GLYCOSA Study:Effect of PAP Treatment on Glycemic Control in Patients With Type 2 Diabetes

NCT ID: NCT00509223

Last Updated: 2013-12-30

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

416 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-07-31

Study Completion Date

2012-02-29

Brief Summary

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Obstructive Sleep Apnea (OSA) and type 2 diabetes mellitus are two prevalent medical conditions with significant associated cardiovascular and cerebrovascular morbidity and mortality. Research indicates that the prevalence of OSA is increased in diabetic patients when compared with normoglycemic patients and that OSA is independently associated with type 2 diabetes. Further research suggests that effective treatment of the OSA with continuous positive airway pressure (CPAP) improves insulin responsiveness in both non-diabetic OSA patients and diabetic-OSA patients. We are proposing a clinical trial to evaluate the impact of 6 months of CPAP therapy on glycemic control in type 2 diabetic patients with OSA.

The primary objective of this study is to assess the effectiveness of CPAP in improving glycemic control (HbA1c) in type 2 diabetic patients with newly diagnosed OSA. Secondary objectives of this study include: assessment of fasting and post prandial glucose, determination as to whether there are any biochemical markers for OSA in the type 2 diabetic population; assessment of any improvements in cardiovascular outcomes; evaluation of any improvement in quality of life. Patients with OSA will be randomized into one of two groups: either a CPAP treatment group or a non-treatment group. Patients will be followed at 3 months and 6 months with collection of various lab tests to assess glycemic control.

Detailed Description

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Patients attending clinical sites involved with the trial will be asked to participate in the study. Patients will undergo a sleep test and if positive for Obstructive Sleep Apnea (OSA) will continue in the study.

At the time of enrolment baseline history and physical examination will be assessed. Baseline lab samples will also be obtained to measure levels of fasting blood glucose, insulin, HbA1c, lipids, biochemical markers and creatinine/albumin ratio. Post-prandial glucose levels and 24-hour ambulatory blood pressure will be evaluated. Participants will also be asked to complete Quality of Life (QoL) questionnaires.

Participants will be randomised into either continuous positive airway pressure CPAP treatment or no treatment. All subjects will be counselled regarding adopting a healthy lifestyle and advised on the Heart Foundation, National Health and Medical Research Council, and American Diabetes Association nutrition and exercise recommendations. Follow-up on adoption of the healthy lifestyle approach will be done for all study participants for the duration of the trial period. Total duration of a patient's participation is 6 months.

Conditions

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Diabetes Mellitus Type 2

Keywords

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Type 2 diabetes Obstructive sleep apnea Glycemic control Insulin resistance Sleep disordered breathing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Group 1

Lifestyle counseling with Positive Airway Pressure (PAP) therapy

Group Type EXPERIMENTAL

Positive Airway Pressure therapy

Intervention Type DEVICE

Positive Airway Pressure (PAP) therapy initiated at Randomization and continued through the entire study duration (6 months), with instructions for use on a daily basis, during periods of sleep.

Lifestyle counseling

Intervention Type BEHAVIORAL

Lifestyle counseling: All subjects were counseled regarding adopting a healthy lifestyle and advised on the Heart Foundation, National Health and Medical Research Council, and American Diabetes Association nutrition and exercise recommendations.

Group 2

Lifestyle counseling without Positive Airway Pressure (PAP) therapy

Group Type ACTIVE_COMPARATOR

Lifestyle counseling

Intervention Type BEHAVIORAL

Lifestyle counseling: All subjects were counseled regarding adopting a healthy lifestyle and advised on the Heart Foundation, National Health and Medical Research Council, and American Diabetes Association nutrition and exercise recommendations.

Interventions

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Positive Airway Pressure therapy

Positive Airway Pressure (PAP) therapy initiated at Randomization and continued through the entire study duration (6 months), with instructions for use on a daily basis, during periods of sleep.

Intervention Type DEVICE

Lifestyle counseling

Lifestyle counseling: All subjects were counseled regarding adopting a healthy lifestyle and advised on the Heart Foundation, National Health and Medical Research Council, and American Diabetes Association nutrition and exercise recommendations.

Intervention Type BEHAVIORAL

Other Intervention Names

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ResMed AutoSet S8

Eligibility Criteria

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Inclusion Criteria

1. 18 years of age or older,
2. Known diagnosis of type 2 diabetes for at least 3 months
3. HbA1c \>6.5% and \</= 8.5%
4. BMI \</= 40 kg/m2

Exclusion Criteria

1. Requires oxygen therapy
2. OSA is severe (AHI\>70 or SaO2\<70%)
3. Work in transport related industries
4. Previous diagnosis of OSA
5. Known MVA due to sleepiness in the previous 5 years
6. Insulin-requiring
7. Use of GLP-1 mimetic (e.g. Byetta) for \< 6 months or \> 6 months but weight not stable
8. Unstable angina
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Royal North Shore Hospital

OTHER

Sponsor Role collaborator

Baker Heart and Diabetes Institute

OTHER

Sponsor Role collaborator

International Diabetes Center at Park Nicollet

OTHER

Sponsor Role collaborator

ResMed

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Paul Zimmet, MBBS MD PhD

Role: STUDY_CHAIR

International Diabetes Institute, Australia

Locations

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Mission Internal Medical Group

Mission Viejo, California, United States

Site Status

Advanced Metabolic Care and Research Institute

Temecula, California, United States

Site Status

Clinical Research of South Florida

Coral Gables, Florida, United States

Site Status

SleepMed of Central Georgia

Macon, Georgia, United States

Site Status

Johns Hopkins University

Baltimore, Maryland, United States

Site Status

International Diabetes Center

Saint Louis Park, Minnesota, United States

Site Status

Rochester Clinical Research

Rochester, New York, United States

Site Status

OSU Sleep Medicine Program

Columbus, Ohio, United States

Site Status

SleepMed of West Ashley

Charleston, South Carolina, United States

Site Status

SleepMed of South Carolina

Columbia, South Carolina, United States

Site Status

Cetero Research

San Antonio, Texas, United States

Site Status

Royal North Shore Hospital

Sydney, New South Wales, Australia

Site Status

Eastern Clinical Research Unit

Box Hill, Victoria, Australia

Site Status

Baker IDI Heart and Diabetes Institute

Melbourne, Victoria, Australia

Site Status

IUCPQ

Québec, Quebec, Canada

Site Status

Countries

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United States Australia Canada

References

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Shaw JE, Punjabi NM, Naughton MT, Willes L, Bergenstal RM, Cistulli PA, Fulcher GR, Richards GN, Zimmet PZ. The Effect of Treatment of Obstructive Sleep Apnea on Glycemic Control in Type 2 Diabetes. Am J Respir Crit Care Med. 2016 Aug 15;194(4):486-92. doi: 10.1164/rccm.201511-2260OC.

Reference Type DERIVED
PMID: 26926656 (View on PubMed)

Other Identifiers

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CA-09-06-01

Identifier Type: -

Identifier Source: org_study_id