TEFA Family Prevention: Glutenfree Diet to Preserve Beta-cell Function

NCT ID: NCT02605148

Last Updated: 2021-10-26

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

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-12-31

Study Completion Date

2022-12-31

Brief Summary

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To evaluate the effect of Gluten Free Diet (GFD) on beta-cell function and glucose metabolism in subjects with one or several islet autoantibodies without and with dysglycemia at baseline. Additionally, all subjects will be given treatment with Vitamin D, omega fatty acids and probiotics.

Subjects will be randomized to GFD or normal diet during 18 months. Beta cell function will be evaluated at baseline, and during follow-up by glucose tolerance tests.

Detailed Description

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The design is a randomized controlled study to determine the safety and the effect of gluten free diet during 18 months on beta-cell function and glucose metabolism. Lead-in and nonstop supplement cocktail including vitamin D, omega fatty acids and probiotics will be used to equalize differences to reduce known confounders. All study subjects will meet with a dietician to obtain a 3-day diet record and to receive instructions on a healthy normal diet or GFD.

Subjects (n=60) at 2-49.99 years of age positive for one or several islet autoantibodies will be recruited. Subjects with one islet autoantibody have done one or several oral glucose tolerance test (OGTT) prior to the baseline visit. One islet autoantibody positive subjects are only eligible if they have dysglycemia. All subjects will be randomized based on baseline intravenous glucose tolerance test (IvGTT) and OGTT into subjects without and with dysglycemia at baseline.

Beta-cell function and glucose metabolism (alternating IvGTT and OGTT) will be assessed at baseline and after 6, 12, 18 months of treatment and after 6 months of wash out on a normal healthy diet.

Adverse events and safety Adverse event will be obtained at visits and during the study, which will be monitored.

It is expected that subjects with one or several islet autoantibodies will show a loss compared to baseline of beta-cell function and glucose control. GFD is expected to reduce the loss in subjects on a healthy diet.

Conditions

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Prediabetes Type 1 Diabetes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Gluten free diet

Gluten free diet during 18 months. The subjects will be referred to a nutritionist every 6 months. Vitamin D 800 U Daily, Omega 3 fatty acids and probiotics as nutritional supplements.

Group Type EXPERIMENTAL

Gluten free diet

Intervention Type DIETARY_SUPPLEMENT

Gluten free diet during 18 months.

Omega 3 fatty acid

Intervention Type DIETARY_SUPPLEMENT

Omega 3 fatty acid

Vitamin D

Intervention Type DIETARY_SUPPLEMENT

Vitamin D 800 U/day

Probiotics

Intervention Type DIETARY_SUPPLEMENT

Probiotics

Normal diet

Normal diet. Vitamin D 800 U Daily, Omega 3 fatty acids and probiotics as nutritional supplements.

Group Type ACTIVE_COMPARATOR

Omega 3 fatty acid

Intervention Type DIETARY_SUPPLEMENT

Omega 3 fatty acid

Vitamin D

Intervention Type DIETARY_SUPPLEMENT

Vitamin D 800 U/day

Probiotics

Intervention Type DIETARY_SUPPLEMENT

Probiotics

Interventions

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Gluten free diet

Gluten free diet during 18 months.

Intervention Type DIETARY_SUPPLEMENT

Omega 3 fatty acid

Omega 3 fatty acid

Intervention Type DIETARY_SUPPLEMENT

Vitamin D

Vitamin D 800 U/day

Intervention Type DIETARY_SUPPLEMENT

Probiotics

Probiotics

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

1. Subjects from two (2) to 49,99 years of age.
2. At least one type 1 diabetes-associated autoantibody (to glutamic acid (GADA), insulin (IAA), insulinoma-associated protein 2 (IA-2A) or zinktransporter 8 (ZnT8R/W/QA) in subjects with impaired glucose metabolism OR at least two type 1 diabetes-associated autoantibodies, regardless of normal or impaired glucose metabolism.
3. Written informed consent from research subject. If a child, also from the child's parents or legal acceptable representative(s) according to local regulations.

Exclusion Criteria

1. Ongoing treatment with immunosuppressant therapy (topical or inhaled steroids are accepted).
2. Diabetes.
3. Treatment with any oral or injected anti-diabetic medications.
4. Significantly abnormal hematology results at screening.
5. Participation in other clinical trials with a new chemical entity within the previous 3 months.
6. History of hypercalcemia.
7. Presence of associated serious disease or condition.
8. Diabetes-protective HLA-DQ6-allele.

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Minimum Eligible Age

2 Years

Maximum Eligible Age

49 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Juvenile Diabetes Research Foundation

OTHER

Sponsor Role collaborator

Lund University

OTHER

Sponsor Role lead

Responsible Party

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Maria Månsson Martinez

Study coordinator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Maria Månsson Martinez, Nutricionist

Role: PRINCIPAL_INVESTIGATOR

Lund University

Locations

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Lund University, Department of Clinical Sciences Malmö

Malmo, , Sweden

Site Status

Countries

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Sweden

References

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Martinez MM, Spiliopoulos L, Salami F, Agardh D, Toppari J, Lernmark A, Kero J, Veijola R, Tossavainen P, Palmu S, Lundgren M, Borg H, Katsarou A, Larsson HE, Knip M, Maziarz M, Torn C; and the TEDDY-Family (TEFA) Study Group. Heterogeneity of beta-cell function in subjects with multiple islet autoantibodies in the TEDDY family prevention study - TEFA. Clin Diabetes Endocrinol. 2022 Jan 5;7(1):23. doi: 10.1186/s40842-021-00135-6.

Reference Type DERIVED
PMID: 34983671 (View on PubMed)

Martinez MM, Salami F, Larsson HE, Toppari J, Lernmark A, Kero J, Veijola R, Koskenniemi JJ, Tossavainen P, Lundgren M, Borg H, Katsarou A, Maziarz M, Torn C; TEDDY Family (TEFA) Study Group. Beta cell function in participants with single or multiple islet autoantibodies at baseline in the TEDDY Family Prevention Study: TEFA. Endocrinol Diabetes Metab. 2020 Nov 5;4(2):e00198. doi: 10.1002/edm2.198. eCollection 2021 Apr.

Reference Type DERIVED
PMID: 33855205 (View on PubMed)

Other Identifiers

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TEFA/2015

Identifier Type: -

Identifier Source: org_study_id