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Type 1 DiabetesNCT05487534

Do "sugar Swings" Impact the Brain Function and the Eating Behaviors of People with Type 1 Diabetes

An observational study of Type 1 Diabetes, run by Laval University at 2 sites in Canada.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

In type 1 diabetes, it is common to choose the food we eat according to the blood sugar level and the insulin dose and vice versa. Beyond the nutritional aspects, the relationship to food and the resulting eating behaviors can be a source of suffering. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Type 1 Diabetes
What is being tested?
Observational
How many people
150 participants
Where
2 sitesCanada
Study dates
26 Apr 2023to Sep 2026
Phase
Observational
Are there results?
Not yet: the study is under way

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
  • No healthy volunteers
  • Adult, Older adult

Study population: Participants will be recruited through the endocrinology clinics of the CHU de Québec (approximately 1000 patients living with type 1 diabetes) and the Institut de recherches cliniques de Montréal (IRCM) (>800 patients living with type 1 diabetes). We will also recruit through the BETTER registry, overseen by Dr. Rabasa-Lhoret and Dr. Brazeau (collaborators on the project) and co-funded by IRSC and JDRF: over 2000 people with type 1 diabetes are currently enrolled in the registry and 98% of participants have agreed to be contacted for future research studies. In case of recruitment difficulties, an announcement will also be made on social networks (such as Facebook).

Who may be able to join

  • Type 1 diabetes (> 12 months)
  • Age between 18 and 65 years old
  • 6.5 % < A1C < 9% (to avoid potential severe eating disorder)

Who cannot join

  • Type 2 diabetes or other form of diabetes; gastroparesis (clinical diagnosis);
  • Recent (< 6 months) major cardiovascular event (e.g. myocardial infarction, cerebrovascular accident, major revascularization)
  • Recent (< 12 weeks) severe hypoglycemia episodes (<2.8 mmol/L or assistance from a third party)
  • Recent (< 12 weeks) changes in insulin type or delivery method
  • Automated Insulin Delivery
  • History of severe brain trauma, epilepsy, schizophrenia or bipolar disorders
  • Inability to use a computer
  • Incorrect vision or auditory problems

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Canada2 sites, 2 recruiting
  • IRCM

    Montreal

    Maha Lebbar, MD

    Recruiting
  • CHU de Québec

    Québec

    Sylvain Iceta, MD, PhD

    Recruiting

Other trials in Canada

About this study

Official title: Impact of Glycemic Variability on Cognitive Impairment, Disordered Eating Behavior, and Self-management Skills in Patients Living with Type 1 Diabetes

In type 1 diabetes, it is common to choose the food we eat according to the blood sugar level and the insulin dose and vice versa. Beyond the nutritional aspects, the relationship to food and the resulting eating behaviors can be a source of suffering. Also, it has been reported that one out of two people over 60 years of age living with type 1 diabetes has cognitive impairment. Changes in cognitive functions can have important implications for daily well-being, diet (e.g., the ability to modulate cravings), and treatment decisions to manage diabetes.

One factor that can affect both eating behaviors and cognitive function is variation in blood glucose levels.

Read more

This research aims to better understand the impact of glycemic variability in disordered eating behaviors and cognitive impairment, and its consequences on self-management skills in people with type 1 diabetes.

The hypotheses are that i) higher glycemic variability is associated with higher disordered eating behaviors and poorer cognitive function in people with type 1 diabetes, and that differences exist between sexes, ii) higher disordered eating behaviors and poorer cognitive function are associated with lower self-management skills; and iii) cognitive impairment, interoception awareness and insulin resistance may mediate the relationship between glycemic variability and disordered eating behaviors.

This research study will contribute to highlighting the consequences of blood sugar fluctuations, "sugar swings", in daily life, in particular the way they disrupt eating behaviors and brain function. A better understanding of the mechanisms involved could eventually allow for early detection and management of these problems. Our study will also seek to understand the patients' point of view, which will allow the design of appropriate and meaningful recommendations.

Read the detailed description

All assessments will be done in virtual mode through secure platforms (but also offered in person in Quebec City if needed to limit discrimination).

