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Evaluatie van gepersonaliseerde voedingsinterventie bij wondgenezing van huidzweren bij diabetici

3 november 2026 bijgewerkt door: Maimónides Biomedical Research Institute of Córdoba

Evaluatie van gepersonaliseerde voedingsinterventie samen met de toepassing van MSC-afgeleide exosomen op het regeneratieve vermogen en wondgenezing van huidzweren bij diabetici

The ageing population and the increase in diabetes raise the prevalence of chronic skin ulcers (CCU). In diabetics, precursor cell mobilization decreases. In wounds, the inflammation is prolonged and oxidative stress increases. This is an unfavorable microenvironment for healing. A major risk factor in the development of CCU is nutritional deficiency. Healing needs energy and nutrients for regeneration. In diabetics the malnutrition can be more than 60%. However, although the provision of certain nutrients can improve the healing capacity, it is not a common clinical practice to nutritionally evaluate diabetic with CCU. Exosomes are extracellular vesicles that reflect the physiological state of the cells producing them. Stem cell derivatives exosomes are rich in factors, that can provide a favorable microenvironment for tissue regeneration.

The aim of this project is to develop a therapeutic process to accelerate the healing of diabetic CCU, based on the correction of nutritional deficiencies, to improve the regenerative capacity, together with the application of exosomes from mesenchymal stem-cell (MSC) in the wound, creating a microenvironment that favors tissue regeneration. For this, a pilot clinical trial with diabetic patients with CCU is proposed, to evaluate the effect of personalized nutritional supplementation on healing and regenerative capacity.

Studie Overzicht

Toestand

Actief, niet wervend

Conditie

Interventie / Behandeling

Studietype

Ingrijpend

Inschrijving (Geschat)

30

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

  • Spanje
    • Andalusia
      • Córdoba, Andalusia, Spanje, 14004
        • Hospital Universitario Reina Sofía de Córdoba

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

50 jaar tot 80 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • Signature of the informed consent
  • Age between 50 and 80 years
  • Diagnosis of Diabetes Mellitus for more than 1 year
  • Documented diagnosis of peripheral artery disease
  • HbA1c < 9%
  • Category 5 in the Rutherford-Becker classification

Exclusion Criteria:

  • Poor cognitive function, dementia or psychiatric conditions
  • Osteomyelitis, gangrene, malignancy or immunocompromised disease
  • Thromboangiitis obliterans or Buerger's disease
  • Clinical evidence of invasive infection in the target limb requiring IV antibiotherapy
  • Presence of neuropathic ulcers only
  • Human immunodeficiency virus (HIV), hepatitis C virus (HCV) or hepatitis B virus (HBV) positive.

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: Faculteitstoewijzing
  • Masker: Verdrievoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Nutritional Intervention (NI)

In addition to the usual treatment, will receive dietary advice and a nutritional supplement, according to the results of their evaluation in the Endocrinology Service
Voedingssupplement: Personalized Nutritional Intervention

Those with malnutrition criteria will also receive a nutritional supplement (e.g. fortimel cubitan, advanced or extra, Nutricia) or another of similar composition, in case of intolerance to the first option. The aim will be to provide at least 50% of the recommended intakes for the main nutrients related to wound healing.
Geen tussenkomst: Control (C)

Who will continue with their usual treatments in the Diabetic Foot Unit and they will receive dietary advice

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Ulcer evaluation
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in size ulcer assessed by picture, including ruler to measure their size
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Composite measure of markers of nutritional status
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in nutritional status assessed from blood samples
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Composite measure of haemogram
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in haemogram assessed from blood samples
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Hemoglobin A1c (HbA1c) Test for Diabetes
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in HbA1c (%) assessed from blood samples
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Measure of markers of nutritional status, include to thyrotropin
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in thyrotropin (mlU/L) assessed from blood samples
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Ultrasensitive C-reactive Protein (CRP) test
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in CRP (mg/L) assessed from blood samples
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Quantification of circulating endothelial progenitor cells (EPC)
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in total CD34+ or CD133+ cells expressing vascular endothelial growth factor receptor 2 (VEGFR2) analyzed by flow cytometry
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Concentration of stromal cell-derived factor 1 (SDF-1) and vascular endothelial growth factor A (VEGFA)
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in concentration of SDF-1 and VEGFA factors in serum by ELISA
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Andere uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Nutritional Risk
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in nutritional risk assessed by Malnutrition Universal Screening Tool (MUST)
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Diagnosis of malnutrition
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in diagnosis of malnutrition assessed by Global Leadership Initiative on malnutrition (GLIM criteria)
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Sarcopenia
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in sarcopenia assessed by SARC-F
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Handgrip Strength
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in handgrip strength assessed by dynamometry
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Body weight and height
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Body weight and height will be combined to report body mass index (BMI) in kg/m^2. Change from baseline in BMI
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Tricipital skinfold
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in tricipital skinfold using a skinfold caliper
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Arm circumference
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in arm circumference in centimeters (cm)
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Waist and hip circumferences
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

waist and hip circumferences (cm) will be combined to report Waist and Hip Ratio (WHR). Change from baseline in WHR
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Body Fat
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in body fat assessed by multifrequency bioimpedaciometry and bioelectrical impedance vector analysis
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Muscle Mass
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in muscle mass assessed by multifrequency bioimpedaciometry and bioelectrical impedance vector analysis
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation
Hydration status
Tijdsspanne: Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Change from baseline in hydration status assessed by multifrequency bioimpedaciometry and bioelectrical impedance vector analysis
Baseline, 30 days after treatment initiation, 60 days after treatment initiation and 90 days after treatment initiation

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Maimónides Biomedical Research Institute of Córdoba

Medewerkers

Instituto de Salud Carlos III
Hospital Universitario Reina Sofia de Cordoba

Onderzoekers

  • Hoofdonderzoeker: Antonio Casado-Díaz, PhD, Maimonides Biomedical Research Institute of Cordoba
  • Hoofdonderzoeker: Alfonso Calañas, PhD, Hospital General Universitario Reina Sofía de Murcia

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.

Algemene publicaties

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)

20 oktober 2023

Primaire voltooiing (Geschat)

30 december 2026

Studie voltooiing (Geschat)

31 december 2026

Studieregistratiedata

Eerst ingediend

20 januari 2022

Eerst ingediend dat voldeed aan de QC-criteria

14 februari 2022

Eerst geplaatst (Werkelijk)

17 februari 2022

Updates van studierecords

Laatste update geplaatst (Werkelijk)

5 november 2026

Laatste update ingediend die voldeed aan QC-criteria

3 november 2026

Laatst geverifieerd

1 november 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • PI21/01935

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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