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DiabetesNCT05500352

Acute Changes in Plasma Glucose and Cardiovascular Disease in Diabetes

A study testing Hyperglycemia with slow decline in plasma glucose in type 1 diabetes, Hyperglycemia with rapid decline in plasma glucose in type 1 diabetes and Rebound hyperglycemia in type 1 diabetes in people with Diabetes and Hypoglycemia, run by Steno Diabetes Center Copenhagen at 1 site in Denmark.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

Patients with diabetes have an increased risk of sudden cardiac death compared to the general population. Severe hypoglycemia is associated with an increased risk of cardiovascular (CV) disease (CVD) and events, including cardiac arrhythmias and sudden cardiac death; likewise, increased glycemic variability is… Read more about this study

Who is it for?
Ages 18 to 80 yearsHealthy volunteers can take part
Conditions the study is for
Diabetes, Hypoglycemia, Hyperglycemia
What is being tested?
Hyperglycemia with slow decline in plasma glucose in type 1 diabetes, Hyperglycemia with rapid decline in plasma glucose in type 1 diabetes and Rebound hyperglycemia in type 1 diabetes
Could I receive a placebo?
No, everyone receives an active treatment
How many people
86 participants
Where
1 siteDenmark
Study dates
1 Jul 2022to 1 Dec 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 18 to 80 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Informed and written consent
  • Type 1 diabetes diagnosed according to the criteria of the World Health Organization (WHO)
  • Age 18-70 years
  • Insulin treatment for ≥3 years
  • Informed and written consent
  • Type 2 diabetes diagnosed according to the criteria of the World Health Organization (WHO)
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  • Treatment with insulin
  • Glycated haemoglobin A1c (HbA1c) ≤58 mmol/mol
  • HbA1c ≤42 mmol/mol
  • Fasting plasma glucose ≤6.1 mmol/l
  • Informed and written consent
  • Type 1 diabetes
  • Age ≥18 years
  • C-peptide negative (<0.2 nmol/l)
  • Insulin treatment for ≥1 year
  • HbA1C ≥63 mmol/mol
  • Informed and written consent
  • Type 1 diabetes
  • Age ≥18 years
  • C-peptide negative (<0.2nmol/l)
  • Insulin treatment for ≥1 year
  • HbA1C ≤53 mmol/mol

Who cannot join

  • Arrhythmia diagnosed prior to the screening visit
  • Implantable cardioverter defibrillator (ICD) or pacemaker at the time of inclusion
  • Severe heart failure (left ventricular ejection fraction <25%)
  • Structural heart disease (Wolf-Parkinson-White syndrome, congenital heart disease, severe valve disease)
  • Thyroid dysfunction (except for well-regulated eltroxin substituted myxoedema)
  • Anemia (male: hemoglobin <8.0; female: hemoglobin <7.0 mmol/l)
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  • Hypo-Heart 2:
  • Arrhythmia diagnosed prior to or at the time of inclusion
  • Implantable cardioverter defibrillator (ICD) or pacemaker at the time of inclusion
  • Severe heart failure (left ventricular ejection fraction <25%)
  • Structural heart disease (Wolf-Parkinson-White syndrome, congenital heart disease, severe valve disease)
  • Insulin naïve patients with type 2 diabetes
  • Thyroid dysfunction (except for well-regulated eltroxine substituted myxoedema)
  • Unable to comply with daily CGM during run-in period
  • Anemia (male: hemoglobin < 8.0; female: hemoglobin < 7.0 mmol/l)
  • Type 1 or type 2 diabetes
  • Prediabetes (HbA1c >42 mmol/l and/or fasting plasma glucose >6.1 mmol/l)
  • Family history of diabetes (type 1 og type 2 diabetes)
  • Arrhythmia diagnosed prior to or at the time of inclusion
  • ICD or pacemaker at the time of inclusion
  • Severe heart failure (left ventricular ejection fraction <25%)
  • Structural heart disease (Wolf-Parkinson-White syndrome, congenital heart disease, severe valve disease)
  • Thyroid dysfunction (except for well-regulated eltroxine substituted myxoedema)
  • Anemia (male: hemoglobin < 8.0; female: hemoglobin < 7.0 mmol/l)
  • Rapid-Heart:
  • Arrhythmia diagnosed prior to or at the time of the screening visit
  • ECG with left or right bundle branch block diagnosed prior to the screening visit.
  • Implantable cardioverter defibrillator or pacemaker at the time of inclusion
  • Heart failure diagnosed prior to the screening visit (left ventricular ejection fraction < 45%)
  • Structural heart disease (Wolf-Parkinson-White syndrome, congenital heart disease, severe valve disease)
  • Thyroid dysfunction (except for well-regulated myxoedema)
  • Anaemia (male: haemoglobin <8.0 mmol/l; female: haemoglobin <7.0 mmol/l)
  • Treatment with anticoagulant or antiplatelet treatment
  • Bleeding disorder diagnosed prior to the screening visit

