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Type 2 DiabetesCir-D-BrainNCT06243172

Determining Circadian Metabolic and Behavioural Rhythms in Patients with and Without Type 2 Diabetes

An observational study of Type 2 Diabetes and Circadian Rhythm, 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 The sponsor has not verified this record for over two years, so it may be out of date.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

The goal of the present clinical descriptive study is to characterize and quantify the potential hormonal chronobiological differences between individuals with type 2 diabetes (T2D) and healthy age and weight-matched controls as either circadian aligned or misaligned. Read more about this study

Who is it for?
Ages 50 to 75 yearsHealthy volunteers can take part
Conditions the study is for
Type 2 Diabetes, Circadian Rhythm
How many people
60 participants
Where
1 siteDenmark
Study dates
1 Feb 2024to 1 May 2025
Phase
Observational
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 50 to 75 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Primary care clinic, Steno Diabetes Center Copenhagen out-patient clinic, community sample

Who may be able to join

  • Individuals with T2D:
  • Informed and written consent.
  • Clinically diagnosed diabetes mellitus type 2 for at least 5 years (diagnosed according to criteria of World Health Organization (WHO)).
  • HbA1c >53 mmol/mol
  • Stable medical treatment for at least 8 weeks.
  • Plasma haemoglobin ≥8.00 mmol/L (male) or ≥6.4 mmol/L (female).
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  • Male or female participants aged 50-75 years.
  • Healthy matched controls:
  • Informed and written consent.
  • Normal haemoglobin ≥8.00 mmol/L (male) or ≥6.4 mmol/L (female).
  • Male or female participants aged 50-75 years.

Who cannot join

  • Body mass index (BMI) <23 kg/m2
  • Receipt of any investigational medicinal product within 3 months before screening in this trial.
  • Inability to perform neuropsychological tests (e.g., visual impairment or auditory impairment, or language barrier).
  • Participants with mental incapacity or language barriers precluding adequate understanding or co-operation or who, in the opinion of the investigator or their general practitioner, should not participate in the trial.
  • Prior or contemporary use of any kind of hypnotica within 6 months, former p.n. use of melatonin is judged by the investigator.
  • Nightshift-worker.
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  • Known dementia or any other major disorders that in the opinion of the investigator precludes compliance with the protocol, evaluation of the results or represent an unacceptable risk for the participant's safety.
  • Diagnosed sleep disorders (e.g., sleep apnoea and narcolepsy).
  • Significant history of alcoholism or drug/chemical abuse as per investigator's judgement.
  • Severe hypoglycaemic event during the past 6 months requiring medical assistance.
  • Diagnosed diabetic retinopathy.
  • Severe renal insufficiency defined as estimated glomerular filtration rate (eGFR) ≤ 30 ml/min/1.73m2 or any kind of kidney disease that in the opinion of the investigator involves an unnecessary risk for the participants.
  • Cardiac problems including any of the following:
  • Classified as being in New York Heart Association (NYHA) class III or IV.
  • Angina pectoris (chest pain) within the last 6 months.
  • Inadequately treated blood pressure at screening defined as repeated resting blood pressure outside the rage 90-150 mmHg for systolic and 50-100 mmHg for diastolic blood pressure.
  • Known lung disease that in the opinion of the investigator represents an unacceptable risk for the participant's safety.
  • Active or recent (≤ 12 months) malignant disease is judged by the investigator.
  • For females only: Pregnancy, breast-feeding status, or intention of becoming pregnant during the trial.
  • For healthy matched controls: prediabetes defined as HbA1c between 42-47 mmol/mol

Trial locations and contacts

1 site in 1 country.

Jørgen Rungby, MD, DMSc contact

+45 21686620

joergen.rungby@regionh.dk

Denmark1 site, 1 recruiting
  • Steno Diabetes Center Copenhagen

    Herlev, 2730

    Helena Z Wodschow, MD, +45 30313426, helena.zander.wodschow.03@regionh.dk

    Jørgen Rungby, MD, DMSc, +45 21686620, joergen.rungby@regionh.dk

    Recruiting

Other trials in Denmark

About this study

Official title: Determining Circadian Metabolic and Behavioural Rhythms in Patients with and Without Type 2 Diabetes and Identifying the Relation to Hormone and Glucose Fluctuations, and Cognition

The goal of the present clinical descriptive study is to characterize and quantify the potential hormonal chronobiological differences between individuals with type 2 diabetes (T2D) and healthy age and weight-matched controls as either circadian aligned or misaligned. The investigators hypothesize that individuals with T2D have a misaligned and different circadian rhythmicity of circadian biomarkers (melatonin and cortisol) than controls, and that this difference in turn is related to 24h hormonal fluctuations, behaviour, and metabolic-, cardiac-, and cognitive parameters.

