Diabetes Type 1 and Fitness. (Diab1Fit)
Assessment of Physical Effort in People With Newly Diagnosed Type 1 Diabetes Mellitus and Its Impact on: Partial Clinical Remission, Insulin Resistance, HDL Cholesterol Function, Immune Function and Length of Life.
研究概览
地位
条件
详细说明
The Diab1Fit Study project aims to a multidirectional assessment of physical activity and its impact in people with type 1 diabetes (DM1). To the study are recruited people with newly diagnosed DM1, treated with intensive functional insulin therapy from the beginning of the disease. The study is planned to cover a minimum of 100 people with newly diagnosed DM1 and lead prospective observation of this group (for a minimum of 5-10 years). The investigators will evaluate the effect of VO2max in people with newly diagnosed DM1 on partial clinical remission. What is more the investigators also assess quantitative and qualitative changes of plasma lipoproteins, with particular emphasis on HDL metabolism, mechanism linking VO2max with management of DM1 (longevity proteins, miostatin, insulin resistance) and immune function.
Patients will be assessed: during the first hospitalization in the moment of diagnosis (prior to introduction of insulin treatment), after 3 weeks, after 6 months and after 12 months of insulin therapy. Further observations planned in the annual intervals. Further continuous observation with follow-up every year and evaluation of final end-points after 5 and 10 years. In addition, the study group will be under constant monitoring of metabolic evaluation every three months in the Outpatient Clinic. An additional visit to assess VO2max will be scheduled between 3 and 12 months of diabetes. The investigators will use an ergospirometer (COSMED K5 System) during an exercise test carried out on a cycloergometer (progressive exercise test). Moreover, the investigators will monitor glucose levels during the exercise test - using a continuous glucose monitoring system using the FreeStyle Libre Flash Glucose Monitoring System (Abbott). A week before the exercise test, the investigators will borrow a Garmin watch that assesses the patient's daily activities
During each follow-up will be assessed parameters:
- The presence of partial clinical remission, according to Mortensen: HbA1c (%) + [4 x dawka insuliny (j/kg/d)] ≤ 9.
- Data on lifestyle (diet, exercise), family history and smoking.
Anthropometric data:
- BMI (body mass index) = weight [kg]/(height [m])2
- Waist circumference
- WHR - waist to hip ratio
- daily insulin requirement (U/kg m.c./d),
- eGDR (estimated glucose disposal rate) = 24.31-12.22(WHR)-3.29(hypertension 0/1)-0.57( HbA1c [mg/kg/min])
VAI (visceral adiposity index):
For women = [Waist circumference/36.58+(1.89xBMI)]x(TG/0.81)x(1.52/HDL), For men = [Waist circumference /39.68+(1.88xBMI)]x(TG/1.03)x(1.31/HDL),
- body composition analysis
Parameters of diabetes metabolic control
- Lipid profile
- Glycated hemoglobin level (HbA1c)
- Protein glycation end products Expected impact of the research project on the development of science, civilization and society: The study confirms the great importance of aerobic physical activity in the treatment of people with DM1 from the beginning of the diagnosis. The project aims to pay attention to the importance of physical activity among people with DM1 and to popularize this method of treatment. The obtained results will be used for the prospective observation of this group to assess the impact of physical effort on the development of chronic complications and will allow planning intervention studies in this population. The results of this study will help enrich knowledge about the body's ability to exercise among people with DM1 and show new intervention solutions. It may contribute to changing the recommendations of scientific societies. What is more knowledge about prolonging partial clinical remission and thereby reducing the risk of developing chronic complications will contribute to the introduction of new recommendations. Research on exercise in diabetes and longevity proteins will increase the length and quality of life of people with DM1.
研究类型
注册 (预期的)
联系人和位置
学习地点
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Poznan、波兰、60-834
- 招聘中
- Department of Internal Medicine and Diabetiology Poznan University of Medical Sciences
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接触:
- Justyna Flotyńska
- 电话号码:+48 728328961
- 邮箱:justynaflotynska@gmail.com
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接触:
- Aleksandra Uruska, PhD
- 电话号码:+48 607620750
- 邮箱:aleksandrauruska@gmail.com
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Age 18-35 years,
- New onset type 1 diabetes (confirmed by the presence of antibodies - antyGAD, ICA, IA2)
- Treatment with intensive insulin therapy,
- Written consent to participate in the study.
Exclusion Criteria:
- Contraindications to the exercise test (including: recent myocardial infarction, unstable coronary artery disease, hypertrophic cardiomyopathy, serious arrhythmias, myocarditis, advanced systemic diseases, hyperthyroidism, recurrent anemia),
- Mental disorders,
- Co-morbidities with potential impact on physical performance (e.g. cancer, renal failure, liver failure, rheumatic diseases, COPD, asthma, anemia, hypothyroidism and hyperthyroidism),
- Pregnancy.
学习计划
研究是如何设计的?
设计细节
- 观测模型:仅案例
- 时间观点:预期
队列和干预
团体/队列 |
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People with newly diagnosed diabetes mellitus type 1
People with newly diagnosed diabetes mellitus type 1 admitted to the Department of Internal Medicine and Diabetology. Treated with intensive insulin therapy. Measurement of VO2max between 3 and 12 month after diagnosis. Further continuous observation with follow-up every year and evaluation of final end-points after 5 and 10 years. |
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
VO2max [ml/min/kg]
大体时间:1 year
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VO2 max level evaluated during ergospirometry (COSMED K5)
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1 year
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Partial clinical remission time
大体时间:1 year
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Presence [(4 x insulin dose (j/kg/d)] ≤ 9] and duration [time] of partial clinical remission
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1 year
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Triglicerydes concentriation in serum [mg/dl]
大体时间:Change from baseline in apolipoproteins' at 6 and 12 months
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Changes in serum triglyceride levels
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Change from baseline in apolipoproteins' at 6 and 12 months
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LDL-C concentriation in serum [mg/dl]
大体时间:Change from baseline in apolipoproteins' at 6 and 12 months
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Changes in serum LDL levels
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Change from baseline in apolipoproteins' at 6 and 12 months
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HDL-C concentriation in serum [mg/dl]
大体时间:Change from baseline in apolipoproteins' at 6 and 12 months
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Changes in serum HDL levels
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Change from baseline in apolipoproteins' at 6 and 12 months
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Total Cholesterol concentriation in serum [mg/dl]
大体时间:Change from baseline in apolipoproteins' at 6 and 12 months
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Changes in serum Total-CH levels
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Change from baseline in apolipoproteins' at 6 and 12 months
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Lipid tissue content [%]
大体时间:5 years
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Evaluation of lipid tissue content prior to yearly visit.
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5 years
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A1c [%]
大体时间:5 years
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Changes in serum A1c levels
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5 years
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Daily insulin requirement [u/kg/d]
大体时间:1 year
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Sum of insulin units administered in the day prior to yearly visit.
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1 year
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Retinopathy
大体时间:5 years
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Evaluation of retinopathy (ophthalmology assessment)
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5 years
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Neuropathy
大体时间:5 years
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Evaluation of presence of neuropathy peripheral and autonomic (clinical examination, Visual Analog Score for pain and ProsciCard)
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5 years
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eGFR [ml/min/1,73m2]
大体时间:5 years
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Assessment of glomerular filtration and renal filtration function
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5 years
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Creatynine [mg/dl]
大体时间:5 years
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Assessment of renal function
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5 years
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Albumine to creatynine ratio ACR [mg/g]
大体时间:5 years
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Assessment of renal function
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5 years
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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