Trial locations and contacts

1 site in 1 country.

Denmark1 site
  • Steno Diabetes Center Copenhagen

    Herlev, 2920

Other trials in Denmark

About this study

Official title: Myocardial Work and Left Ventricular Mechanical Dyssynchrony During Acute Changes in Plasma Glucose in Individuals With Type 1 Diabetes, Type 2 Diabetes and Without Diabetes

Patients with diabetes have an increased risk of sudden cardiac death compared to the general population. Severe hypoglycemia is associated with an increased risk of cardiovascular (CV) disease (CVD) and events, including cardiac arrhythmias and sudden cardiac death; likewise, increased glycemic variability is associated with macrovascular complications and increased mortality. The physiological mechanisms linking hypoglycemia and glycemic variability to CVD and CV events remain unclear.

Myocardial work and mechanical dyssynchrony will be measured by speckle tracking echocardiography during euglycemia, hypoglycemia and hyperglycemia in individuals with type 1 diabetes, type 2 diabetes, and without diabetes. Echocardiographic images from three experimental clamp studies - Hypo-Heart 1 (sub-study 1), Hypo-Heart 2 (sub-study 2) and Rapid-Heart - will be included in this study.

Read the detailed description

The results of this study may be compiled into one or more manuscripts for publication.

Study ID's:

Hypo-Heart 1 (sub-study 1): NCT03956173 Hypo-Heart 2 (sub-study 2): NCT03150030 Rapid-Heart: NCT04800536

Being tested
Hyperglycemia with slow decline in plasma glucose in type 1 diabetes, Hyperglycemia with rapid decline in plasma glucose in type 1 diabetes, Rebound hyperglycemia in type 1 diabetes, Rebound euglycemia in type 1 diabetes, Hypoglycemia in type 1 diabetes
Medical subject headings
Diabetes Mellitus, Hypoglycemia, Hyperglycemia, Cardiovascular Diseases, Death, Sudden, Cardiac

What participants receive

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

  • Hyperglycemia with slow decline in plasma glucose in type 1 diabetesOther

    Acute plasma glucose decline, divided into the following three phases: 1) Hyperglycaemic phase (plasma glucose 15 mmol/l), 2) Slow plasma glucose decline phase and 3) Euglycaemic phase (plasma glucose 4.5-5.5 mmol/l).

  • Hyperglycemia with rapid decline in plasma glucose in type 1 diabetesOther

    Acute plasma glucose decline, divided into the following three phases: 1) Hyperglycaemic phase (plasma glucose 15 mmol/l), 2) Rapid plasma glucose decline phase and 3) Euglycaemic phase (plasma glucose 4.5-5.5 mmol/l).

  • Rebound hyperglycemia in type 1 diabetesOther

    Also called Experimental clamp

    Includes three steady state phases in plasma glucose, 1) euglycemic phase (5-8 mmol/L), 2) hyperinsulinemic hypoglycemic phase (PG: 2.5 mmol/L), 3) recovery phase in hyperglycemia (20.0 mmol/L)

  • Rebound euglycemia in type 1 diabetesOther

    Also called Experimental clamp

    Includes three steady state phases in plasma glucose, 1) euglycemic phase (5-8 mmol/L), 2) hyperinsulinemic hypoglycemic phase (PG: 2.5 mmol/L), 3) recovery phase in euglycemia (PG: 5-8 mmol/L).

