The Effect of a Nutritional Supplement in Individuals With Type 2 Diabetes Mellitus: a Pilot Study

NCT ID: NCT01505803

Last Updated: 2012-01-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-07-31

Study Completion Date

2011-12-31

Brief Summary

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Diabetes Mellitus (DM) is a major risk factor for cardiovascular disease, with 50% of diabetes-associated deaths being attributed to cardiovascular complications. The characterising features of DM include: the presence of chronic hyperglycaemia, consequent upon decreased secretion or action of insulin; dyslipidaemia; and enhanced levels of oxidative stress and inflammation. Zinc and omega 3 polyunsaturated fatty acids have been shown to influence each of these outcomes via several mechanisms. This pilot study will examine the effect of nutritional supplements containing zinc and omega 3 on these outcomes in a population with type 2 DM.

Detailed Description

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The prevalence of type 2 DM and related-complications continues to increase. Diet is a significant factor in the aetiology of type 2 DM. Intakes of zinc and omega 3 fatty acids may modulate glycaemic control, lipid metabolism, and inflammatory processes in the disease. Zinc is involved in many biological processes that include enzyme action, stabilisation of cell membranes, regulation of gene expression, and cell signalling. Zinc supplementation has been demonstrated to improve glycaemic control in both animals and humans. The normalising effect of zinc on glucose homeostasis may relate to its involvement in insulin metabolism. Zinc functions in the synthesis, storage, secretion, and action of insulin. Omega-3 also enhances glycaemic control and dietary supplementation with omega-3 polyunsaturated fatty acids has been shown to improve insulin sensitivity in subjects with DM. Both zinc and omega-3 function to mediate lipid metabolism. Zinc supplementation has been found to be associated with a beneficial increase in HDL cholesterol concentrations in individuals with type 2 DM. The mechanism may again involve insulin, which has been proposed as an independent predictor of plasma HDL. Omega-3 directly activates transcription factors that regulate lipid metabolism and is known to decrease serum triglyceride levels in DM. Zinc appears to beneficially impact oxidative stress-related parameters in DM via a range of mechanisms, including the regulation of copper,zinc superoxide dismutase, metallothionein, NF-κB and nitric oxide signaling. The purpose of this pilot study is to explore the effect of zinc and omega 3 supplementation on hyperglycaemia, dyslipidaemia, chronic inflammation, and oxidative stress in a population with type 2 DM.

This study will recruit 48 postmenopausal women with type 2 DM. Participants will be randomly allocated to one of 4 groups for a period of 12 weeks: placebo, zinc, omega 3, or zinc + omega 3 supplementation. Usual dietary intake will be assessed before and after the trial period using 2-day estimated food records, which will be checked by a research dietitian. Blood samples will be collected from all participants at the start of the intervention (week 0) then at 4 weekly intervals (weeks 4, 8, 12) by qualified phlebotomists. Blood samples will be analysed for plasma zinc, plasma lipids and fatty acids, markers of inflammation and oxidative stress, and indicators of glycaemic control. An aliquot of blood will also be used for the measurement of zinc transporter mRNA levels utilising real-time quantitative PCR techniques.

Conditions

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Diabetes Mellitus, Type 2 Insulin Resistance

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Zinc supplement

Group Type ACTIVE_COMPARATOR

Zinc supplements

Intervention Type DIETARY_SUPPLEMENT

Participants will receive 40 mg of zinc each day for 12 weeks.

Placebo supplements

Intervention Type DIETARY_SUPPLEMENT

Participants will receive placebo supplements each day for 12 weeks.

Omega 3 supplement

Group Type ACTIVE_COMPARATOR

Omega 3 supplements

Intervention Type DIETARY_SUPPLEMENT

Participants will receive 2 g of omega 3 fatty acids each day for 12 weeks.

Placebo supplements

Intervention Type DIETARY_SUPPLEMENT

Participants will receive placebo supplements each day for 12 weeks.

Zinc and omega 3 supplements

Group Type ACTIVE_COMPARATOR

Zinc supplements

Intervention Type DIETARY_SUPPLEMENT

Participants will receive 40 mg of zinc each day for 12 weeks.

Omega 3 supplements

Intervention Type DIETARY_SUPPLEMENT

Participants will receive 2 g of omega 3 fatty acids each day for 12 weeks.

Placebo supplement

Group Type PLACEBO_COMPARATOR

Placebo supplements

Intervention Type DIETARY_SUPPLEMENT

Participants will receive placebo supplements each day for 12 weeks.

Interventions

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Zinc supplements

Participants will receive 40 mg of zinc each day for 12 weeks.

Intervention Type DIETARY_SUPPLEMENT

Omega 3 supplements

Participants will receive 2 g of omega 3 fatty acids each day for 12 weeks.

Intervention Type DIETARY_SUPPLEMENT

Placebo supplements

Participants will receive placebo supplements each day for 12 weeks.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Female, postmenopausal
* Type 2 diabetes (controlled by diet and lifestyle; or oral hypoglycaemic medication (i.e. metformin) for not more than 7 years)
* Normal Glomerular Filtration Rate (GFR) and normal microalbumin/creatine ratio
* No nutritional supplements in the 6 weeks prior to the trial \& continuing through the trial period
* Non-smoking

Exclusion Criteria

* Diagnosed with current major illness (renal disease, significant cardiovascular disease, gastrointestinal disorders, cancer, or other significant disorder likely to interfere with zinc metabolism)
* Taking medications that are likely to interfere with zinc metabolism
Minimum Eligible Age

48 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Sydney

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Samir Samman

Role: PRINCIPAL_INVESTIGATOR

University of Sydney

Meika Foster

Role: PRINCIPAL_INVESTIGATOR

University of Sydney

Locations

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University of Sydney

Sydney, New South Wales, Australia

Site Status

Countries

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Australia

References

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Foster M, Petocz P, Samman S. Effects of zinc on plasma lipoprotein cholesterol concentrations in humans: a meta-analysis of randomised controlled trials. Atherosclerosis. 2010 Jun;210(2):344-52. doi: 10.1016/j.atherosclerosis.2009.11.038. Epub 2009 Nov 29.

Reference Type BACKGROUND
PMID: 20034629 (View on PubMed)

Foster M, Samman S. Zinc and redox signaling: perturbations associated with cardiovascular disease and diabetes mellitus. Antioxid Redox Signal. 2010 Nov 15;13(10):1549-73. doi: 10.1089/ars.2010.3111.

Reference Type BACKGROUND
PMID: 20568953 (View on PubMed)

Foster M, Hancock D, Petocz P, Samman S. Zinc transporter genes are coordinately expressed in men and women independently of dietary or plasma zinc. J Nutr. 2011 Jun;141(6):1195-201. doi: 10.3945/jn.111.140053. Epub 2011 Apr 13.

Reference Type BACKGROUND
PMID: 21490290 (View on PubMed)

Other Identifiers

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HREC 12392

Identifier Type: -

Identifier Source: org_study_id

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