The study will start with an inclusion visit during which self-reported and medical data will be collected as well as some anthropometric parameters measured. Following the visit, the participant will be asked to wear a continuous glucose sensor provided by the investigator (Dexcom®) to perform a continuous glucose recording for 10 days. During this 10-day period, the participant will be required to complete:

  • A food diary during 3 weekdays and 1 weekend day using the Keenoa® app.
  • 3 online sessions combining questionnaires (using the Redcap platform) and computerized tests (Inquisit® platform). Each session will last approximately 45 minutes (can vary between 30 and 60 minutes).

Participants who wish to participate in the qualitative phase of this study will also be offered the opportunity to do so. Participants will be recruited consecutively until a total of 50 are reached. For this part of the study, an individual interview will be conducted by a professional specifically trained in this method of analysis. This meeting will last on average 1.5 hours, but may last up to 2.5 hours depending on the length of the discussion. There will be an audio and video recording of this meeting. The discussions will then be transcribed into text and analyzed.

Conditions
Type 1 Diabetes
Being tested
Observational
Keywords
Diabetes, Cognition, Eating behaviors, Glycemic variation, Blood glucose
Medical subject headings
Diabetes Mellitus, Type 1, Diabetes Mellitus, Feeding Behavior

What participants receive

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

  • ObservationalOther

    The same self-reported questionnaires and cognitive tests will be completed by both groups. There is no intervention.

Study groups in NCT05487534
Study groupRoleWhat they receive
Sugar Swing +Patients with type 1 diabetes with a high glucose variability (i.e., a coefficient of variation > 36% over a 10-day continuous glucose monitoring)
Receives: Other: Observational
Sugar Swing -Patients with type 1 diabetes with low glucose variability (i.e., a coefficient of variation < 36% over a 10-day continuous glucose monitoring)
Receives: Other: Observational

What is being measured

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

  1. Eating Disorder examination (EDE-Q)

    To assess eating behaviors according to their glycemic variability.

    Measured: Day 1 (+/- 2 days)

  2. Glucose variability and insulin resistance (CGMS - 10 days)

    CGMS will be performed over a 10-day period using a DEXCOM G6 to separate participants into groups based on glycemic variation (i.e., a coefficient of variation [CV] >36% over a 10-day CGMS) versus those with a low glucose variability (i.e., CV <36%).

    Measured: Start at inclusion (Day 1 to Day 10)

Secondary outcomes (33)
  1. Distress Diabetes Scale (T1-DDS)

    To assess self-management's skills.

    Measured: Inclusion

  2. Diabetes Behavior Ratting Scale (DBRS)

    To assess self-management's skills.

    Measured: Inclusion

  3. Generalized Anxiety Disorder (GAD-7)

    To assess anxiety disorders.

    Measured: Inclusion

  4. Patient Health Questionnaire (PHQ-9)

    To assess depression disorder.

    Measured: Inclusion

  5. Diabetes Numeracy Test (DNT-15)

    To assess diabetes literacy and numeracy skills.

    Measured: Inclusion

  6. Physical and psychological comorbidities

    Including eating disorders.

    Measured: Inclusion (medical data)

  7. Diabetes Information : Duration

    Number of years since the diagnosis of diabetes.

    Measured: Inclusion (medical data)

  8. Diabetes Information : Modality of insulin delivery

    Pumps or injections of insulin.

    Measured: Inclusion (medical data)

  9. Diabetes Information : Total daily insulin dose

    The dose of insulin taken per day.

    Measured: Inclusion (medical data)

  10. Diabetes Information : Duration of diabetes self-monitoring

    Number of years or months of its use, either self-monitoring with capillary glucose tests or CGMS.

    Measured: Inclusion (medical data)

  11. Diabetes Information : Severe hypoglycemic episodes

    Number of severe hypoglycemic episodes over the last year.

    Measured: Inclusion (medical data)

  12. Diabetes Information : Medication

    Past year and current medications (included use of psychotropic drugs to be considered as a potential confounding factor).

    Measured: Inclusion (medical data)

  13. Diabetes Information : Diabetes complications

    Number and type of diabetes complications.

    Measured: Inclusion (medical data)

  14. Diabetes Information : Coefficient of variation

    Measured coefficient of variation based on previous CGMS and last available HbA1c (max 6 months).

