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Carbohydrate-based Strategies to Prevent Exercise-induced Hypoglycemia

8 juni 2020 bijgewerkt door: Rémi Rabasa-Lhoret, Institut de Recherches Cliniques de Montreal

Comparison of Two Carbohydrate Intake Strategies to Improve Glucose Control During Exercise in Adolescents and Adults With Type 1 Diabetes

To prevent hypoglycemia during prolonged exercise (>30 minutes), additional carbohydrate intake is frequently required. Carbohydrate intake required will vary with insulin regimens, timing and type of exercise as well as starting blood glucose level. In addition to the amount of carbohydrate ingested, the timing of carbohydrate intake could also have an impact on glucose control during exercise. Therefore, the objective of this study will be to compare the efficacy of two snacking strategies to maintain glucose levels in the target range during an exercise period in adolescents and adults with type 1 diabetes: 1) a snack containing ~0.5g of carbohydrates per kilogram of body weight - rounded to the nearest 5g - given 5 minutes before exercise; 2) a snack containing ~0.5g of carbohydrates per kilogram of body weight - rounded to the nearest 5g - distributed this way: ~40% given 5 minutes before exercise, ~30% after 20 minutes of exercise and the last ~30% after 40 minutes of exercise.

Studie Overzicht

Toestand

Voltooid

Interventie / Behandeling

Studietype

Ingrijpend

Inschrijving (Werkelijk)

37

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

    • Quebec
      • Montreal, Quebec, Canada
        • Institut de recherches cliniques de Montreal

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

14 jaar en ouder (Kind, Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  1. Males and females ≥ 14 years of old.
  2. Clinical diagnosis of type 1 diabetes for at least one year.
  3. Last (less than 3 months) HbA1c ≤ 10%.
  4. Patients using multiple daily injections with basal-bolus insulin regimen.

Exclusion Criteria:

  1. Clinically significant microvascular complications: nephropathy (estimated glomerular filtration rate below 40 ml/min), neuropathy (especially diagnosed gastroparesis) or severe proliferative retinopathy as judged by the investigator.
  2. Recent (< 3 months) acute macrovascular event e.g. acute coronary syndrome or cardiac surgery.
  3. Abnormal blood panel and/or anemia.
  4. Ongoing pregnancy.
  5. Severe hypoglycemic episode within two weeks of screening.
  6. Other serious medical illness likely to interfere with study participation or with the ability to complete the exercise periods by the judgment of the investigator (e.g. orthopedic limitation).
  7. Treatment with CSII (Continuous Subcutaneous Insulin Infusion) "insulin pump therapy".

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Crossover-opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Actieve vergelijker: Full snack given before exercise
A snack containing ~0.5g of carbohydrates per kilogram of body weight will be given 5 minutes before exercise
Participants will be admitted at IRCM at 14:00. At 15:30, participants will performed a 60-minute exercise on the ergocycle at 60% of VO2 peak (moderate intensity). During exercise, capillary glucose levels will be measured every 10 minutes. At 16:30, the exercise will be completed and capillary glucose levels will be monitored every 20 minutes for 1 hour. At 17:30, the participant will be discharged.
Full snack or Distributed snack
Actieve vergelijker: Distributed snack over exercise period
A snack containing ~0.5g of carbohydrates per kilogram of body weight distributed this way will be given: ~40% given 5 minutes before exercise, ~30% after 20 minutes of exercise and the last ~30% after 40 minutes of exercise.
Participants will be admitted at IRCM at 14:00. At 15:30, participants will performed a 60-minute exercise on the ergocycle at 60% of VO2 peak (moderate intensity). During exercise, capillary glucose levels will be measured every 10 minutes. At 16:30, the exercise will be completed and capillary glucose levels will be monitored every 20 minutes for 1 hour. At 17:30, the participant will be discharged.
Full snack or Distributed snack

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Percentage of time of capillary glucose levels spent between 4-10 mmol/L
Tijdsspanne: This outcome will be measured over 120 minutes
This time frame corresponds to the exercise period and the 1 hour following it
This outcome will be measured over 120 minutes

