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Type2 DiabetesACTIDIANENCT03184662

Efficacy of a High-intensity Physical Activity Program on Renal Function in High Risk Patients With Type 2 Diabetes

A study testing HIPA and Counseling PA in people with Type2 Diabetes and Diabetic Kidney Disease, run by Poitiers University Hospital at 20 sites in 2 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Type 2 diabetes is a chronic condition whose prevalence is increasing globally. Kidney disease is a key complication of diabetes and is among the most common cause of end-stage renal disease, requiring renal replacement therapy. Read more about this study

Who is it for?
Ages 45 years and older
Conditions the study is for
Type2 Diabetes, Diabetic Kidney Disease
What is being tested?
HIPA and Counseling PA
Could I receive a placebo?
No, everyone receives an active treatment
How many people
178 participants
Where
20 sitesin 2 countries
Study dates
12 Feb 2018to 28 Jul 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 45 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Type 2 diabetes
  • Rapid renal decline function (yearly loss of eGFR over -5ml/min/1.73 m2) in the 6 to 24 preceding months

Who cannot join

  • Lower limb amputation
  • Indication for rehabilitation program
  • Contra-indication for physical activity
  • Unstable angina, left atrial thrombus,
  • Unstable thyroid function
  • Corticosteroids treatment
  • Long-term NSAIDs
  • Simultaneous participation to any interventional study able to interfere with the current study endpoints

Trial locations and contacts

20 sites in 2 countries.

20 sites in 2 countries

France19 sites
  • Besançon Hospital

    Besançon

  • Bordeaux University Hospital

    Bordeaux, 33000

  • Caen University Hospital

    Caen, 14033

  • CH Chartres

    Chartres

  • Clermont Ferrand University Hospital

    Clermont-Ferrand, 63000

  • CHG Sud Francilien

    Corbeil-Essonnes, 91100

  • CHU Dijon

    Dijon, 21000

  • CHU Lille

    Lille, 59000

  • Chu de Lyon

    Lyon, 69229

  • CHRU

    Montpellier

  • CHU Nancy

    Nancy, 54000

  • Chu de Nice

    Nice, 06003

  • Bichat University Hospital

    Paris, 75000

  • La Riboisière Hospital

    Paris, 75000

  • Hôpital Pitié Salpétrière

    Paris, 75651

  • Poitiers University Hospital

    Poitiers, 86000

  • CHU Strasbourg

    Strasbourg, 67000

  • CHU Toulouse

    Toulouse, 31000

  • CHU de TOURS

    Tours, 37044

Other trials in France

Belgium1 site
  • Hospital of Liège

    Liège

Other trials in Belgium

About this study

Official title: Randomized Trial to Assess the Efficacy of a High-intensity Physical Activity Program on Renal Function Decline in High Risk Patients With Type 2 Diabetes

Type 2 diabetes is a chronic condition whose prevalence is increasing globally. Kidney disease is a key complication of diabetes and is among the most common cause of end-stage renal disease, requiring renal replacement therapy.

It has been shown that the trajectory of renal function (estimated glomerular filtration rate - eGFR) is of great prognostic value for renal and cardiovascular endpoints in diabetic patients. However the clinical use of this prognostic marker is not associated to date with a clear therapeutic intervention, effective in patients with type 2 diabetes identified with this biomarker.

Read more

In France, type 2 diabetes patients have twice less physical activity than non-diabetic persons. Recently, it has been published that physical activity was associated with an improvement of renal risk in patients with type 2 diabetes, recruited from the LOOK-AHEAD study. It was demonstrated that high-intensity physical activity (HIPA) can have several additional advantages over moderate-intensity, on blood pressure improvement, and cardiovascular risk profile modification. In addition, this procedure was shown to be safe in patients with high cardiovascular risk.

We plan to perform a randomized intervention comparing a structured program of high-intensity physical activity (HIPA) vs standard recommendations for physical activity on renal function decline (primary outcome) and mortality, renal and cardiovascular endpoints, patients' safety and quality of life (secondary outcomes). Study participants will be patients with established type 2 diabetes and a high renal risk, identified by rapid renal function decline, defined as a eGFR slope below -5ml/min per 1.73 m2/yr. The intervention is planned to last for 2 years.

