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DiabetesNCT04102657

Blood Glucose Differences Between Left Arm and Right Arm Using a Continuous Glucose Monitor

A study testing Intermittent Fasting, Free-Living Diet and Left Arm Exercise in people with Diabetes, run by University of the Pacific at 1 site in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Interest in continuous glucose monitors (CGMs) is growing for use in evaluating real time glucose levels and in detecting extreme high and low values. A CGM is a small device primarily placed on the patient's upper arm or abdomen to measure glucose at frequent time intervals. Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Diabetes
What is being tested?
Intermittent Fasting, Free-Living Diet and Left Arm Exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
46 participants
Where
1 siteUnited States
Study dates
20 Sep 2019to Nov 2019
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 18 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Adults 18-65 years of age
  • Willing to wear CGM device for 12-14 days on both arms
  • Have active health insurance
  • Willing to refrain from any heat therapy for the duration of the study
  • Having an interest to comply with the fasting requirements of the study as appropriate
  • Willingness to maintain once daily email responses

Who cannot join

  • Any active dermatologic condition on the upper arms
  • Implanted medical devices (i.e. pacemaker)
  • Critically ill or dialysis patients
  • Planned magnetic resonance imaging screening, computed tomography scan, x-ray imaging or high-frequency electrical heat treatment during study period
  • Current systemic infections
  • Subjects who are unable to fully understand the study or consent process will not be included in the study due to the lack of a qualified medical translator
Show all 17Show fewer
  • Refusal to sign the informed consent document
  • Pregnant, planned-pregnancy in the next 30 days, or breast-feeding
  • Active eating disorder
  • Taking any medications that have an increased risk of hypoglycemia (e.g. sulfonylureas, insulin, thiazolidinediones) as determined by the primary investigators
  • Taking medications for obesity
  • You have one of the following medical conditions that can cause rapid weight loss: rheumatoid arthritis, hyperthyroidism, irritable bowel syndrome, cancer, HIV, active tuberculosis, Addison's disease
  • In an active weight loss program
  • On a specialized diet (e.g. Weight Watchers, ketogenic diet, Atkins diet)
  • Completed a specialized diet in the past 2 weeks (e.g. Weight Watchers, ketogenic diet, Atkins diet)
  • History of adverse events (i.e. shaking, dizziness, fatigue, fainting) during any prior fasting experience
  • Below the age of 18 years and above the age of 65 years

Trial locations and contacts

1 site in 1 country.

Essie Liu, PharmD contact

707-423-3277

xliu2@pacific.edu

Sonoko Kawakatsu, PharmD contact

707-423-3277

skawakatsu@pacific.edu

United States1 site, 1 recruiting
  • University of the Pacific

    Stockton, California, 95211

    Essie Liu, PharmD, 707-423-3277, xliu2@pacific.edu

    Sonoko Kawakatsu, PharmD, 7074233277, skawakatsu@pacific.edu

    Recruiting

Other trials in United States

About this study

Official title: Blood Glucose Differences Between Left Arm and Right Arm Using a Continuous Glucose

Interest in continuous glucose monitors (CGMs) is growing for use in evaluating real time glucose levels and in detecting extreme high and low values. A CGM is a small device primarily placed on the patient's upper arm or abdomen to measure glucose at frequent time intervals. While the accuracy of these devices is researched extensively, there are no large-scale studies evaluating the differences in the right and left arm in terms of device placement. In addition, intermittent fasting has gained popularity due to potential health benefits including reductions in weight, cholesterol, and blood glucose. However, there remains a shortage of studies researching the effect of short-term intermittent fasting on body fat.

The purpose of this study is to see if there is a difference between glucose levels in the right arm and left arm and to examine if short-term intermittent fasting may impact an individual's body fat percentage.

Read the detailed description

Continuous glucose monitoring (CGM) is an emerging field for diabetes management. CGM allows providers to individualize therapy by looking at real time glucose levels, detect changes in blood glucose and raise awareness for hypo- and hyperglycemic events.[1] Some CGM devices can be placed on the patient's arm to monitor blood glucose every few minutes. The data is then sent to a monitor for visualization. There are multiple Food and Drug Administration (FDA)- approved devices for continuous glucose monitoring. The FDA considers a device to be accurate if 99% of blood glucose measurements are within 20% of lab results and if 95% of blood glucose measurements are within 15% of lab results.[2]

The accuracy and precision of CGM devices is improving with several products gaining FDA approval. CGM data has been deemed accurate for self-use to adjusted insulin dosage, detection of hypoglycemia and determining the clinical response to therapy. However, events of low glucose readings and false alarms have been reported.[3]

An analysis conducted of the reports to the FDA Manufacturer and User Facility Device Experience (MAUDE) database since 2015 revealed over 25,000 complaints of CGM device inaccuracy.[4] Although CGM devices are researched extensively, there are no studies confirming that the measurements amongst the right arm and left arm are the same.

