Effect of Circadian Rhythm and Physical Exercise in Overweight Type 1 Diabetes Patients

NCT ID: NCT05277532

Last Updated: 2024-10-15

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

RECRUITING

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-05-18

Study Completion Date

2026-10-31

Brief Summary

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Cardiometabolic risk in patients with abdominal obesity and type 1 diabetes can be moderated by life style modifications. There is an intimate link between gene regulation and circadian rhythm in mediating response to exercise in a variety of insulin sensitive organs.

The aim of this project is to evaluate, by intervention, the interplay of circadian rhythm and high intensity interval training (HIIT) on glucose control and skeletal muscle metabolism in patients with overweight with or without type 1 diabetes (T1D).

Detailed Description

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High intensity interval training (HIIT) is a promising intervention for lifestyle treatment in type 1 diabetes. In spite of the interplay between circadian rhythms and exercise, the time of day in which the most robust adaption to HIIT can be achieved is unknown. The main goal of the study is to compare the efficacy of morning and afternoon HIIT in regulating blood glucose values in participants with type 1 diabetes and overweigt and to compare the effect in overweight but otherwise healthy subjects. Additionally, the investigators aim to to elucidate the metabolomics in the different settings. Healthy controls will be used to compare whether the effect of HIIT and interplay with circadian rhythm on organ metabolism is impaired in patients with T1D.

A randomized cross-over trial with 25 participants with type 1 diabetes and 25 control subjects will be performed. The participants will be examined on three occasions on an out-patient basis . Visit 1 aim to run baseline measurements and a bicycle test to define maximum exertion . On visit 2 the participants will perform a single bout of HIIT (6 1-minute pulses at maximal exertion, interspersed with 1-minute recovery) either in the morning (09.00) or afternoon (16.00). After a 1-week washout period, the participants will return for visit 3 and an opposing exercise time. Primarily, the efficacy of the morning and afternoon HIIT will be judged by the continuous glucose monitor (CGM) -based glycaemia measurements. Additionally, during the visits the investigators will collect repeated blood samples to assess the effect of exercise timing on the diurnal hormonal rhythms. Muscle biopsies will be collected before and directly after HIIT.

The hypothesis is that afternoon HIIT will be more efficacious in controlling blood glucose based on the preliminary data gathered from a 'free living' pilot study in type 2 diabetes. The current study will aim to compare the morning and afternoon exercise in controlled conditions, eliminating the effects of dietary intake, medication and sleep cycle disruption. Additionally, the tissue factors responsible for the differing glycaemic response to morning and afternoon exercise will be elucidated.

Conditions

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Type 1 Diabetes Overweight

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

A randomized crossover design (comparing morning vs afternoon exercise) in parallel groups (Type 1 diabetes and control subjects)
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Type 1 diabetes with overweight

High intensity interval training (HIIT), a single bout, randomly performed either in the morning or in the afternoon in a cross-over design.

Group Type ACTIVE_COMPARATOR

High intensity interval training (HIIT)

Intervention Type BEHAVIORAL

HIIT performed either in the morning or in the afternoon

Overweight but otherwise healthy control subjects

High intensity interval training (HIIT), a single bout, randomly performed either in the morning or in the afternoon in a cross-over design.

Group Type ACTIVE_COMPARATOR

High intensity interval training (HIIT)

Intervention Type BEHAVIORAL

HIIT performed either in the morning or in the afternoon

Interventions

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High intensity interval training (HIIT)

HIIT performed either in the morning or in the afternoon

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* BMI 25-30
* type 1 diabetes or healthy subjects

Exclusion Criteria

* nicotine usage,
* cardiovascular disease (CVD),
* blood pressure \>160/95,
* pregnancy,
* treatment with other pharmaceutical drugs than insulin, stable dose of thyroid hormone, statins, and antihypertensive drugs (excluding beta blockers).


* diabetes duration less than 6 months,
* proliferative or severe non-proliferative retinopathy,
* chronic kidney disease with glomerular filtration rate (GFR) \<60 ml/min,
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Karolinska Institutet

OTHER

Sponsor Role lead

Responsible Party

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Eva Toft

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ingrid Dahlman, Professor

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Locations

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Ersta sjukhus

Stockholm, , Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Eva Toft, Assoc Prof

Role: CONTACT

+46 706722363

Veronica Qvisth, M.D.

Role: CONTACT

+46 87146500 ext. 6630

Facility Contacts

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Eva Toft, Assoc Prof

Role: primary

+4687146500 ext. 6245

Veronica Qvist, MD, Ph D

Role: backup

+4687146500 ext. 6630

Other Identifiers

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EPN 2021-05137

Identifier Type: -

Identifier Source: org_study_id

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