after randomization)
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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)
|
Toissijaiset tulostoimenpiteet
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Time above range(TAR)
Aikaikkuna: 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)
Aikaikkuna: 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)
Aikaikkuna: 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)
|
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Standard deviation of glucose (SD)
Aikaikkuna: 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)
|
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Glucose coefficient of variation (CV)
Aikaikkuna: 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)
|
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Mean amplitude of glycemic excursions (MAGE)
Aikaikkuna: 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)
|
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Largest amplitude of glycemic excursions (LAGE)
Aikaikkuna: 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)
Aikaikkuna: 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)
Aikaikkuna: 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)
Aikaikkuna: 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)
|
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Glucagon area under the curve (AUC glucagon)
Aikaikkuna: 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)
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Fasting blood glucose (FBG)
Aikaikkuna: 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)
Aikaikkuna: 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)
|
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Triglycerides (TG)
Aikaikkuna: 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.
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4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
|
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Low-density lipoprotein cholesterol (LDL-C)
Aikaikkuna: 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.
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4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
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High-density lipoprotein cholesterol (HDL-C)
Aikaikkuna: 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)
|
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1,5-Anhydroglucitol (1,5-AG)
Aikaikkuna: 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.
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4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
|
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Total daily insulin dose
Aikaikkuna: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
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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.
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4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
|
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Basal insulin dose
Aikaikkuna: 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)
|
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Prandial insulin dose
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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.
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4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
|
|
Hip circumference
Aikaikkuna: 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.
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4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
|
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Waist-to-hip ratio (WHR)
Aikaikkuna: 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)
|
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Body composition
Aikaikkuna: 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
Aikaikkuna: 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)
Aikaikkuna: 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
|
Muut tulostoimenpiteet
Muut tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Gut microbiota profile
Aikaikkuna: 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
Aikaikkuna: 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
Aikaikkuna: 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)
|
Yhteistyökumppanit ja tutkijat
Sponsori
Sponsori
Tutkijat
Tutkijat
- Päätutkija: Tao Yang, MD/PhD, First Affiliated Hospital, Nanjing Medical University, China
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
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Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Opiskelun aloitus
Ensisijainen valmistuminen (Arvioitu)
Ensisijainen valmistuminen
Opintojen valmistuminen (Arvioitu)
Opintojen valmistuminen
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Ensimmäinen Lähetetty
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin päivitys julkaistu
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
Muut tutkimustunnusnumerot
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