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Effekt av endringer i karbohydratinntak på glukosekontroll hos pasienter med type 1 diabetes

7. september 2026 oppdatert av: Yang Tao

Effekt av endringer i karbohydratinntak på glukosekontroll hos pasienter med type 1 diabetes.

Blodsukkeret svinger sterkt hos T1DM-pasienter, spesielt i midt- og senstadier av sykdommen, og karbohydrat (CHO) er hoveddeterminanten for postprandial glukoserespons (PGR). Basert på den forrige undersøkelsen for å forstå hvordan ernæringsvaner påvirker blodsukkerkontrollen, vil vi gjennomføre diettintervensjonsstudier på T1DM-pasienter for å undersøke om justeringen av kostholdsmønsteret er fordelaktig for blodsukkerkontrollen, og videre utforske den relevante mekanismen gjennom påvisning av relaterte metabolske indikatorer.

Studieoversikt

Detaljert beskrivelse

1. Hovedmål: Å evaluere effekten av endringer i karbohydratinntak på glukosekontroll hos pasienter med type 1 diabetes.

  1. Primært endepunkt: tidsforskjell i rekkevidde (TIR) ​​mellom de 2 gruppene.
  2. Sekundært endepunkt:

1) forskjell av variasjonskoeffisient (CV), gjennomsnittlig amplitude av glykemiske ekskursjoner (MAGE), stor amplitude av glykemiske ekskursjoner (LAGE) mellom de 2 gruppene; 2) forskjell i endring i HbA1c,GA,1,5-anhydroglucitol (1,5-AG) fra baseline mellom de 2 gruppene; 3) forskjell i endring i forekomst av hypoglykemiske hendelser (%), alvorlig hypoglykemi og nattlig hypoglykemi fra baseline mellom de 2 gruppene; 4) forskjell i endring i insulindose (IE/kg/dag) fra baseline mellom de 2 gruppene.

2. Sekundært mål: Å utforske den mulige mekanismen for diettintervensjon for å forbedre blodsukkerkontrollen hos pasienter med type 1 diabetes.

  1. Effekter av diettintervensjon på tarmmikromiljø og mikroflora hos type 1 diabetespasienter;
  2. Effekter av diettintervensjon på immunfunksjonen til pasienter med type 1 diabetes;
  3. Effekter av diettintervensjon på metabolomikk hos pasienter med type 1 diabetes.

Studietype

Intervensjonell

Registrering (Antatt)

80

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

  • Navn: Tao Yang, MD/PhD
  • Telefonnummer: 6466 86-25-83718836
  • E-post: yangt@njmu.edu.cn

Studiesteder

    • Jiangsu
      • Nanjing, Jiangsu, Kina, 210029
        • Rekruttering
        • First Affiliated Hospital, Nanjing Medical University
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inklusjonskriterier:

  1. De som godtar å delta i studien og signerer informert samtykke;
  2. Diagnose av type 1 diabetes mellitus (ADA2024);
  3. Alder 18~65 år;
  4. Avhengig av eksogen insulinbehandling (CSII), forblir behandlingsplanen uendret innen 2 måneder (insulintypen kan ikke endres, og dosen kan justeres i henhold til plasmaglukose);
  5. Kroppsmasseindeks (BMI) på 18~24 kg/m2;
  6. HbA1c ≤9,5%;
  7. Tilfeldig C-peptid ≥200 pmol/L.

Ekskluderingskriterier:

  1. Bryllupsreisende med type 1 diabetes mellitus;
  2. Kvinner som er gravide eller planlegger å bli gravide;
  3. Pasienter som er vegetarianere;
  4. Pasienter som bruker orale hypoglykemiske legemidler (alfa-glukosidasehemmere, DPP-IV-hemmere, etc.);
  5. Pasienter som bruker glukokortikoider innen 30 dager;
  6. Historie med alvorlig matallergi;
  7. Pasienter med akutte komplikasjoner som DKA;
  8. Pasienter med gastroparese, inflammatorisk tarmsykdom og andre komplikasjoner;
  9. Pasienter med stor albuminuri og nyresvikt;
  10. Pasienter med ukontrollert hypertyreose og hypotyreose;
  11. Anamnese med hjertesykdom, koronar hjertesykdom og arytmi;
  12. Alvorlig leverdysfunksjon (ALT eller AST>1,5 ganger øvre normalgrense);
  13. Anamnese med ondartede svulster, ukontrollerte andre immunsystemsykdommer, ukontrollerte infeksjoner;
  14. Alkoholmisbruk, psykiske lidelser eller andre forhold som ikke er egnet til å være observatør i narkotikatester;
  15. Pasienter med en hvilken som helst sykdom som sannsynligvis vil forstyrre studiedeltakelse eller evaluering.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: 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%.
Annen: 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%.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Time in range (TIR)
Tidsramme: 4 weeks (2 weeks after randomization)
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)

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Time above range(TAR)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Standard deviation of glucose (SD)
Tidsramme: 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)
Glucose coefficient of variation (CV)
Tidsramme: 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)
Mean amplitude of glycemic excursions (MAGE)
Tidsramme: 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)
Largest amplitude of glycemic excursions (LAGE)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Tidsramme: 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)
Glucagon area under the curve (AUC glucagon)
Tidsramme: 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)
Fasting blood glucose (FBG)
Tidsramme: 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)
Tidsramme: 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)
Triglycerides (TG)
Tidsramme: 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.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Low-density lipoprotein cholesterol (LDL-C)
Tidsramme: 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.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
High-density lipoprotein cholesterol (HDL-C)
Tidsramme: 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)
1,5-Anhydroglucitol (1,5-AG)
Tidsramme: 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.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Total daily insulin dose
Tidsramme: 4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
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.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Basal insulin dose
Tidsramme: 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)
Prandial insulin dose
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Hip circumference
Tidsramme: 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.
4 weeks (2 weeks after randomization) and 16 weeks (14 weeks after randomization)
Waist-to-hip ratio (WHR)
Tidsramme: 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)
Body composition
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Gut microbiota profile
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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)

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Etterforskere

  • Hovedetterforsker: Tao Yang, MD/PhD, First Affiliated Hospital, Nanjing Medical University, China

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

1. august 2024

Primær fullføring (Antatt)

31. desember 2027

Studiet fullført (Antatt)

31. desember 2027

Datoer for studieregistrering

Først innsendt

23. februar 2023

Først innsendt som oppfylte QC-kriteriene

16. februar 2024

Først lagt ut (Faktiske)

22. februar 2024

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

10. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

7. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

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