Read the detailed description

I- Visit organisation

V1 (screening) informed consent / examination / inclusion and non-inclusion criteria / medical history M/F LUTS / EPICES score / ECG Serum creatinine determination

V2 (Randomization) examination / verification of participation criteria / randomization Cystatin C collection / Biology Hypoglycemia notification / QAPPA / RPAQ / NAQA / Questionnaires (EQ-5D3L, SF12, Rosenberg Self esteem) / Accelerometer (ancillary) / Impedance-meter (ancillary) 6-minute step test / 10-meter walk test

V3 (1 month) examination / Hypoglycemia notification / QAPPA / RPAQ / Accelerometer (ancillary)

V4 (3 months) examination / Hypoglycemia notification / QAPPA / RPAQ / Questionnaires (EQ-5D3L, SF12, Rosenberg Self esteem) / Accelerometer (ancillary) 6-minute step test Biology

V5 (6 months) examination / Hypoglycemia notification / QAPPA / RPAQ / Questionnaires(EQ-5D3L, SF12, Rosenberg Self esteem) / Accelerometer (ancillary) 6-minute step test Cystatin C collection / Biology

V6 (12 months) examination / Hypoglycemia notification / QAPPA / RPAQ / NAQA / M/F LUTS / Questionnaires(EQ-5D3L, SF12, Rosenberg Self esteem) / ECG /Accelerometer (ancillary) / Impedance-meter (ancillary) Cystatin C collection / Biology 6-minute step test / 10-meter walk test

V7 (18 months) examination / Hypoglycemia notification / QAPPA / RPAQ / Questionnaires(EQ-5D3L, SF12, Rosenberg Self esteem) / Accelerometer (ancillary) Cystatin C collection / Biology 6-minute step test

V8 (24 months) / premature discontinuation examination / Hypoglycemia notification / QAPPA / RPAQ / NAQA / M/F LUTS / Questionnaires (EQ-5D3L, SF12, Rosenberg Self esteem) / ECG / Accelerometer (ancillary) / Impedance-meter (ancillary) 6-minute step test / 10-meter walk test Cystatin C collection / Biology

II- Recruitment criteria Inclusion

  • Age : 45 and higher
  • Female or male
  • Type 2 diabetes with diabetes typing according to widely-accepted clinical and biological criteria [3].
  • Subject able to practice physical activity. This includes a normal exercise test with or without anti-ischemic drugs, performed in the preceding 6 months or short before randomization. A certificate of no contre-indication for PA is to be delivered prior to randomization.
  • With at least 3 available creatinine measurements in the 6 to 24 preceding months showing a rapid renal function decline defined as an eGFR slope below -5 ml/min/yr
  • Estimated GFR equal to or higher than 30 ml/min/1.73m², defined by the CKD-EPI formula, at inclusion visit

Non inclusion

  • Age strictly lower than 45 years
  • Indication for cardiovascular rehabilitation (notably patient with ischemic heart disease or coronary revascularisation)
  • Treatment with systemic NSAIDs or corticosteroids
  • Lower limb amputation (above trans-metacarpal)
  • Active proliferative retinopathy (risk of bleeding in case of effort)
  • Contra-indication for the participation to PA:
  • Severe non-operated valvulopathy
  • Uncontrolled hypertension > 180/110 mmHg
  • Thrombus in the left ventricular cavity
  • Unstable coronaropathy, according to physician
  • NYHA stage IV heart failure
  • Any condition that would jeopardize patient's safety or would affect the conduct of the study
  • Pregnant or breast-feeding women or women of child-bearing potential without effective contraception during the study
  • Any situation associated with unreliable cystatin-C determinations, according to patient medical history: HIV positivity, melanoma and thyroid dysfunction
  • Simultaneous participation to any interventional study able to interfere with the current study endpoints
  • Patients not registered to the social security
  • Protected adults (under guardianship and trusteeship)
  • Subject unable to express their consent (due to intellectual/mental incapacity)

III- Intervention HIPA group Twice weekly physical activity session in a dedicated structure, supervised by a graduated coach, alternating sessions of strengthening and intermittent HIPA, allowing a mixed stimulation of neuro-muscular and cardiovascular systems, and regular (every 3 months) adjustment of the intensity of the program.

Control group Counseling of physical activity according to recommendations from the working group on Physical Activity of the SFD (French Language Diabetes Society) supported by patient's oriented leaflet.

