Muscle Oxygenation, Type 1 Diabetes, and Glycated Hemoglobin

NCT ID: NCT02051504

Last Updated: 2016-09-13

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Total Enrollment

79 participants

Study Classification

OBSERVATIONAL

Study Start Date

2010-03-31

Study Completion Date

2013-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Most of the studies concerning aerobic fitness in Type 1 diabetic patients noted a relationship between impaired aerobic fitness and high glycated haemoglobin (HbA1c) levels, reflecting poor long term glycaemic control. To explain this relationship, the indirect effect of chronically high blood glucose levels on cardiovascular complications - and hence on exercise cardiovascular adaptations - are often mentioned. However, one could wonder if HbA1c could also have a direct impact on aerobic fitness patients with Type 1 diabetes. Haemoglobin glycation may increase its O2 affinity, thus limiting the O2 availability at the muscular level and impairing maximal aerobic power. Moreover, chronic hyperglycaemia might have deleterious effect on muscle mitochondrial capacity to use O2. The aim of this study is to assess the effect of Type 1 diabetes and of HbA1c level on muscular oxygen delivery and use and hence on aerobic fitness.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The current study aims at assessing the impact of Type 1 diabetes and HbA1c on muscle oxygen delivery and on muscle mitochondrial capacity. Our hypothesis is that these both steps of the oxygen cascade might be involved in the aerobic fitness impairment usually observed in poor-controlled patients.

Adults with Type 1 diabetes, aged 18-40 years, without microvascular and macrovascular diabetic complications, will be recruited among patients that regularly attend the unit of diabetology of the University Hospital of Lille and the regional hospital of Roubaix. They will be separated into 2 groups according to their glycaemic control at entrance in the study (HbA1c \< 7%, HbA1c \> 8%). Subsequently, two healthy control groups (checked by an OGTT) will be selected to strictly match the patients with Type 1 diabetes (age, sex, BMI, number of hours of physical activity per week, tobacco smoking). This is a cross-sectional study including 4 groups.

On their first visit, after the determination of HbA1c, all the subjects will perform at rest a DLCO/DLNO. Then they will realise an incremental exercise test to exhaustion on an electromagnetic cycle ergometer. Non-invasive measures will be performed throughout the exercise test, including gas exchange parameters (and maximal oxygen uptake), muscular and brain oxygenation (Near Infra Red Spectroscopy at vastus lateralis muscle and at prefrontal cortex). A blood sample from an arterialised ear-lobe will be taken at rest and exhaustion to determine O2 haemoglobin saturation, arterial partial pressure in O2 and CO2, haemoglobin concentration, hematocrit, and bicarbonates. Blood, from a catheter in a superficial cubital vein, will also be taken at rest, at a precise time during the exercise and immediately after the exercise to measure potential of hydrogen, bicarbonates, haemoglobin concentration, hematocrit, erythrocyte 2,3-diphosphoglycerate, and other blood markers of metabolic and hormonal adaptations to exercise. The subjects will also fill in questionnaires.

On a second visit, in a fasting state, the subjects will have a muscle biopsy at vastus lateralis using a specific needle (less than 150mg) in order to assess mitochondrial respiration capacity and endocannabinoid system activity. A venous blood sampling will allow analysing other health markers (lipid profile, insulin resistance...).

On another visit, the subjects will have a measure of body composition by Dual energy X-ray Absorptiometry and skinfold thickness.

They will also wear an accelerometer over one week and fill in a diet questionnaire over 3 days.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Type 1 Diabetes

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

CASE_CONTROL

Study Time Perspective

CROSS_SECTIONAL

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Type 1 diabetes, HbA1c <7%

Patients with Type 1 diabetes and adequate glycemic control: HbA1c \<7% at the entrance in the study.

