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Inspiratory Muscle Strength Training in Adults With Type 1 Diabetes

2026年10月7日 更新者:Joseph Watso、Florida State University

Time-Efficient Inspiratory Muscle Strength Training as a New Approach to Improve Cardiovascular Function Among Adults With Type 1 Diabetes

Adults with type 1 diabetes have elevated cardiovascular disease risk, and systolic blood pressure is a leading modifiable contributor to that risk. Aerobic exercise lowers blood pressure but poses time and glycemic-management barriers for people with type 1 diabetes. Inspiratory muscle strength training is a brief, home-based, device-based intervention that takes about five minutes per day and has lowered systolic blood pressure in other adult populations.

This pilot trial will test whether eight weeks of daily high-resistance inspiratory muscle strength training lowers blood pressure and improves vascular function in adults with type 1 diabetes. Participants will be randomized 2:1 to high-resistance or very-low-resistance sham training using a POWERbreathe K3 device and will complete 30 training breaths per day at home for eight weeks. Outcomes are assessed before and after the training period.

調査の概要

状態

まだ募集していません

条件

介入・治療

詳細な説明

Approximately two million Americans live with type 1 diabetes, and cardiovascular disease is the leading cause of death in this population. After glycemic control, systolic blood pressure is the leading modifiable cardiovascular risk factor. Traditional aerobic exercise lowers blood pressure and improves vascular function, but most adults with type 1 diabetes do not meet physical activity recommendations, citing time constraints and concern about exercise-associated hypoglycemia.

Inspiratory muscle strength training (IMST) requires about five minutes per day, is performed seated at home with a commercially available handheld device, and is unlikely to provoke hypoglycemia. A retrospective analysis of five independent trials in 128 adults reported a 9 mmHg reduction in casual systolic blood pressure following high-resistance IMST compared with sham training, with effects that appear consistent across age, sex, health status, and baseline blood pressure. No study has examined IMST in people with type 1 diabetes.

Participants are randomized in a 2:1 ratio to high-resistance IMST or very-low-resistance sham IMST. Randomization uses a computer-generated sequence held by an unmasked team member who is responsible only for setting device resistance; participants, investigators, and outcome assessors remain masked to group assignment. All participants complete approximately 56 daily training sessions over eight weeks, each consisting of five bouts of six forceful inhalations with about 30 seconds of rest between bouts.

Maximal inspiratory pressure is measured at weeks 0, 2, 4, 6, and 8. For the high-resistance group, device resistance is set to a graded percentage of the participant's current maximal inspiratory pressure: 55% during weeks 1-2, 65% during weeks 3-4, and 75% during weeks 5-8. The sham group trains at 15% of maximal inspiratory pressure throughout. Participants are debriefed on their group assignment at the end of the post-training visit.

Testing visits at week 0 and week 8 include laboratory blood pressure, brachial artery flow-mediated dilation and post-occlusion reactive hyperemia by high-resolution ultrasound, central blood pressure and arterial stiffness by applanation tonometry, and isometric handgrip exercise testing with post-exercise circulatory occlusion. Participants measure their blood pressure at home once weekly on a provided automated monitor during weeks without a laboratory visit. Brief check-in contacts occur on odd weeks and device adjustment visits on even weeks. An optional follow-up visit repeating all assessments is offered at week 12.

研究の種類

介入

入学 (推定)

30

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

    • Florida
      • Tallahassee、Florida、アメリカ、32306
        • Florida State University
      • Tallahassee、Florida、アメリカ、32306
        • Cardiovascular and Applied Physiology Laboratory
        • コンタクト:
          • Joseph Watso, PhD
          • 電話番号:8506441281
          • メール:jwatso@fsu.edu

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~35年 (大人)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion Criteria:

  • Age 18 to 35 years
  • Type 1 diabetes diagnosed more than 1 year before screening
  • Hemoglobin A1c (HbA1c) 10.0% or less within the last 3 months (may be measured at screening)- Body mass index 18 to 29.9 kg/m^2
  • Stable insulin delivery method for the past 30 days
  • Ability to read all device instructions and insulin pump settings
  • Estimated glomerular filtration rate at least 60 mL/min/1.73 m^2 within the last 3 months (may be measured at screening)
  • Use of an insulin pump or insulin delivery by multiple daily injections
  • Attendance at 3 or more diabetes care visits over the past 12 months

Exclusion Criteria:

  • Diabetes-related hospitalization, including for diabetic ketoacidosis or severe hypoglycemia, within 12 months of screening
  • Poorly controlled hypertension, defined as systolic blood pressure at least 140 mmHg or diastolic blood pressure at least 90 mmHg
  • Taking diabetes medications other than insulin
  • Structured exercise more than 150 minutes per week for the last 3 months
  • Pregnant, lactating, or planning to become pregnant within the study period
  • Unstable weight, defined as more than 5% change in the last 3 months
  • Significant organ system dysfunction, such as severe pulmonary, renal, hepatic, or cardiovascular disease
  • Diagnosed anemia or known hemoglobin less than 10 g/dL
  • Diagnosed neuropathic or psychiatric illness
  • Active nicotine or illegal drug use
  • Alcohol consumption totaling more than 10 standard drinks per week
  • Unable to grant voluntary informed consent
  • Unable or unwilling to follow the study protocol
  • Per the POWERbreathe device user manual: history of spontaneous pneumothorax; a collapsed lung that has not fully healed; a pacemaker or medical implant containing magnets or electronics; any condition of the eardrum, such as a burst eardrum that has not fully healed

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:防止
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:トリプル

武器と介入

参加者グループ / アーム
介入・治療
実験的:High-Resistance Inspiratory Muscle Strength Training

Participants complete daily inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks. Each session consists of five bouts of six forceful inhalations against resistance, with approximately 30 seconds of rest between bouts, for 30 training breaths per day. Resistance is set to a graded percentage of the participant's current maximal inspiratory pressure: 55% during weeks 1-2, 65% during weeks 3-4, and 75% during weeks 5-8.

Daily home-based inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks, at 55% of maximal inspiratory pressure during weeks 1-2, 65% during weeks 3-4, and 75% during weeks 5-8. Maximal inspiratory pressure is re-measured at weeks 0, 2, 4, 6, and 8 and resistance is adjusted accordingly.

偽コンパレータ:Sham Inspiratory Muscle Strength Training

Participants complete daily inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks. Each session consists of five bouts of six forceful inhalations against resistance, with approximately 30 seconds of rest between bouts, for 30 training breaths per day. Resistance is set to 15% of the participant's maximal inspiratory pressure throughout the eight weeks.

Daily home-based inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks, at 15% of maximal inspiratory pressure throughout.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Change From Baseline in Laboratory-Measured Seated Systolic Blood Pressure at 8 Weeks
時間枠:Baseline and 8 weeks

Seated brachial systolic blood pressure measured in the laboratory with an automated oscillometric monitor after a period of quiet rest. This is the powered primary outcome.

Baseline and 8 weeks

二次結果の測定

結果測定
メジャーの説明
時間枠
Change From Baseline in Home Systolic Blood Pressure at 8 Weeks
時間枠:Baseline and 8 weeks

Self-measured seated brachial systolic blood pressure recorded at home once weekly on a provided automated monitor, following American Heart Association home-monitoring recommendations.

Baseline and 8 weeks

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

協力者

捜査官

  • 主任研究者:Joseph C Watso、Florida State University

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2027年1月1日

一次修了 (推定)

2028年9月1日

研究の完了 (推定)

2028年10月1日

試験登録日

最初に提出

2026年9月30日

QC基準を満たした最初の提出物

2026年9月30日

最初の投稿 (実際)

2026年10月6日

学習記録の更新

投稿された最後の更新 (実際)

2026年10月8日

QC基準を満たした最後の更新が送信されました

2026年10月7日

最終確認日

2026年10月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • STUDY00007503
  • R03HL183276 (米国 NIH グラント/契約)

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

はい

IPD プランの説明

De-identified individual participant-level data (IPD) that correspond directly to the key outcomes reported in peer-reviewed publications will be preserved and shared.

IPD 共有時間枠

Data will be made available after peer-review publication of the final dataset, but no later than 1 year after the completion of data collection. Data will remain available for a period of at least 10 years, per the University's guidelines for records retention.

IPD 共有アクセス基準

Access will be unrestricted and open to the scientific community without controlled-access barriers. All data will be fully de-identified in compliance with HIPAA guidelines by removing direct/indirect personal identifiers and assigning coded study IDs prior to upload. Datasets will be structured in open, interoperable formats (CSV and/or TXT) requiring no specialized software to access. Datasets will be archived and publicly searchable in Zenodo (a FAIR-aligned public generalist repository) and assigned a persistent Digital Object Identifier (DOI). Summary results will also be submitted directly to ClinicalTrials.gov.

IPD 共有サポート情報タイプ

  • STUDY_PROTOCOL
  • SAP
  • ICF

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

はい

米国で製造され、米国から輸出された製品。

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。