IV- Handling with the COVID-19 pandemics

The COVID-19 pandemics has modified the shape of the study with

  • difficulties to comply with the study plan, including recruitment pace. Visits can be postponed if required but investigators are encouraged to follow the initial plan. The time between randomization and V3 (1 month) and V4 (3 months) can sometimes be too short and it is acceptable to perform this visit by phone or even to cancel it.
  • difficulties to comply with physical activity (PA) plan. As PA facilities have been locked down in the pandemics context, the sports committee of the ACTIDIANE study has agreed to move attendances to the gym to some remote PA sessions, via websession or if not possible, via telephone coaching sessions.
Being tested
HIPA, Counseling PA
Keywords
High-intensity physical activity, Diabetes, Renal function decline
Medical subject headings
Diabetic Nephropathies, Diabetes Mellitus

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • HIPAOther

    inclusion in a program with 2 weekly sessions of structured physical activity of 1 hour in a dedicated structure, under the supervision of a graduated coach.

    First 3 months : physical reconditioning 3 months and after: alternating sessions of physical strengthening and intermittent high-intensity physical activity Adaptation of the intensity of the program according to evaluation tests every 3 months

  • Counseling PAOther

    Counseling of physical activity according to recommendations from the working group on Physical Activity of the SFD

Study groups in NCT03184662
Study groupRoleWhat they receive
HIPA groupExperimentalTwice weekly physical activity session in a dedicated structure, supervised by a graduated coach, alternating sessions of strengthening and intermittent HIPA, allowing a mixed stimulation of neuro-muscular and cardiovascular systems, and regular (every 3 months) adjustment of the intensity of the program. The sessions will be preferably performed in sports gyms but if required can also be performed online with supervised coaches, trained for the study.
Receives: Other: HIPA
Control groupActive comparatorCounseling of physical activity according to recommendations from the working group on Physical Activity of the SFD (French Language Diabetes Society).
Receives: Other: Counseling PA

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Renal Function Decline

    Estimated glomerular filtration rate slope computed within 2 years, evaluated with the cystatin-derived CKD-EPI formula At least 3 available determinations of estimated glomerular filtration rate will be required to perform the calculation of the slope

    Measured: 2 years

Secondary outcomes (13)
  1. Incidence of ESRF

    Incidence of end-stage renal failure requiring renal replacement therapy

    Measured: 2 years

  2. Number of patients with a decrease in eGRF

    Number of patients with a decrease in eGRF greater than 40% of baseline value

    Measured: 2 years

  3. All cause death

    Number of patients who died during the study (all cause)

    Measured: 2 years

  4. Cardiovascular death

    Cardiovascular death as proposed by the ICD-10 classification

    Measured: 2 years

  5. Renal death

    Renal death as defined as a situation where renal replacement therapy could be used but was not applied

    Measured: 2 years

  6. MACE

    MACE : major adverse cardiovascular endpoints : first occuring among cardiovascular death, myocardial infarction and stroke

    Measured: 2 years

  7. Severe congestive heart failure

    Severe congestive heart failure requiring hospitalization, adjudicated by a study outcome committee

    Measured: 2 years

  8. Coronary artery disease

    Coronary artery disease : myocardial infarction and/or coronary artery revascularizaton

    Measured: 2 years

  9. Quality of life EQ-5D3L

    Quality of life : assessed by using EQ-5D3L questionnaire

    Measured: 2 years

  10. Male/Female lower urinary tract symptoms (LUTS)

    Male/Female lower urinary tract symptoms : assessed by using M/F LUTS questionnaire

    Measured: 2 years

  11. Safety of the intervention

    including : adverse events, foot ulceration requiring medical advise, musculoskeletal disorders, hypoglycemia

    Measured: 2 years

  12. Quality of life SF12

    Quality of life : assessed by using SF12 questionnaire

    Measured: 2 years

  13. Safety of HIPA performed by e-coaching in the context of COVID infection

    AE and SAE will be carefully reviewed to assess if the HIPA sessions are safe as performed with e-coaching/ telephone-coaching during lock-down due to the COVID-19 pandemics

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Jun 2017
  2. Study start12 Feb 2018
  3. Primary completion28 Jul 2023
  4. Study completion28 Jul 2023

Why it stopped: COVID period

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
178 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03184662
Sponsor's protocol ID
ACTIDIANE
Acronym
ACTIDIANE
Status last verified
Apr 2025
First submitted
26 Apr 2017
Last updated
9 Apr 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: sharing policy is under the responsibility of the scientific committee who will organise this point Any request can be posted to the PI in the meantime.

Questions about this trial

What is this clinical trial studying?

A study testing HIPA and Counseling PA in people with Type2 Diabetes and Diabetic Kidney Disease, run by Poitiers University Hospital at 20 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 9 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in France, Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: COVID period). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Renal Function Decline (time frame: 2 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Apr 2025.

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