  • Hypoglycemia in type 1 diabetesOther

    Also called Experimental clamp

    Includes three steady state phases in plasma glucose, 1) euglycemic phase (5-8 mmol/L), 2) hyperinsulinemic hypoglycemic phase (PG: 2.5 mmol/L), 3) recovery phase in hyperglycemia (20.0 mmol/L) or euglycemia (PG: 5-8 mmol/L)

  • Hypoglycemia in type 2 diabetesOther

    Also called Experimental clamp

    Includes three steady state phases in plasma glucose, 1) euglycemic phase (fasting PG), 2) hyperglycemic phase (fasting PG + 10 mmol/L), 3) hyperinsulinemic hypoglycemic phase (PG < 3.0 mmol/L).

  • Hypoglycemia in healthy controlsOther

    Also called Experimental clamp

    Includes three steady state phases in plasma glucose, 1) euglycemic phase (fasting PG), 2) hyperglycemic phase (fasting PG + 10 mmol/L), 3) hyperinsulinemic hypoglycemic phase (PG < 3.0 mmol/L).

  • Hyperglycemia in type 2 diabetesOther

    Also called Experimental clamp

    Includes three steady state phases in plasma glucose, 1) euglycemic phase (fasting PG), 2) hyperglycemic phase (fasting PG + 10 mmol/L), 3) hyperinsulinemic hypoglycemic phase (PG < 3.0 mmol/L).

  • Hyperglycemia in healthy controlsOther

    Also called Experimental clamp

    Includes three steady state phases in plasma glucose, 1) euglycemic phase (fasting PG), 2) hyperglycemic phase (fasting PG + 10 mmol/L), 3) hyperinsulinemic hypoglycemic phase (PG < 3.0 mmol/L).

Study groups in NCT05500352
Study groupRoleWhat they receive
Cardiovascular effects of slowly declining plasma glucose in type 1 diabetesExperimentalNot described
Receives: Other: Hyperglycemia with slow decline in plasma glucose in type 1 diabetes
Cardiovascular effects of rapidly declining plasma glucose in type 1 diabetesExperimentalNot described
Receives: Other: Hyperglycemia with rapid decline in plasma glucose in type 1 diabetes
Cardiovascular effects of rebound hyperglycemia in type 1 diabetesExperimentalNot described
Receives: Other: Rebound hyperglycemia in type 1 diabetes
Cardiovascular effects of rebound euglycemia in type 1 diabetesExperimentalNot described
Receives: Other: Rebound euglycemia in type 1 diabetes
Cardiovascular effects of hypoglycemia in type 1 diabetesExperimentalNot described
Receives: Other: Hypoglycemia in type 1 diabetes
Cardiovascular effects of hypoglycemia in type 2 diabetesExperimentalNot described
Receives: Other: Hypoglycemia in type 2 diabetes
Cardiovascular effects of hypoglycemia in healthy controlsExperimentalNot described
Receives: Other: Hypoglycemia in healthy controls
Cardiovascular effects of hyperglycemia in type 2 diabetesExperimentalNot described
Receives: Other: Hyperglycemia in type 2 diabetes
Cardiovascular effects of hyperglycemia in healthy controlsExperimentalNot described
Receives: Other: Hyperglycemia in healthy controls

What is being measured

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

  1. Change in the global work during hypoglycemia in individuals with type 1 diabetes, type 2 diabetes, and without diabetes, respectively.

    Absolute change in the global work index measured by pressure-strain loop analysis during insulin-induced hypoglycemia compared to euglycemia in individuals with type 1 diabetes, type 2 diabetes, and without diabetes, respectively (Hypo-Heart 1 and Hypo-Heart 2).

    Study outcomes will be analyzed separately for each included study.

    Measured: 255 minutes (Hypo-Heart 1) and 190 minutes (Hypo-Heart 2)

Secondary outcomes (5)
  1. Primary secondary outcome: Change in mechanical dyssynchrony during hypoglycemia in individuals with type 1 diabetes, type 2 diabetes, and without diabetes, respectively.