    Measured: Inclusion (medical data)

  15. Anthropometric markers : BMI

    Weight and height will be combined to report BMI in kg/m^2.

    Measured: Inclusion (medical data)

  16. Anthropometric markers : Waist, hips and neck circumferences

    Waist, hips and neck circumferences will be self measured in cm with a measuring tape.

    Measured: Inclusion (medical data)

  17. Biological information : Cholesterol and triglycerides

    Measurement of cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides in mg/dL.

    Measured: Inclusion (biological data)

  18. Biological information : Fasting blood glucose

    Measurement of fasting blood glucose in mg/dL.

    Measured: Inclusion (biological data)

  19. Biological information : C-peptide

    Measurement of c-peptide in nmol/L.

    Measured: Inclusion (biological data)

  20. Biological information : Triglycerides

    otal cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, fasting blood glucose, c-peptide, ghrelin fasting and CRP

    Measured: Inclusion (biological data)

  21. Biological information : Ghrelin fasting and C-Reactive protein (CRP)

    Measurement of ghrelin fasting and CRP in mg/L.

    Measured: Inclusion (biological data)

  22. Detail and Flexibility Questionnaire (DFQ)

    To assess cognitive flexibility.

    Measured: Day 1 (+/- 2 days)

  23. Adult ADHD Self-Report Scale (ASRS)

    To screen for Attention Deficit Hyperactive Disorder (ADHD).

    Measured: Day 1 (+/- 2 days)

  24. Category Switch Task

    To assess attention.

    Measured: Day 1 (+/- 2 days)

  25. Multidimensional Assessment of Interoceptive Awareness Version 2 (MAIA)

    To assess the level of interoception.

    Measured: Day 4 (+/- 2 days)

  26. Binge Eating Scale (BES)

    To assess eating behaviors.

    Measured: Day 4 (+/- 2 days)

  27. Tower of London Task

    To assess executive functioning.

    Measured: Day 4 (+/- 2 days)

  28. Stop Signal Task

    To assess impulsivity and inhibition.

    Measured: Day 4 (+/- 2 days)

  29. 5-Trial Adjusting Delay Discounting

    To assess temporal discounting.

    Measured: Day 4 (+/- 2 days)

  30. Short UPPS-P Impulsive Behavior Scale

    To assess behavior impulsivity.

    Measured: Day 8 (+/- 2 days)

  31. Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0)

    To estimate susceptibility to food reward.

    Measured: Day 8 (+/- 2 days)

  32. Emotional Go/No-Go Task

    To assess inhibition leverages by emotion recognition and regulation.

    Measured: Day 8 (+/- 2 days)

  33. Attentional Cueing Procedure

    To assess the effects of threat stimuli on capturing and holding attention.

    Measured: Day 8 (+/- 2 days)

Timeline

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

  1. First posted4 Aug 2022
  2. Study start26 Apr 2023
  3. Primary completionSep 2026 (estimated)
  4. Study completionSep 2026 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
150 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05487534
Sponsor's protocol ID
MP-20-2023-6466
Status last verified
Oct 2024
First submitted
8 Jul 2022
Last updated
9 Oct 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Iceta S, Sohier L, Begin C, Brazeau AS, Rabasa-Lhoret R, Gagnon C. Impact of glycemic variability on cognitive impairment, disordered eating behaviors and self-management skills in patients with type 1 diabetes: study protocol for a cross-sectional online study, the Sugar Swing study. BMC Endocr Disord. 2022 Nov 18;22(1):283. doi: 10.1186/s12902-022-01191-4.

    PubMed 36401237

Questions about this trial

What is this clinical trial studying?

An observational study of Type 1 Diabetes, run by Laval University at 2 sites in Canada.

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 3 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: looking for participants now, as of the sponsor's last update on 9 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Canada. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Sylvain Iceta, MD, PhD (+1 (418) 656-8711 ext. 4565, equipe.iceta@criucpq.ulaval.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Eating Disorder examination (EDE-Q) (time frame: Day 1 (+/- 2 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 NCT05487534, which also lists 1 linked publication.

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 Oct 2024.

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