Participants will be asked to:

  • fill-out a diary on eating and sleeping habits for 30 days
  • wear an actigraphy and continuous glucose monitor for 10-14 days
  • stay overnight at the research facility, including continuous blood sampling and polysomnography
Read the detailed description

T2D is associated with cognitive dysfunction and an increased risk of developing dementia. This negative effect on cognition is worsened by T2D duration, yet the mechanisms are unknown.

Sleep disturbances increase peripheral insulin resistance, and is associated with the development of T2D, temporarily worsened cognitive function, and the development of cognitive impairment. In turn, T2D is associated with circadian misalignment (a condition where the internal physiological clock is unaligned with the external behavior). A major external signal (also known as zeitgeber) for synchronizing the internal and external clock is sleep in accordance with the day-night cycle.

Determining the circadian rhythm of an individual and whether it is aligned or misaligned is complex and can't be done by one measurement. However, melatonin and cortisol are often used as "circadian biomarkers" due to significant and well-defined circadian rhythm profiles. Another measure of the circadian phase is the timing of melatonin production under dim light conditions (dim light melatonin onset) which is an individual phase marker depending on the persons habitual time of sleep. Most studies focusing on circadian alignment in an everyday setting have used questionnaires, and to our knowledge, no studies have described 24-h circadian oscillations between individuals with T2D and healthy age and weight matched controls. Mapping these potential differences could help explain the pathophysiological mechanisms behind T2D and circadian misalignment.

The Cir-D-Brain study is a clinical descriptive study. The study comprises of an information visit, a screening visit, a midway visit (2 weeks after screening), a 24-h in-hospital day (a day between the midway visit and the final visit), and a final visit (2 weeks after the midway visit). Participants will keep a diary on eating and sleeping habits for all 30 days. At the midway visit, participants will be equipped with an actigraphy and a continuous glucose monitor. At the 24-h in-hospital day, participants will have their blood sampled every third hour for 24 hours to measure their circadian rhythm, every hour from 6 pm till 12 am to map dim light melatonin onset, and at wake-up to map cortisol awakening response. At the 24-h in-hospital day, participants will furthermore have their sleep stages measured by polysomnography. The study will include 30 participants with T2D and 30 age and BMI matched controls.

The specific objectives are:

  1. To characterize and quantify the hormonal chronobiological differences between individuals with T2D and healthy matched controls measured by circadian biomarkers.
  2. To relate the findings to 24-h hormonal fluctuations, different patterns in metabolism, behavioural circadian rhythms differences (sleep-wake and eating habits), sleep stages, glycaemic variability, inflammation, heart rate variability, and cognition.
Keywords
Type 2 Diabetes, Circadian Rhythm, Cognition, Sleep
Medical subject headings
Diabetes Mellitus, Type 2

What participants receive

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

Study groups in NCT06243172
Study groupRoleWhat they receive
Type 2 DiabetesIndividuals with type 2 diabetes
ControlsIndividuals without type 2 diabetes matched on age and body mass index

What is being measured

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

  1. Melatonin oscillations (amplitude, peak, mesor, phase, period length (TAU))

    Blood samples

    Measured: 24-hour in-hospital day, blood samples taken every third hour for 24 hours (9 timepoints in total)

  2. Cortisol oscillations (amplitude, peak, mesor, phase, period length (TAU))

    Blood samples

    Measured: 24-hour in-hospital day, blood samples taken every third hour for 24 hours (9 timepoints in total)

Secondary outcomes (20)
  1. Dim light melatonin onset

    Blood samples (pg/ml)

    Measured: 24-hour in-hospital day, blood samples taken every hour from 18:00 until 00:00 (7 timepoints in total)

  2. Phase angle (time between dim light melatonin onset and sleep)

    Blood samples

    Measured: 24-hour in-hospital day, blood samples taken every hour from 18:00 until 00:00 (7 timepoints in total)

  3. Cortisol awakening response

    Blood samples (pg/ml)

    Measured: 24-hour in-hospital day, blood samples taken at wake up, and 15-, 30-, and 60-minutes post-wake up

