Cut Down on Carbohydrate Usage in the Diet of Type 2 Diabetes - Mechanisms of Effective Therapy of Diabetes by Selective Choice of Macronutrients - The Phenotype Study

NCT ID: NCT02472951

Last Updated: 2018-03-02

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

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-08-31

Study Completion Date

2017-12-31

Brief Summary

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Scientific evidence for the dietary treatment of type 2 diabetes is insufficient. The investigators hypothesize that a lower carbohydrate content in the diabetic diet than the recommended 55 E% will decrease the postprandial glucose excursion, decrease insulinotropic factors like incretin hormones and decrease their insulinotropic effects due to their glucose dependency. This will reduce postprandial insulin concentration, resulting in an improved insulin sensitivity and glucose metabolism. This clinical study will examine in diabetic, prediabetic and healthy subjects the acute effects of short term highly controlled dietary low carbohydrate intervention on metabolic pathways with respect to insulin action, pancreatic islet function, lipid metabolism, incretin hormones, low grade inflammation in plasma and novel measures of fatty acid metabolism.

Detailed Description

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Conditions

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Type 2 Diabetes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Type 2 diabetic subjects

Group Type ACTIVE_COMPARATOR

Low carbohydrate meals

Intervention Type OTHER

Meal macronutritional energy composition:

Carbohydrate 30% Protein 30% Fat 40%

Standard carbohydrate meals

Intervention Type OTHER

Meal macronutritional energy composition:

Carbohydrate 55% Protein 15% Fat 30%

Prediabetic subjects

Group Type ACTIVE_COMPARATOR

Low carbohydrate meals

Intervention Type OTHER

Meal macronutritional energy composition:

Carbohydrate 30% Protein 30% Fat 40%

Standard carbohydrate meals

Intervention Type OTHER

Meal macronutritional energy composition:

Carbohydrate 55% Protein 15% Fat 30%

Healthy subjects

Group Type ACTIVE_COMPARATOR

Low carbohydrate meals

Intervention Type OTHER

Meal macronutritional energy composition:

Carbohydrate 30% Protein 30% Fat 40%

Standard carbohydrate meals

Intervention Type OTHER

Meal macronutritional energy composition:

Carbohydrate 55% Protein 15% Fat 30%

Interventions

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Low carbohydrate meals

Meal macronutritional energy composition:

Carbohydrate 30% Protein 30% Fat 40%

Intervention Type OTHER

Standard carbohydrate meals

Meal macronutritional energy composition:

Carbohydrate 55% Protein 15% Fat 30%

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Men age 18-70 years
* Postmenopausal women age 55-70 years
* Non-smoker (abstinent at least 6 months)
* HbA1c \< 74 mmol/mol
* Fasting blood glucose \< 11 mmol/L (mean of 3 measurements)
* Negative (\<25 IU/L) plasma glutamate decarboxylase (GAD-65) antibodies (IgG)
* Hemoglobin \> 7.5 mmol/L (men); \> 6.8 mmol/L (women)
* Normal thrombocytes (140-400 x 109/L)
* eGFR \> 45 ml/min per 1.73 m2
* Alkaline phosphatase \< 140 IU/L
* Alanine aminotransferase \< 70 IU/L
* Normal International Normalized Ratio (0.9-1.2)

Exclusion Criteria

* Critical illness
* Anti-diabetic drugs other than metformin (maximum of 2000 mg / day)
* Steroid treatment e.g. prednisolone
* Reported or journalized severe food allergy or intolerance
* Reported or journalized gut disease e.g. Crohn's disease, Coeliac disease
* Reported or journalized alcohol dependence syndrome
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Bispebjerg Hospital

OTHER

Sponsor Role lead

Responsible Party

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Amirsalar Samkani

MD, PhD-stud

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Steen B Haugaard, MD, DMSc, associate prof.

Role: STUDY_DIRECTOR

Amager og Hvidovre Hospital

Thure Krarup, MD, DMSc

Role: STUDY_DIRECTOR

Bispebjerg Hospital

Amirsalar Samkani, MD

Role: PRINCIPAL_INVESTIGATOR

Bispebjerg Hospital

Locations

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Endocrinological Dept. Bispebjerg University Hospital

Copenhagen, Region Sjælland, Denmark

Site Status

Countries

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Denmark

References

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Thomsen MN, Skytte MJ, Samkani A, Astrup A, Fenger M, Frystyk J, Hartmann B, Holst JJ, Larsen TM, Madsbad S, Magkos F, Rehfeld JF, Haugaard SB, Krarup T. Weight loss improves beta-cell function independently of dietary carbohydrate restriction in people with type 2 diabetes: A 6-week randomized controlled trial. Front Nutr. 2022 Aug 19;9:933118. doi: 10.3389/fnut.2022.933118. eCollection 2022.

Reference Type DERIVED
PMID: 36061897 (View on PubMed)

Thomsen MN, Skytte MJ, Astrup A, Deacon CF, Holst JJ, Madsbad S, Krarup T, Haugaard SB, Samkani A. The clinical effects of a carbohydrate-reduced high-protein diet on glycaemic variability in metformin-treated patients with type 2 diabetes mellitus: A randomised controlled study. Clin Nutr ESPEN. 2020 Oct;39:46-52. doi: 10.1016/j.clnesp.2020.07.002. Epub 2020 Aug 1.

Reference Type DERIVED
PMID: 32859328 (View on PubMed)

Samkani A, Skytte MJ, Anholm C, Astrup A, Deacon CF, Holst JJ, Madsbad S, Boston R, Krarup T, Haugaard SB. The acute effects of dietary carbohydrate reduction on postprandial responses of non-esterified fatty acids and triglycerides: a randomized trial. Lipids Health Dis. 2018 Dec 27;17(1):295. doi: 10.1186/s12944-018-0953-8.

Reference Type DERIVED
PMID: 30591062 (View on PubMed)

Samkani A, Skytte MJ, Kandel D, Kjaer S, Astrup A, Deacon CF, Holst JJ, Madsbad S, Rehfeld JF, Haugaard SB, Krarup T. A carbohydrate-reduced high-protein diet acutely decreases postprandial and diurnal glucose excursions in type 2 diabetes patients. Br J Nutr. 2018 Apr;119(8):910-917. doi: 10.1017/S0007114518000521.

Reference Type DERIVED
PMID: 29644957 (View on PubMed)

Other Identifiers

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46559

Identifier Type: -

Identifier Source: org_study_id

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