Preventing Diabetic Osteoporosis With Exercise

NCT ID: NCT03930758

Last Updated: 2019-04-29

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

15 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-10-08

Study Completion Date

2012-12-20

Brief Summary

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The two specific aims of the study were to determine whether:

1. Greater mechanical loading of downhill exercise will increase the osteogenic index (ratio between CICP, the marker of bone formation (c-terminal propeptide of type I collagen, and CTX, the marker of bone resorption (c terminal telopeptide of type I collagen)) to a greater extent than uphill exercise that provides lower ground-reaction force;
2. Exercise after the meals will induce greater osteogenic response than exercise pefore the meals as it is known that meal eating during daytime inhibits bvone resorption markers.

Detailed Description

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The study addresses the problem that postmenopausal women with type 2 diabetes have a higher incidence of bone breaks despite their often normal bone mineral density (BMD).

The investigators pursued two hypotheses, that:

1. 40-minute bout of downhill exercise will increase the CICP/CTX osteogenic index to a greater extent than the same amount of uphill exercise; and
2. Performing exercise one hour after the meals will be more osteogenic than exercise before the meals.

Subjects were 15 postmenopausal women with type 2 diabetes, age 57.7 years, BMI 27.2 kg/m2 who were randomly assigned to two out of 5 trials:

Uphill exercise before the meals (UBM), Uphill exercise after the meals (UAM), Downhill exercise before the meals (DBM), Downhill exercise after the meals (DAM), and Sedentary, no-exercise, trial (SED). All subjects signed an informed consent approved by the University of Michigan Medical School Institutional Review Board. Subjects had their BMD measured with DXA at the outset.

Weight-maintenance meals contained 50% carbohydrate, 15% protein, and 25% fat and were provided at 10 h and 17 h. Exercise (40 minutes at 50% of maximal effort) on either uphill (+6o slope) or downhill treadmill (-6o slope) was performed either before the two meals, at 9 h and 16 h, respectively, or after the meals. at 11 h and 18 h, respectively.

Blood was drawn through an intravenous catheter from ante-cubital vein at hourly intervals between 8 and 20 h with two additional blood draws at 0 h and 6 h the next morning. Blood was treated with protease inhibitors, and plasma, frozen at -80o C, was used to measure bone markers, CICP, CTX, osteocalcin , and bone-specific alkaline phosphatase using Millipore chemoluminescen reagents, glucose by glucose oxidase, and hormones insulin, cortisol, parathyroid hormone (PTH) , and growth hormone (GH) by radio-immunoassays..

Mixed-model ANOVA was used for analysis of outcome measures where the trial procedures served as fixed variable and individual subjects as intercept variables.

Conditions

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Diabetes Mellitus, Type 2

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Study consisted of 5 experimental trials (or arms), of which 4 were compared to a sedentary (or control) arm. The five trials were: Uphill exercise before the meals (UBM), Uphill exercise after the meals (UAM), Downhill exercise before the meals (DBM), and Downhill exercise after the meals (DAM), and the Sedentary (Sed) or control trial.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Uphill exercise before the meals

40 minutes of uphill treadmill exercise at +6o slope completed 1 hour before eating the meal

Group Type EXPERIMENTAL

Behavior intervention of uphill exercise

Intervention Type COMBINATION_PRODUCT

40 minutes of uphill exercise

Dietary intervention of exercise before the meal

Intervention Type COMBINATION_PRODUCT

40 minutes of uphill exercise completed 1 h before the meal

Uphill exercise after the meals

40 minutes of uphill treadmill exercise at +6o slope started 1 hour after eating the meal

Group Type EXPERIMENTAL

Dietary intervention of uphill exercise

Intervention Type COMBINATION_PRODUCT

40 minutes of uphill exercise

Dietary intervention of exercise after the meal

Intervention Type COMBINATION_PRODUCT

40 minutes of uphill exercise started 1 hour after gthe meal

Downhill exercise before the meals

40 minutes of downhill treadmill exercise at -6o slope completed 1 hour before eating the meal

Group Type EXPERIMENTAL

Behavior intervention of downhill exercise

Intervention Type COMBINATION_PRODUCT

40 minutes of downhill exercise

Dietary intervention of exercise before the meal

Intervention Type COMBINATION_PRODUCT

40 minutes of downhill exercise completed 1 hour before the meal

Downhill exercise after the meals

40 minutes of downhill treadmill exercise at -6o slope started 1 hour after eating the meal

Group Type EXPERIMENTAL

Behavioral intervention of downhill exercise

Intervention Type COMBINATION_PRODUCT

40 minutes of downhill exercise

Dietary intervention of exercise after the meal

Intervention Type COMBINATION_PRODUCT

40 minutes of downhill exercise started 1 hour after the meal

Sedentary trial

A trial with no exercise

Group Type SHAM_COMPARATOR

Behavioral intervention of sedentary no-exercise trial

Intervention Type COMBINATION_PRODUCT

Sedentary no-exercise trial

Dietary intervention of eating two meals

Intervention Type COMBINATION_PRODUCT

Meals eaten at 10 and 17 h during a sedentary trial

Interventions

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Behavior intervention of uphill exercise

40 minutes of uphill exercise

Intervention Type COMBINATION_PRODUCT

Dietary intervention of exercise before the meal

40 minutes of uphill exercise completed 1 h before the meal

Intervention Type COMBINATION_PRODUCT

Dietary intervention of uphill exercise

40 minutes of uphill exercise

Intervention Type COMBINATION_PRODUCT

Dietary intervention of exercise after the meal

40 minutes of uphill exercise started 1 hour after gthe meal

Intervention Type COMBINATION_PRODUCT

Behavior intervention of downhill exercise

40 minutes of downhill exercise

Intervention Type COMBINATION_PRODUCT

Dietary intervention of exercise before the meal

40 minutes of downhill exercise completed 1 hour before the meal

Intervention Type COMBINATION_PRODUCT

Behavioral intervention of downhill exercise

40 minutes of downhill exercise

Intervention Type COMBINATION_PRODUCT

Dietary intervention of exercise after the meal

40 minutes of downhill exercise started 1 hour after the meal

Intervention Type COMBINATION_PRODUCT

Behavioral intervention of sedentary no-exercise trial

Sedentary no-exercise trial

Intervention Type COMBINATION_PRODUCT

Dietary intervention of eating two meals

Meals eaten at 10 and 17 h during a sedentary trial

Intervention Type COMBINATION_PRODUCT

Eligibility Criteria

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Inclusion Criteria

postmenopausal type-2 diabetes melllitus age between 50 and 65 exercise less than 20 minutes three times a week
Minimum Eligible Age

50 Years

Maximum Eligible Age

65 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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University of Wisconsin, La Crosse

OTHER

Sponsor Role collaborator

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Dr. Katarina Borer

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Katarina T Borer

Role: PRINCIPAL_INVESTIGATOR

Professor Emerita

Other Identifiers

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R15DK082800

Identifier Type: NIH

Identifier Source: secondary_id

View Link

M01RR024986

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

HUM32227/ HUM32700

Identifier Type: -

Identifier Source: org_study_id

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