  4. Diary on sleeping habits

    Expanded Consensus Sleep Diary (time in bed, time to fall asleep, number of awakenings and durations, time of final awakening, time to get out of bed, total sleep time, sleep quality, daytime sleepiness, number of naps and duration, number and last time of alcohol consumption, number and last time of coffein consumption, use of sleep medicine)

    Measured: 30 days

  5. Diary on eating window

    The eating window (initiation of first consumption and termination of last consumption of food)

    Measured: 30 days

  6. Glycaemic variability

    Continuous glucose monitor (amplitude (mmol/L), frequency, and duration of the fluctuation, mean glucose (mmol/L), time in range, time in hyperglycemic and hypoglycemic range, area under the curve)

    Measured: 10-14 days

  7. Sleep and waking states

    Actrigraph worn on the wrist of the non-dominant hand (acceleration at different times)

    Measured: 10-14 days

  8. Heart rate variability (fluctuations in time intervals between adjacent heart beats)

    Measured continuously by the polysomnograph (ms)

    Measured: 24-hour in-hospital day

  9. Sleep architecture

    Polysomnography (minutes and percentages). Sleep stages (N1, N2, N3, rapid eye movement (REM)), total time asleep, sleep latency, REM sleep latency, arousals, awakenings, total sleep efficiency.

    Measured: 24-hour in-hospital day

  10. Cognition (verbal memory)

    Rey Auditory Verbal Learning Test (RAVLT)

    Measured: 24-hour in-hospital day

  11. Cognition (psychomotor speed and executive function)

    Trail Making Test (TMT) part A and B ), Symbol Digit Modalities Test (SDMT)

    Measured: 24-hour in-hospital day

  12. Cognition (executive function)

    WAIS-III Letter-Number Sequencing test, Verbal fluency test (letters S and D)

    Measured: 24-hour in-hospital day

  13. Cognition (sustained attention)

    Rapid Visual Processing (RVP) test from the Cambridge Neuropsychological Test Automated Battery (CANTAB)

    Measured: 24-hour in-hospital day

  14. Cognition (verbal IQ)

    Danish Adult Reading Test (DART) (equivalent to the National Adult Reading Test; NART)

    Measured: 24-hour in-hospital day

  15. Insulin oscillations (amplitude, peak, mesor, phase, period length (TAU))

    Blood samples.

    Measured: 24-hour in-hospital day, blood samples taken every third hour for 24 hours (9 timepoints in total)

  16. C-peptide oscillations (amplitude, peak, mesor, phase, period length (TAU))

    Blood samples.

    Measured: 24-hour in-hospital day, blood samples taken every third hour for 24 hours (9 timepoints in total)

  17. TSH oscillations (amplitude, peak, mesor, phase, period length (TAU))

    Blood samples.

    Measured: 24-hour in-hospital day, blood samples taken every third hour for 24 hours (9 timepoints in total)

  18. Glucose oscillations (amplitude, peak, mesor, phase, period length (TAU))

    Blood samples.

    Measured: 24-hour in-hospital day, blood samples taken every third hour for 24 hours (9 timepoints in total)

  19. Glucagon oscillations (amplitude, peak, mesor, phase, period length (TAU))

    Blood samples.

    Measured: 24-hour in-hospital day, blood samples taken every third hour for 24 hours (9 timepoints in total)

  20. Glucagon-like peptide-1 (GLP-1) oscillations (amplitude, peak, mesor, phase, period length (TAU))

    Blood samples.

    Measured: 24-hour in-hospital day, blood samples taken every third hour for 24 hours (9 timepoints in total)

Timeline

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

  1. First posted6 Feb 2024
  2. Study start1 Feb 2024
  3. Primary completion1 May 2025 (estimated)
  4. Study completion1 May 2025 (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
Other
Time perspective
Cross-sectional
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06243172
Sponsor's protocol ID
H-22014311
Acronym
Cir-D-Brain
Status last verified
Jan 2024
First submitted
28 Jan 2024
Last updated
7 Nov 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Type 2 Diabetes and Circadian Rhythm, 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 11 inclusion and 20 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 7 Nov 2024. 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?

Contact Helena Z Wodschow, MD (+45 30313426, helena.zander.wodschow.03@regionh.dk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Melatonin oscillations (amplitude, peak, mesor, phase, period length (TAU)) (time frame: 24-hour in-hospital day, blood samples taken every third hour for 24 hours (9 timepoints in total)). 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?
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 7 Nov 2024.

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