Intervention:

Incremental maximal exercise Near-Infra Red-Spectroscopy at vastus lateralis and pre-frontal cortex (during exercise) Gas exchanges (VO2, VCO2) during exercise Combined DLCO/DLNO (at rest) Venous and arterialised blood sampling (rest and exercise) Muscle biopsy at the vastus lateralis (rest) Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires Accelerometry over one week Dual energy X-ray Absorptiometry

Incremental maximal exercise

Intervention Type BEHAVIORAL

The exercise test starts 2-4h after a standardised breakfast. After a 2-min resting period sitting on the cycle ergometer (Excalibur Sport, Lode B.V, Medical Technology, Groningen, Netherlands), the test starts at 30 watts with a 20 watts increment every 2min until exhaustion.

Muscle biopsy

Intervention Type PROCEDURE

A sample of vastus lateralis (less than 150mg) is taken with a specific needle under local anesthesia.

Combined DLCO-DLNO

Intervention Type PROCEDURE

Lung carbon monoxide and nitric oxide diffusion capacities are assessed at rest in a sitting position.

Dual energy X-ray absorptiometry

Intervention Type PROCEDURE

Body composition is measured using dual energy X-ray absorptiometry at rest.

Accelerometry over one week

Intervention Type PROCEDURE

The subjects wear an uniaxial accelerometer over one week to assess their usual physical activity level

Questionnaires

Intervention Type OTHER

Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires

Type 1 diabetes, HbA1c >8%

Patients with Type 1 diabetes and inadequate glycemic control: HbA1c \>8% at the entrance in the study.

Intervention:

Incremental maximal exercise Near-Infra Red-Spectroscopy at vastus lateralis and pre-frontal cortex (during exercise) Gas exchanges (VO2, VCO2) during exercise Combined DLCO/DLNO (at rest) Venous and arterialised blood sampling (rest and exercise) Muscle biopsy at the vastus lateralis (rest) Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires Accelerometry over one week Dual energy X-ray Absorptiometry

Incremental maximal exercise

Intervention Type BEHAVIORAL

The exercise test starts 2-4h after a standardised breakfast. After a 2-min resting period sitting on the cycle ergometer (Excalibur Sport, Lode B.V, Medical Technology, Groningen, Netherlands), the test starts at 30 watts with a 20 watts increment every 2min until exhaustion.

Muscle biopsy

Intervention Type PROCEDURE

A sample of vastus lateralis (less than 150mg) is taken with a specific needle under local anesthesia.

Combined DLCO-DLNO

Intervention Type PROCEDURE

Lung carbon monoxide and nitric oxide diffusion capacities are assessed at rest in a sitting position.

Dual energy X-ray absorptiometry

Intervention Type PROCEDURE

Body composition is measured using dual energy X-ray absorptiometry at rest.

Accelerometry over one week

Intervention Type PROCEDURE

The subjects wear an uniaxial accelerometer over one week to assess their usual physical activity level

Questionnaires

Intervention Type OTHER

Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires

Healthy controls, Groupe 1

Healthy controls for patients with Type 1 diabetes and adequate glycemic control matched on age, sex, body composition and physical activity level.

Intervention:

Oral Glucose Tolerance Test Incremental maximal exercise Near-Infra Red-Spectroscopy at vastus lateralis and pre-frontal cortex (during exercise) Gas exchanges (VO2, VCO2) during exercise Combined DLCO/DLNO (at rest) Venous and arterialised blood sampling (rest and exercise) Muscle biopsy at the vastus lateralis (rest) Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires Accelerometry over one week Dual energy X-ray Absorptiometry

Incremental maximal exercise

Intervention Type BEHAVIORAL

The exercise test starts 2-4h after a standardised breakfast. After a 2-min resting period sitting on the cycle ergometer (Excalibur Sport, Lode B.V, Medical Technology, Groningen, Netherlands), the test starts at 30 watts with a 20 watts increment every 2min until exhaustion.

Oral Glucose Tolerance Test

Intervention Type DIETARY_SUPPLEMENT

The subjects arrive after an overnight fast and have a 75g Glucose Oral Charge.

