Study Results
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Basic Information
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COMPLETED
PHASE3
15 participants
INTERVENTIONAL
2007-01-31
2010-02-28
Brief Summary
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A long known therapy for the acute treatment of patients with deteriorated glucose metabolism and insulin resistance are carbohydrate days. The principle of the therapy was firstly introduced in 1903 by Carl von Noorden (Noorden et al. 1903). The diabetic patients were treated for several days with a carbohydrate rich diet with fat restriction. Surprisingly, this resulted in an amelioration of glucosuria. Today it's still a valuable tool for patients with uncontrollable diabetes mellitus and severe insulin resistance (Willms B. 1989). But up to now there has been no systemic evaluation of carbohydrate days in patients with deteriorated Diabetes mellitus and insulin resistance.
The investigators conducted a pilot study with 14 patients to evaluate the efficacy of two days of oatmeal on insulin resistance and glucose metabolism in an acute clinical setting and after a four week outpatient period. Inclusion criteria were type 2 diabetes with deteriorated glucose metabolism, insulin resistance defined as an insulin dosage of more than 1 U per day and kg bodyweight. Within this pilot trial the investigators found a marked decrease of insulin requirements (\~40%) and mean daily blood glucose to a mean blood glucose of 114.7±36.7 mg/dl in the acute setting as well as after the four week outpatient period (Lammert et al. 2006).
The most important shortcomings of this study were the hypocaloric interventions in both groups (diabetes-adapted diet: 1500kcal/d vs. oatmeal 1200kcal/d) making it difficult to attribute the observed effects to oatmeal alone as well as the uncontrolled nature. These design flaws have been addressed within this new clinical trial. The investigators plan an open label, cross-over study with isocaloric interventions (oatmeal and diabetes-adapted diet: \~ 1200kcal/d). The intervention comprises two days of oatmeal (third and fourth day) within a 5 day hospital stay. The control is only treated with 5 days of diabetes adapted diet. Thereafter, the patients are followed every four weeks for an overall of 16 weeks.
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
CROSSOVER
TREATMENT
NONE
Interventions
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Diet: carbohydrate days. (Name: oatmeal.)
Dietary intervention with two days of oatmeal compared to normal diabetes adapted diet in insulin resistant subjects.
Eligibility Criteria
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Inclusion Criteria
* insulin therapy
* stable therapy modality within the last 3 months
* deteriorated glucose metabolism (Hba1c \> 7%)
* insulin resistance, defined as more than 1 unit of insulin per kg and day
Exclusion Criteria
* planed weight reducing therapy
* acute and chronic inflammatory disease
* therapy with corticosteroids
* pregnancy
18 Years
80 Years
ALL
No
Sponsors
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Universitätsmedizin Mannheim
OTHER
Responsible Party
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Universty Hospital Mannheim
Principal Investigators
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Hans-Peter Hammes, PhD
Role: STUDY_DIRECTOR
fifth medical clinic, university hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
Alexander Lammert, MD
Role: PRINCIPAL_INVESTIGATOR
fifth medical clinic, University hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
Locations
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Fifth Medical Clinic
Mannheim, Baden-Wurttemberg, Germany
Countries
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References
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Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998 Sep 12;352(9131):837-53.
Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet. 2005 Apr 9-15;365(9467):1333-46. doi: 10.1016/S0140-6736(05)61032-X.
ACE/ADA Task Force on Inpatient Diabetes. American College of Endocrinology and American Diabetes Association Consensus statement on inpatient diabetes and glycemic control. Diabetes Care. 2006 Aug;29(8):1955-62. doi: 10.2337/dc06-9913. No abstract available.
Lammert A, Kratzsch J, Selhorst J, Humpert PM, Bierhaus A, Birck R, Kusterer K, Hammes HP. Clinical benefit of a short term dietary oatmeal intervention in patients with type 2 diabetes and severe insulin resistance: a pilot study. Exp Clin Endocrinol Diabetes. 2008 Feb;116(2):132-4. doi: 10.1055/s-2007-984456. Epub 2007 Dec 20.
Other Identifiers
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2006-119N-MA
Identifier Type: -
Identifier Source: org_study_id
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