Ketogenic Diet Treatment of Obesity With Co-morbid Type 2 Diabetes Mellitus and/or Obstructive Sleep Apnea

NCT ID: NCT02069197

Last Updated: 2018-08-17

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

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-31

Study Completion Date

2020-09-30

Brief Summary

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The purpose of the study is to evaluate the efficacy and safety of ketogenic diet (KD) treatment of (i) obesity, (ii) type 2 diabetes mellitus and (iii) obstructive sleep apnea (OSA) in patients with obesity and Type 2 DM and in patients with obesity and/or OSA. This will be a randomized, open-label three arm controlled study comparing weight loss in obese participants with type 2 diabetes and/or obstructive sleep apnea treated for 9 months with 3:1 \[fat\]:\[protein+carbohydrate\] ratio, 1600 kcal/day diet (Group A) with weight loss in participants treated with orlistat 120 mg TID and lifestyle intervention consisting of dietary advice, recommended caloric goal of 1600 kcal/day (Group B), and in participants treated with only lifestyle intervention consisting of dietary advice, recommended caloric goal of 1600 kcal/day (Group C).

Detailed Description

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The study sample will be randomized into three treatment arms, KD (Group A, n=50), Orlistat 120 mg TID (Group B, n=50) and dietary and lifestyle counseling (Group C, n=50) in a 1:1:1 ratio. Each arm will include 100% participants with obesity and co-morbid type 2 DM and 50% participants with co-morbid OSA. Randomization will be stratified for diabetic status.

Conditions

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Obesity Diabetes Obstructive Sleep Apnea

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Ketogenic diet, lifestyle counseling

ketogenic diet consisted of 3:1\[fat\]:\[protein+carbohydrate\] weight ratio with 1600kcal restriction.

Group Type ACTIVE_COMPARATOR

Ketogenic diet

Intervention Type OTHER

ketogenic diet will consist of 3:1\[fat\]:\[protein+carbohydrate\]weight ratio with 1600 kcal restriction. Diet will last 9 months.

Orlistat, Lifestyle counseling

Orlistat 120 mg TID, standardized diet and lifestyle-modification counseling based on the LEARN (Life, Exercise, Attitudes, Relationships,and Nutrition) program with recommended caloric goal of 1600 kcal/day.

Group Type ACTIVE_COMPARATOR

Orlistat

Intervention Type DRUG

Orlistat 120 mg TID for 9 months; life style intervention with recommended caloric goal of 1600 kcal/day.

Standartized diet, Lifestyle counseling

Standardized diet and lifestyle-modification counseling based on the LEARN (Lifestyle, Exercise, Attitudes, Relationship, Nutrition) program with recommended caloric goal of 1600kcal/day.

Group Type ACTIVE_COMPARATOR

Standardized diet

Intervention Type OTHER

Standardized diet treatment for 9 months with recommended caloric goal of 1600kcal/day.

Interventions

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Ketogenic diet

ketogenic diet will consist of 3:1\[fat\]:\[protein+carbohydrate\]weight ratio with 1600 kcal restriction. Diet will last 9 months.

Intervention Type OTHER

Orlistat

Orlistat 120 mg TID for 9 months; life style intervention with recommended caloric goal of 1600 kcal/day.

Intervention Type DRUG

Standardized diet

Standardized diet treatment for 9 months with recommended caloric goal of 1600kcal/day.

Intervention Type OTHER

Other Intervention Names

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high fat, low protein, low carbohydrate diet tetrahydrolipstatin

Eligibility Criteria

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Inclusion Criteria

* age 18-70
* ability and willingness to signed informed consent form
* BMI more than 30kg/m2, with type 2 DM and/or OSA
* For diabetic participants, stable hypoglycemic medications for at least 2 months
* For participants with OSA, previously documented polysomnogram with apnea/hypopnea index (AHI)\>15/h.

Exclusion Criteria

* BMI change of +/- 3.0 kg/m2 of baseline BMI within past 12 months.
* History of bariatric surgery ≤ 3 years prior to enrollment.
* Any systemic illness or unstable medical condition that might pose additional risk, including: cardiac, unstable metabolic or endocrine disturbances, renal or liver disease, past history of renal calculi, hyperuricemia, hypercalcemia, mitochondrial disease, known disorder of fatty acid metabolism, porphyria, and active systemic cancer.
* History of uncontrolled hyperlipidemia
* For participants with DM, change in the dose or type of hypoglycemic treatment within 2 months prior to enrollment.
* Psychosis within six months of enrollment, evidenced by treatment with anti-psychotic medications with recent medication initiation or dose increase.
* Active drug or alcohol dependence or any other factors that, in the opinion of the site investigators would interfere with adherence to study requirements;
* History of hyperthyroidism
* History of glaucoma
* History of cerebrovascular disease or unstable heart disease within 6 months of enrollment
* Pregnancy
* Use of any investigational drugs within 3 months of enrollment.
* Inability or unwillingness of subject to give written informed consent.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mid-Atlantic Epilepsy and Sleep Center, LLC

OTHER

Sponsor Role lead

Responsible Party

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Pavel Klein

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Pavel Klein, M.D.

Role: PRINCIPAL_INVESTIGATOR

Mid-Atlantic Epilepsy and Sleep center

Locations

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Mid-Atlantic Epilepsy and Sleep Center, LLC

Bethesda, Maryland, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Ivana Tyrlikova, MD

Role: CONTACT

301-530-9744

Arcady Barber, MSCN

Role: CONTACT

301-530-9744

Facility Contacts

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Ivana Tyrlikova, MD

Role: primary

301-530-9744

Arcady Barber, MSCN

Role: backup

301-530-9744

Other Identifiers

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maes 004

Identifier Type: -

Identifier Source: org_study_id

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