Restoration of Hypoglycemia Awareness With Home-based High Intensity Interval Training

NCT ID: NCT04825366

Last Updated: 2026-01-08

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

47 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-08-03

Study Completion Date

2025-08-31

Brief Summary

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The objective of this study is to investigate if the addition of a 12-week program of home-based high intensity interval training to a standard educational program aiming at preventing hypoglycemia episodes will restore hypoglycemia awareness in people living with type 1 diabetes and impaired awareness of hypoglycemia to a further extent than a standard educational program alone.

Participants will be randomized for 12 weeks to the standard educational program with or without high intensity interval training. The Gold method will be used to identify people with impaired awareness of hypoglycemia.

The educational program will consist of two education sessions on avoidance of hypoglycemia, causes of hypoglycemia, treatment (e.g. glucagon) of hypoglycemia, how to better recognize hypoglycemia symptoms, understand how to use a CGM/Flash-GM and understand CGM/Flash-GM reports to adjust insulin doses.

Participants randomized to the training program will be asked to train three times per week for 12 weeks following the home-based program that will be provided to them. Participants will be asked to perform at least 2 training sessions per week (ideally all 3 sessions) with the exercise specialist on a virtual platform.

Detailed Description

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Conditions

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Type 1 Diabetes Hypoglycemia Unawareness

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Standard educational program

Participants will be closely followed by a team of diabetes specialists. Participants will attend two education sessions to discuss the following topics: avoidance of hypoglycemia, causes of hypoglycemia, treatment (e.g. glucagon) of hypoglycemia, how to better recognize hypoglycemia symptoms, understand how to use a continuous glucose monitor (CGM) and understand CGM reports to adjust insulin doses.

Group Type ACTIVE_COMPARATOR

Continuous glucose monitoring device

Intervention Type DEVICE

Participants will have to wear their continuous glucose monitoring device throughout the study.

Gold method

Intervention Type OTHER

The Gold method will be used to assess impaired awareness of hypoglycemia

Clarke questionnaire

Intervention Type OTHER

The Clarke questionnaire will be used to assess impaired awarness of hypoglycemia

Edinburgh Hypoglycemia Symptom Scale

Intervention Type OTHER

The Edinburgh Hypoglycemia Symptom Scale will be used to assess symptoms of hypoglycemia

BAPAD questionnaire

Intervention Type OTHER

The BArriers to Physical Activity in type 1 Diabetes (BAPAD) questionnaire will be used to assess barriers of physical activity

Hypoglycemia Fear Survey II

Intervention Type OTHER

The Hypoglycemia Fear Survey II will be used to assess fear of hypoglycemia

Physical activity questionnaire

Intervention Type OTHER

The International Physical Activity Questionnaire will be used to assess physical activity practice

Well-being

Intervention Type OTHER

The WHO-5 well-being index will be used to assess well-being.

Treatment satisfaction

Intervention Type OTHER

The Diabetes Treatment Satisfaction Questionnaire will be used to assess treatment satisfaction.

Hypoglycemia diary

Intervention Type OTHER

Participants will be asked to record in a diary treatments for hypoglycemic events

Piezo RxD

Intervention Type DEVICE

Participants will be asked to wear a pedometer throughout the study

Standard educational program combined with high intensity interval training

Participants will be closely followed by a team of diabetes specialists. Participants will attend two education sessions to discuss the following topics: avoidance of hypoglycemia, causes of hypoglycemia, treatment (e.g. glucagon) of hypoglycemia, how to better recognize hypoglycemia symptoms, understand how to use a continuous glucose monitor (CGM) and understand CGM reports to adjust insulin doses.

Each study participant will be asked to train 3 times per week following the home-based program that will be provided to them. Participants will be asked to perform at least 2 training sessions per week with the exercise specialist on a virtual platform. The training session will consist of a 3 to 5-minute low-intensity warm-up followed by 6 to 12 1-minute bouts of high-intensity exercise interspersed with 1-minute bouts of low-intensity exercise. Each session will end with a 3-minutes cool-down period.

Group Type ACTIVE_COMPARATOR

Continuous glucose monitoring device

Intervention Type DEVICE

Participants will have to wear their continuous glucose monitoring device throughout the study.

Gold method

Intervention Type OTHER

The Gold method will be used to assess impaired awareness of hypoglycemia

Clarke questionnaire

Intervention Type OTHER

The Clarke questionnaire will be used to assess impaired awarness of hypoglycemia

Edinburgh Hypoglycemia Symptom Scale

Intervention Type OTHER

The Edinburgh Hypoglycemia Symptom Scale will be used to assess symptoms of hypoglycemia

BAPAD questionnaire

Intervention Type OTHER

The BArriers to Physical Activity in type 1 Diabetes (BAPAD) questionnaire will be used to assess barriers of physical activity

Hypoglycemia Fear Survey II

Intervention Type OTHER

The Hypoglycemia Fear Survey II will be used to assess fear of hypoglycemia

Physical activity questionnaire

Intervention Type OTHER

The International Physical Activity Questionnaire will be used to assess physical activity practice

Well-being

Intervention Type OTHER

The WHO-5 well-being index will be used to assess well-being.