Intermittent fasting is an eating pattern in which individuals alternate between a period (~16 or more hours) of eliminated or restricted food intake, and a period of normal food intake. It has gained popularity in the public due to proposed health benefits including reductions in weight, cholesterol, and blood glucose.[6] There is published evidence that suggests beneficial effects of intermittent fasting on body fat. In an 8-week study, a significant decrease in fat mass was observed in the intermittent fasting group compared to the free-living group (-16.4 vs -2.8%).[8] However, this is the only human study assessing time-restrictive intermittent fasting and its effects on body fat, and there remains a shortage of high-quality evidence. We would like to further expand existing research by assessing the effect of short-term intermittent fasting on body fat.

This study is a controlled, prospective trial that aims to evaluate the difference in glucose readings between the right arm and left arm using continuous glucose monitors. In addition this study aims to evaluate the difference in percent body fat between short-term intermittent fasting and a free-living diet. Subjects will follow their designated diet for 12-14 days. The study will assess any changes in glucose levels, body fat percent, body mass index (BMI), weight, body composition before and after this 12-14 day study.

Conditions
Diabetes
Being tested
Intermittent Fasting, Free-Living Diet, Left Arm Exercise, Right Arm Exercise
Keywords
CGM, Glucose Monitoring, Intermittent Fasting, Fasting, Exercise
Medical subject headings
Diabetes Mellitus, Intermittent Fasting, Fasting, Motor Activity

What participants receive

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

  • Intermittent FastingOther

    Participants will be instructed to limit their daily food consumption to an 8-hour period in the day of their choosing. For the 16-hour fasting period, subjects are to eliminate caloric intake.

  • Free-Living DietOther

    Participants will maintain their current daily food consumption with no caloric restriction. Patient must not have participated in a specialized diet or weight loss program within 2 weeks of enrollment.

  • Left Arm ExerciseOther

    Participants will complete a 20-minute period of rest followed by a 20-minute unilateral arm exercise on the left arm. In the middle of the study, participants will switch to the right arm to complete their unilateral arm exercises.

  • Right Arm ExerciseOther

    Participants will complete a 20-minute period of rest followed by a 20-minute unilateral arm exercise on the right arm. In the middle of the study, participants will switch to the left arm to complete their unilateral arm exercises.

Study groups in NCT04102657
Study groupRoleWhat they receive
Intermittent Fasting with Left Arm ExerciseExperimentalHealthy volunteers willing to fast for a 16-hour period daily for 12-14 days. Volunteers will also complete a 20-minute unilateral arm exercise daily.
Receives: Other: Intermittent Fasting; Other: Left Arm Exercise
Intermittent Fasting with Right Arm ExerciseExperimentalHealthy volunteers willing to fast for a 16-hour period daily for 12-14 days. Volunteers will also complete a 20-minute unilateral arm exercise daily.
Receives: Other: Intermittent Fasting; Other: Right Arm Exercise
Free-living Diet with Left Arm ExerciseExperimentalHealthy volunteers maintaining their current diet for 12-14 days. Volunteers will also complete a 20-minute unilateral arm exercise daily.
Receives: Other: Free-Living Diet; Other: Left Arm Exercise
Free-living Diet with Right Arm ExerciseExperimentalHealthy volunteers maintaining their current diet for 12-14 days. Volunteers will also complete a 20-minute unilateral arm exercise daily.
Receives: Other: Free-Living Diet; Other: Right Arm Exercise

What is being measured

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

  1. Difference in time-matched glucose levels between the right arm and left arm

    Measured: 12-14 days

  2. Difference in body-fat percentage before and after 12-14 days of designated diet

    Measured: 12-14 days

Secondary outcomes (14)
  1. Difference in glucose readings between the right arm and left arm before and after 20-minutes of unilateral arm exercise

    Measured: 12-14 days

  2. Difference in glucose readings between the right arm and left arm per designated diet

    Measured: 12-14 days

  3. Change in Body Mass Index before and after 12-14 days of designated diet

    Measured: 12-14 days

  4. Change in Body Fat Analysis before and after 12-14 days of designated diet

    Measured: 12-14 days

  5. Difference in percent of total glucose readings in hypoglycemic range (Interstitial BG <70mg/dL) between the right arm and left arm

    Measured: 12-14 days

  6. Difference in percent of total glucose readings in euglycemic range (Interstitial BG 70mg/dL-180mg/dL) between the right arm and left arm