    Absolute change in mechanical dyssynchrony (defined as the standard deviation of regional time to peak strain) measured by speckle tracking echocardiography measured by pressure-strain loop analysis during insulin-induced hypoglycemia compared to euglycemia in individuals with type 1 diabetes, type 2 diabetes, and without diabetes, respectively (Hypo-Heart 1 and Hypo-Heart 2).

    Study outcomes will be analyzed separately for each included study.

    Measured: 255 minutes (Hypo-Heart 1) and 190 minutes (Hypo-Heart 2)

  2. Change in the global work during recovery in individuals with type 1 diabetes.

    Absolute change in the global work index measured by pressure-strain loop analysis during recovery (post-hypoglycemic euglycemia and hyperglycemia) compared to euglycemia in individuals with type 1 diabetes (Hypo-Heart 1).

    Study outcomes will be analyzed separately for each included study.

    Measured: 255 minutes

  3. Change in mechanical dyssynchrony during recovery in individuals with type 1 diabetes.

    Absolute change in mechanical dyssynchrony (defined as the standard deviation of regional time to peak strain) measured by speckle tracking echocardiography measured by pressure-strain loop analysis during recovery (post-hypoglycemic euglycemia and hyperglycemia) compared to euglycemia in individuals with type 1 diabetes (Hypo-Heart 1).

    Study outcomes will be analyzed separately for each included study.

    Measured: 255 minutes

  4. Change in the global work during hyperglycemia in individuals with type 1 diabetes, type 2 diabetes and without diabetes, respectively.

    Absolute change in the global work index measured by pressure-strain loop analysis during hyperglycemia compared to euglycemia in individuals with type 1 diabetes, type 2 diabetes and without diabetes, respectively (Rapid Heart and Hypo-Heart 2).

    Study outcomes will be analyzed separately for each included study.

    Measured: 255 minutes (Rapid Heart) and 190 minutes (Hypo-Heart 2)

  5. Change in mechanical dyssynchrony during hyperglycemia in individuals with type 1 diabetes, type 2 diabetes and without diabetes, respectively.

    Absolute change in mechanical dyssynchrony (defined as the standard deviation of regional time to peak strain) measured by speckle tracking echocardiography measured by pressure-strain loop analysis during hyperglycemia compared to euglycemia in individuals with type 1 diabetes, type 2 diabetes and without diabetes, respectively (Rapid Heart and Hypo-Heart 2).

    Study outcomes will be analyzed separately for each included study.

    Measured: 255 minutes (Rapid Heart) and 190 minutes (Hypo-Heart 2)

Timeline

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

  1. First posted15 Aug 2022
  2. Study start1 Jul 2022
  3. Primary completion1 May 2023 (estimated)
  4. Study completion1 Dec 2023 (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
Basic science
Allocation
Randomised
Intervention model
Crossover
Model description
The present echocardiographic study includes participants from three experimental clamp studies; the Hypo-Heart 1 (Study 1), Hypo-Heart 2 (Study 2) and Rapid-Heart (Study 3).
Masking
Single blind
Who is masked
Investigator
Enrolment
86 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05500352
Sponsor's protocol ID
H18034040_part2
Status last verified
Aug 2022
First submitted
6 Jul 2022
Last updated
17 Aug 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Hyperglycemia with slow decline in plasma glucose in type 1 diabetes, Hyperglycemia with rapid decline in plasma glucose in type 1 diabetes and Rebound hyperglycemia in type 1 diabetes in people with Diabetes and Hypoglycemia, run by Steno Diabetes Center Copenhagen at 1 site in Denmark.

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 22 inclusion and 34 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 17 Aug 2022. 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 Denmark. 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?

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?

Change in the global work during hypoglycemia in individuals with type 1 diabetes, type 2 diabetes, and without diabetes, respectively. (time frame: 255 minutes (Hypo-Heart 1) and 190 minutes (Hypo-Heart 2)). 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 17 Aug 2022.

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