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Percentage of time of sensor glucose levels spent between 4-10 mmol/L
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Percentage of time of glucose levels spent below 4 mmol/L
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Decrease in glucose levels
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Difference between glucose level at the start of the exercise and the lowest glucose level from the start of the exercise until 1) the end of the exercise and 2) 1 hour after the end of the exercise.
This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Increase in glucose level
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Difference between glucose level at the start of the exercise and the highest glucose level from the start of the exercise until 1) the end of the exercise and 2) 1 hour after the end of the exercise.
This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Number of participants with an exercise-induced hypoglycemia below 4 mmol/L
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Number of participants with an exercise-induced hypoglycemia below 3.5 mmol/L
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Number of participants requiring an oral treatment for hypoglycemia
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Total number of hypoglycemia episodes requiring treatment
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Percentage of time of glucose levels spent above 10 mmol/L
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Mean time (minutes) to the first hypoglycemic event
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes)
This outcome will be measured for the exercise period only (60 minutes)
Mean glucose levels
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Standard deviation of glucose levels
Tijdsspanne: This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
This outcome will be measured for the exercise period only (60 minutes) and for the exercise period and the hour following the exercise (120 minutes)
Percentage of time of glucose levels between 4 and 10 mmol/L
Tijdsspanne: From the end of the exercise period to dinner time.
Dinner time will be up to the patient.
From the end of the exercise period to dinner time.
Percentage of time of glucose levels between 4 and 10 mmol/L
Tijdsspanne: From the end of the exercise period to midnight (7.5 hours)
From the end of the exercise period to midnight (7.5 hours)
Percentage of time of glucose levels between 4 and 10 mmol/L
Tijdsspanne: From midnight to 6:00 next morning (6 hours)
From midnight to 6:00 next morning (6 hours)
Percentage of time of glucose levels between 4 and 10 mmol/L
Tijdsspanne: From the end of the exercise period to 6:00 next morning (13.5 hours)
From the end of the exercise period to 6:00 next morning (13.5 hours)
Percentage of time of glucose levels spent below 4 mmol/L
Tijdsspanne: From the end of the exercise period to dinner time
Dinner time will be up to the patient.
From the end of the exercise period to dinner time
Percentage of time of glucose levels spent below 4 mmol/L
Tijdsspanne: From the end of the exercise period to midnight (7.5 hours)
From the end of the exercise period to midnight (7.5 hours)
Percentage of time of glucose levels spent below 4 mmol/L
Tijdsspanne: From midnight to 6:00 next morning (6 hours)
From midnight to 6:00 next morning (6 hours)
Percentage of time of glucose levels spent below 4 mmol/L
Tijdsspanne: From the end of the exercise period to 6:00 next morning (13.5 hours)
From the end of the exercise period to 6:00 next morning (13.5 hours)
Percentage of time of glucose levels spent above 10 mmol/L
Tijdsspanne: From the end of the exercise period to dinner time
Dinner time will be up to the patient
From the end of the exercise period to dinner time
Percentage of time of glucose levels spent above 10 mmol/L
Tijdsspanne: From the end of the exercise period to midnight (7.5 hours)
From the end of the exercise period to midnight (7.5 hours)
Percentage of time of glucose levels spent above 10 mmol/L
Tijdsspanne: From midnight to 6:00 next morning (6 hours)
From midnight to 6:00 next morning (6 hours)
Percentage of time of glucose levels spent above 10 mmol/L
Tijdsspanne: From the end of the exercise period to 6:00 next morning (13.5 hours)
From the end of the exercise period to 6:00 next morning (13.5 hours)
Number of participants requiring treatment for hypoglycemia
Tijdsspanne: From the end of the exercise period to dinner time
Dinner time will be up to the patient
From the end of the exercise period to dinner time
Number of participants requiring treatment for hypoglycemia
Tijdsspanne: From the end of the exercise period to midnight (7.5 hours)
From the end of the exercise period to midnight (7.5 hours)
Number of participants requiring treatment for hypoglycemia
Tijdsspanne: From midnight to 6:00 next morning (6 hours)
From midnight to 6:00 next morning (6 hours)
Number of participants requiring treatment for hypoglycemia
Tijdsspanne: From the end of the exercise period to 6:00 next morning (13.5 hours)
From the end of the exercise period to 6:00 next morning (13.5 hours)
Number of hypoglycemic episodes requiring treatment
Tijdsspanne: From the end of the exercise period to dinner time
Dinner time will be up to the patient
From the end of the exercise period to dinner time
Number of hypoglycemic episodes requiring treatment
Tijdsspanne: From the end of the exercise period to midnight (7.5 hours)
From the end of the exercise period to midnight (7.5 hours)
Number of hypoglycemic episodes requiring treatment
Tijdsspanne: From midnight to 6:00 next morning (6 hours)
From midnight to 6:00 next morning (6 hours)
Number of hypoglycemic episodes requiring treatment
Tijdsspanne: From the end of the exercise period to 6:00 next morning (13.5 hours)
From the end of the exercise period to 6:00 next morning (13.5 hours)
Mean glucose levels
Tijdsspanne: From the end of the exercise period to dinner time
Dinner time will be up to the patient
From the end of the exercise period to dinner time
Mean glucose levels
Tijdsspanne: From the end of the exercise period to midnight (7.5 hours)
From the end of the exercise period to midnight (7.5 hours)
Mean glucose levels
Tijdsspanne: From midnight to 6:00 next morning (6 hours)
From midnight to 6:00 next morning (6 hours)
Mean glucose levels
Tijdsspanne: From the end of the exercise period to 6:00 next morning (13.5 hours)
From the end of the exercise period to 6:00 next morning (13.5 hours)

Medewerkers en onderzoekers

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Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

3 augustus 2017

Primaire voltooiing (Werkelijk)

2 augustus 2019

Studie voltooiing (Werkelijk)

2 augustus 2019

Studieregistratiedata

Eerst ingediend

6 juli 2017

Eerst ingediend dat voldeed aan de QC-criteria

10 juli 2017

Eerst geplaatst (Werkelijk)

11 juli 2017

Updates van studierecords

Laatste update geplaatst (Werkelijk)

11 juni 2020

Laatste update ingediend die voldeed aan QC-criteria

8 juni 2020

Laatst geverifieerd

1 juni 2020

Meer informatie

Termen gerelateerd aan deze studie

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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