    Measured: 12-14 days

  7. Difference in percent of total glucose readings in hyperglycemic range (Interstitial BG >180mg/dL) between the right arm and left arm

    Measured: 12-14 days

  8. Difference in percent of total glucose readings in hypoglycemic range (Interstitial BG <70mg/dL) between designated diet groups

    Measured: 12-14 days

  9. Difference in percent of total glucose readings in euglycemic range (Interstitial BG 70mg/dL-180mg/dL) between designated diet groups

    Measured: 12-14 days

  10. Difference in percent of total glucose readings in hyperglycemic range (Interstitial BG >180mg/dL) between designated diet groups

    Measured: 12-14 days

  11. Time in range (Interstitial BG 70mg/dL-180mg/dL) between the right arm and left arm

    Measured: 12-14 days

  12. Time below range (Interstitial BG <70 mg/dL) between the right arm and left arm

    Measured: 12-14 days

  13. Time in range (Interstitial BG 70mg/dL-180mg/dL) between designated diet groups

    Measured: 12-14 days

  14. Time below range (Interstitial BG <70 mg/dL) between designated diet groups

    Measured: 12-14 days

Timeline

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

  1. First posted25 Sep 2019
  2. Study start20 Sep 2019
  3. Primary completionNov 2019 (estimated)
  4. Study completionNov 2019 (estimated)

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
Other
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
46 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04102657
Sponsor's protocol ID
20-04
Status last verified
Sep 2019
First submitted
23 Sep 2019
Last updated
25 Sep 2019
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • 2. Food and Drug Administration. Self-monitoring blood glucose test systems for over-the-counter use-guidance for industry and food and drug administration staff. Available at: http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM380327.pdf. Accessed October 10, 2016.

  • 1. Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group, Beck RW, Hirsch IB, Laffel L, Tamborlane WV, Bode BW, Buckingham B, Chase P, Clemons R, Fiallo-Scharer R, Fox LA, Gilliam LK, Huang ES, Kollman C, Kowalski AJ, Lawrence JM, Lee J, Mauras N, O'Grady M, Ruedy KJ, Tansey M, Tsalikian E, Weinzimer SA, Wilson DM, Wolpert H, Wysocki T, Xing D: The effect of continuous glucose monitoring in well-controlled type 1 diabetes. Diabetes Care 2009;32:1378-1383

  • Rodbard D. Continuous Glucose Monitoring: A Review of Successes, Challenges, and Opportunities. Diabetes Technol Ther. 2016 Feb;18 Suppl 2(Suppl 2):S3-S13. doi: 10.1089/dia.2015.0417.

    PubMed 26784127
  • Shapiro AR. Nonadjunctive Use of Continuous Glucose Monitors for Insulin Dosing: Is It Safe? J Diabetes Sci Technol. 2017 Jul;11(4):833-838. doi: 10.1177/1932296816688303. Epub 2017 Mar 1.

    PubMed 28540756
  • Stote KS, Baer DJ, Spears K, Paul DR, Harris GK, Rumpler WV, Strycula P, Najjar SS, Ferrucci L, Ingram DK, Longo DL, Mattson MP. A controlled trial of reduced meal frequency without caloric restriction in healthy, normal-weight, middle-aged adults. Am J Clin Nutr. 2007 Apr;85(4):981-8. doi: 10.1093/ajcn/85.4.981.

    PubMed 17413096
  • Moro T, Tinsley G, Bianco A, Marcolin G, Pacelli QF, Battaglia G, Palma A, Gentil P, Neri M, Paoli A. Effects of eight weeks of time-restricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. J Transl Med. 2016 Oct 13;14(1):290. doi: 10.1186/s12967-016-1044-0.

    PubMed 27737674
  • Kawakatsu S, Liu X, Tran B, Tran BP, Manzanero L, Shih E, Shek A, Lim JJ. Differences in Glucose Readings Between Right Arm and Left Arm Using a Continuous Glucose Monitor. J Diabetes Sci Technol. 2022 Sep;16(5):1183-1189. doi: 10.1177/19322968211008838. Epub 2021 May 6.

    PubMed 33955249

Questions about this trial

What is this clinical trial studying?

A study testing Intermittent Fasting, Free-Living Diet and Left Arm Exercise in people with Diabetes, run by University of the Pacific at 1 site in United States.

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 6 inclusion and 17 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: status not confirmed, as of the sponsor's last update on 25 Sep 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. 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?

Results are not available in the source record.

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

Contact Essie Liu, PharmD (707-423-3277, xliu2@pacific.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Difference in time-matched glucose levels between the right arm and left arm (time frame: 12-14 days). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04102657, which also lists 7 linked publications.

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 25 Sep 2019.

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