Muscle biopsy

Intervention Type PROCEDURE

A sample of vastus lateralis (less than 150mg) is taken with a specific needle under local anesthesia.

Combined DLCO-DLNO

Intervention Type PROCEDURE

Lung carbon monoxide and nitric oxide diffusion capacities are assessed at rest in a sitting position.

Dual energy X-ray absorptiometry

Intervention Type PROCEDURE

Body composition is measured using dual energy X-ray absorptiometry at rest.

Accelerometry over one week

Intervention Type PROCEDURE

The subjects wear an uniaxial accelerometer over one week to assess their usual physical activity level

Questionnaires

Intervention Type OTHER

Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires

Healthy controls, Group 2

Healthy controls for patients with Type 1 diabetes and inadequate glycemic control matched on age, sex, body composition and physical activity level.

Intervention:

Oral Glucose Tolerance Test Incremental maximal exercise Near-Infra Red-Spectroscopy at vastus lateralis and pre-frontal cortex (during exercise) Gas exchanges (VO2, VCO2) during exercise Combined DLCO/DLNO (at rest) Venous and arterialised blood sampling (rest and exercise) Muscle biopsy at the vastus lateralis (rest) Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires Accelerometry over one week Dual energy X-ray Absorptiometry

Incremental maximal exercise

Intervention Type BEHAVIORAL

The exercise test starts 2-4h after a standardised breakfast. After a 2-min resting period sitting on the cycle ergometer (Excalibur Sport, Lode B.V, Medical Technology, Groningen, Netherlands), the test starts at 30 watts with a 20 watts increment every 2min until exhaustion.

Oral Glucose Tolerance Test

Intervention Type DIETARY_SUPPLEMENT

The subjects arrive after an overnight fast and have a 75g Glucose Oral Charge.

Muscle biopsy

Intervention Type PROCEDURE

A sample of vastus lateralis (less than 150mg) is taken with a specific needle under local anesthesia.

Combined DLCO-DLNO

Intervention Type PROCEDURE

Lung carbon monoxide and nitric oxide diffusion capacities are assessed at rest in a sitting position.

Dual energy X-ray absorptiometry

Intervention Type PROCEDURE

Body composition is measured using dual energy X-ray absorptiometry at rest.

Accelerometry over one week

Intervention Type PROCEDURE

The subjects wear an uniaxial accelerometer over one week to assess their usual physical activity level

Questionnaires

Intervention Type OTHER

Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Incremental maximal exercise

The exercise test starts 2-4h after a standardised breakfast. After a 2-min resting period sitting on the cycle ergometer (Excalibur Sport, Lode B.V, Medical Technology, Groningen, Netherlands), the test starts at 30 watts with a 20 watts increment every 2min until exhaustion.

Intervention Type BEHAVIORAL

Oral Glucose Tolerance Test

The subjects arrive after an overnight fast and have a 75g Glucose Oral Charge.

Intervention Type DIETARY_SUPPLEMENT

Muscle biopsy

A sample of vastus lateralis (less than 150mg) is taken with a specific needle under local anesthesia.

Intervention Type PROCEDURE

Combined DLCO-DLNO

Lung carbon monoxide and nitric oxide diffusion capacities are assessed at rest in a sitting position.

Intervention Type PROCEDURE

Dual energy X-ray absorptiometry

Body composition is measured using dual energy X-ray absorptiometry at rest.