Treatment satisfaction

Intervention Type OTHER

The Diabetes Treatment Satisfaction Questionnaire will be used to assess treatment satisfaction.

Hypoglycemia diary

Intervention Type OTHER

Participants will be asked to record in a diary treatments for hypoglycemic events

Piezo RxD

Intervention Type DEVICE

Participants will be asked to wear a pedometer throughout the study

Heart rate monitor

Intervention Type DEVICE

During training sessions, participants will be asked to wear a heart rate monitor

Exercise diary

Intervention Type OTHER

Before each training session, participants will be asked to note in a diary their glucose levels, if they have taken a snack or not and if insulin was administered. After each training session, participants will be asked to note that same information. In addition, they will be asked to note their bedtime blood glucose, if they have taken a bedtime snack and if adjustment to insulin doses was made.

Interventions

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Continuous glucose monitoring device

Participants will have to wear their continuous glucose monitoring device throughout the study.

Intervention Type DEVICE

Gold method

The Gold method will be used to assess impaired awareness of hypoglycemia

Intervention Type OTHER

Clarke questionnaire

The Clarke questionnaire will be used to assess impaired awarness of hypoglycemia

Intervention Type OTHER

Edinburgh Hypoglycemia Symptom Scale

The Edinburgh Hypoglycemia Symptom Scale will be used to assess symptoms of hypoglycemia

Intervention Type OTHER

BAPAD questionnaire

The BArriers to Physical Activity in type 1 Diabetes (BAPAD) questionnaire will be used to assess barriers of physical activity

Intervention Type OTHER

Hypoglycemia Fear Survey II

The Hypoglycemia Fear Survey II will be used to assess fear of hypoglycemia

Intervention Type OTHER

Physical activity questionnaire

The International Physical Activity Questionnaire will be used to assess physical activity practice

Intervention Type OTHER

Well-being

The WHO-5 well-being index will be used to assess well-being.

Intervention Type OTHER

Treatment satisfaction

The Diabetes Treatment Satisfaction Questionnaire will be used to assess treatment satisfaction.

Intervention Type OTHER

Hypoglycemia diary

Participants will be asked to record in a diary treatments for hypoglycemic events

Intervention Type OTHER

Piezo RxD

Participants will be asked to wear a pedometer throughout the study

Intervention Type DEVICE

Heart rate monitor

During training sessions, participants will be asked to wear a heart rate monitor

Intervention Type DEVICE

Exercise diary

Before each training session, participants will be asked to note in a diary their glucose levels, if they have taken a snack or not and if insulin was administered. After each training session, participants will be asked to note that same information. In addition, they will be asked to note their bedtime blood glucose, if they have taken a bedtime snack and if adjustment to insulin doses was made.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Males and females aged between 18 and 65 years old.
2. Clinical diagnosis of type 1 diabetes for at least five years.
3. Treatment with multiple daily insulin injections or insulin pump therapy and using insulin analogs (rapid, ultra-rapid or basal). The type of insulin should be stable for at least 1 month. Participants not using an insulin analog will be offered the opportunity to switch to an insulin analog and this will be done at least 1 month before inclusion.
4. Impaired awareness of hypoglycemia (Gold score ≥ 4).
5. HbA1c ≤ 10%
6. Using a continuous glucose monitor or being willing to start using one for the study
7. Having an electronic device supporting the Polar Beat application (heart rate monitor).

Exclusion Criteria

1. Clinically significant microvascular complications: nephropathy (estimated glomerular filtration rate below 40 ml/min), neuropathy (especially advanced peripheral neuropathy with significantly lower limb reduced proprioceptive perception) or severe proliferative retinopathy as reported by the patient and/or judged by the investigator.
2. High risk foot problem (e.g., previous amputation, history of foot wound, known severe neuropathy or peripheral arterial disease)
3. Recent (\< 3 months) acute macrovascular event e.g., acute coronary syndrome or cardiac surgery or history of significant heart disease.
4. Known significant cardiac rhythm abnormality based on investigator judgment.
5. Abnormal blood panel and/or anemia (Hb \< 100g/L).
6. Ongoing pregnancy or breastfeeding.
7. Severe hypoglycemic episode or diabetic ketoacidosis within 1 month of screening.
8. Uncontrolled hypertension (blood pressure \>160/100 mm Hg).
9. Uncontrolled angina.
10. Treatment with oral steroids within the last 3 months.
11. History of significant lung disease that would limit exercise.
12. Seizure within the last 3 months.
13. Participation in high-intensity interval training (or equivalent) in the past 6 months.
14. Physical ability preventing the completion of the 12-week training program (e.g., orthopedic limitation).
15. Inability to give consent.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut de Recherches Cliniques de Montreal

OTHER

Sponsor Role lead

Responsible Party

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Rémi Rabasa-Lhoret

Full professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rémi Rabasa-Lhoret

Role: PRINCIPAL_INVESTIGATOR

Institut de recherches cliniques de Montréal

Locations

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Institut de recherches cliniques de Montréal

Montreal, Quebec, Canada

Site Status

Countries

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Canada

Other Identifiers

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2021-1117

Identifier Type: -

Identifier Source: org_study_id

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