Intervention Type PROCEDURE

Accelerometry over one week

The subjects wear an uniaxial accelerometer over one week to assess their usual physical activity level

Intervention Type PROCEDURE

Questionnaires

Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Patients with Type 1 diabetes (duration of Type 1 diabetes \> 1 year and \< 20 years)
* Healthy subjects

Exclusion Criteria

* Maturity onset diabetes of the young, mitochondrial diabetes, Type 2 diabetes
* Macro or microvascular complications of diabetes


• Diabetes (Glycaemia \> 11 mmol/L two hours after the OGTT)


* Obesity (Body Mass Index \> 30 kg/m2)
* Contra-indication to maximal exercise
* Pregnant or breast-feeding women
* Other chronic disease than diabetes
* Muscle or articular problems
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University Hospital, Lille

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Elsa HEYMAN, PHD

Role: STUDY_DIRECTOR

EA4488 'Physical activity, Muscle, Health

Pierre FONTAINE, MD-PHD

Role: PRINCIPAL_INVESTIGATOR

CHRU LILLE

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

CHRU Lille

Lille, , France

Site Status

Countries

Review the countries where the study has at least one active or historical site.

France

References

Explore related publications, articles, or registry entries linked to this study.

Jlali I, Heyman E, Matran R, Marais G, Descatoire A, Rabasa-Lhoret R, Touil I, Pawlak-Chaouch M, Mucci P, Fontaine P, Baquet G, Tagougui S. Respiratory function in uncomplicated type 1 diabetes: Blunted during exercise even though normal at rest! Diabet Med. 2023 May;40(5):e15036. doi: 10.1111/dme.15036. Epub 2023 Jan 10.

Reference Type DERIVED
PMID: 36585956 (View on PubMed)

Lespagnol E, Tagougui S, Fernandez BO, Zerimech F, Matran R, Maboudou P, Berthoin S, Descat A, Kim I, Pawlak-Chaouch M, Boissiere J, Boulanger E, Feelisch M, Fontaine P, Heyman E. Circulating biomarkers of nitric oxide bioactivity and impaired muscle vasoreactivity to exercise in adults with uncomplicated type 1 diabetes. Diabetologia. 2021 Feb;64(2):325-338. doi: 10.1007/s00125-020-05329-8. Epub 2020 Nov 21.

Reference Type DERIVED
PMID: 33219433 (View on PubMed)

Heyman E, Daussin F, Wieczorek V, Caiazzo R, Matran R, Berthon P, Aucouturier J, Berthoin S, Descatoire A, Leclair E, Marais G, Combes A, Fontaine P, Tagougui S. Muscle Oxygen Supply and Use in Type 1 Diabetes, From Ambient Air to the Mitochondrial Respiratory Chain: Is There a Limiting Step? Diabetes Care. 2020 Jan;43(1):209-218. doi: 10.2337/dc19-1125. Epub 2019 Oct 21.

Reference Type DERIVED
PMID: 31636081 (View on PubMed)

Tagougui S, Fontaine P, Leclair E, Aucouturier J, Matran R, Oussaidene K, Descatoire A, Prieur F, Mucci P, Vambergue A, Baquet G, Heyman E. Regional cerebral hemodynamic response to incremental exercise is blunted in poorly controlled patients with uncomplicated type 1 diabetes. Diabetes Care. 2015 May;38(5):858-67. doi: 10.2337/dc14-1792. Epub 2015 Feb 9.

Reference Type DERIVED
PMID: 25665816 (View on PubMed)

Tagougui S, Leclair E, Fontaine P, Matran R, Marais G, Aucouturier J, Descatoire A, Vambergue A, Oussaidene K, Baquet G, Heyman E. Muscle oxygen supply impairment during exercise in poorly controlled type 1 diabetes. Med Sci Sports Exerc. 2015 Feb;47(2):231-9. doi: 10.1249/MSS.0000000000000424.

Reference Type DERIVED
PMID: 24983346 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2009-A00746-51.

Identifier Type: OTHER

Identifier Source: secondary_id

2009_12

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Hyperglycemia and Exercise.
NCT03284216 COMPLETED NA
Priming Exercise in Type 1 Diabetes
NCT03285386 COMPLETED NA
Exercise and Acarbose in Type 2 Diabetes
NCT01244971 COMPLETED PHASE4
Life Without Diabetes
NCT02212665 COMPLETED NA