Gfree - For Improved Blood Sugar and Reduced Inflammation.

NCT ID: NCT05894746

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

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-04

Study Completion Date

2030-12-31

Brief Summary

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The goal of this clinical trial is to reduce inflammation and improve glycemic control in healthy volunteers, parents, as well as children, adolescents and adults with or without diabetes. The main questions it aims to answer are: • does a reduction wheat gluten improve glycemic control and/or inflammatory biomarkers • does a reduction in certain amino acids (which is most common in wheat gluten) improve glycemic control and/or inflammatory biomarkers • can we identify individuals with an inflammatory response, which leads to poor glycemic control. Participants will eat gluten-free products as well as similar products containing gluten. They will also eat gluten together with probiotics to see if an effect of gluten can be reduced. Researchers will compare everyone with themselves (cross-over design) and if possible individuals with and without diabetes.

Detailed Description

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BACKGROUND AND PURPOSE Many diseases, which are common in high-income countries, have an inflammatory component. In the world's rich countries, about 10% of the population will be diagnosed with a traditional inflammatory autoimmune disease during their lifetime. In an autoimmune disease, the body produces auto-antibodies against the body's own protein and the immune system destroys the body's own tissues. There are hundreds of different types of autoimmune diseases where some of the most common are; celiac disease (gluten intolerance), psoriasis, type 1 diabetes (T1D), multiple sclerosis, rheumatic diseases or thyroid diseases. Diseases such as cardiovascular disease, type 2 diabetes (T2D) and Alzheimer's disease are now also considered to have inflammatory components, and so-called auto-antibodies have been identified that indicate autoimmunity also in these diseases. Autoantibodies have also been identified in COVID-19 patients.

To try to understand the biology behind autoimmunity and inflammatory disease, the investigators have analyzed the entire genome of patients with celiac disease as a model for autoimmunity. Celiac disease is a good so-called model disease for autoimmunity because the autoimmune reaction can be switched on and off with the help of gluten in the diet. With a strict gluten-free diet, virtually all signs of illness disappear and the inflammation ceases. The results from our whole genome analysis showed that genes involved in amino acid signaling were important for disease development and pointed to associations between celiac disease, T2D and anorexia. These results were somewhat surprising and the investigators began to look at the role of nutritional signaling and amino acids in inflammatory processes further.

The purpose of this study is to test whether a reduction in certain amino acids (which is most common in wheat gluten) can improve glycemic control in healthy volunteers, parents, as well as children, adolescents and adults with diabetes and whether levels of inflammatory amino acids may be one of the factors behind the link between diabetes and severe COVID-19 infection.

The participants will, for 4 weeks, eat one week as usual, eat one week wheat gluten-free, one week wheat gluten and one week with gluten and probiotics. The participants will be provided with continuous glucose monitors and activity-tracking bracelets. The investigators will analyze the efficiency of glucose uptake using continuous glucose monitors (CGM). During these four weeks, the research subjects will be admitted for 4 clinical visits (baseline, after 1 week, 2 weeks, 3 weeks) where blood samples will be taken. Also, during these weeks the participant will take capillary blood samples, faeces, urine, buccal swabs and saliva at home and fill out a questionnaire based on diet and risk factors for diabetes and questions about COVID-19.

Total number of participants: 60 Sampling occasions per participant: 15 Follow-up period per participant: 4 weeks Number of years for inclusion: 2 years (20221201-20241201)

Conditions

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Diabetes Celiac Disease Autoimmunity Metabolic Disease

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

CROSSOVER

Four week crossover trial with three arms, gluten-free, gluten and gluten with probiotic
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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gluten-free

The study participants will start the gluten-free diet and be asked to exchange any products they normally buy with similar products. Three days in the week they will eat a meal with gluten free pasta. Two to six hours after the meal they will take samples at home and store until they return to the clinic.

Group Type EXPERIMENTAL

gluten-free

Intervention Type DIETARY_SUPPLEMENT

see info in arm description

gluten

The study participants will continue the gluten-free diet and be asked to exchange any products they normally buy with similar products. Three days however, in the week they will eat a meal with regular gluten containing pasta. Two to six hours after the meal they will take samples at home and store until they return to the clinic.

Group Type ACTIVE_COMPARATOR

gluten-free

Intervention Type DIETARY_SUPPLEMENT

see info in arm description

gluten

Intervention Type DIETARY_SUPPLEMENT

see info in arm description

probiotic

The study participants will continue the gluten-free diet and be asked to exchange any products they normally buy with similar products. During the week they will also take probiotic (Probion, Active) every morning and every evening. Three days however, in the week they will eat a meal with regular gluten containing pasta. Two to six hours after the meal they will take samples at home and store until they return to the clinic.

Group Type ACTIVE_COMPARATOR

gluten-free

Intervention Type DIETARY_SUPPLEMENT

see info in arm description

probiotic

Intervention Type DIETARY_SUPPLEMENT

see info in arm description

Interventions

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gluten-free

see info in arm description

Intervention Type DIETARY_SUPPLEMENT

probiotic

see info in arm description

Intervention Type DIETARY_SUPPLEMENT

gluten

see info in arm description

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

\- none

Exclusion Criteria

\- A diagnosis of celiac disease
Minimum Eligible Age

6 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Skövde

OTHER

Sponsor Role collaborator

Sahlgrenska University Hospital

OTHER

Sponsor Role collaborator

Ekhaga foundation

UNKNOWN

Sponsor Role collaborator

Göteborg University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Åsa Torinsson Naluai, PhD

Role: PRINCIPAL_INVESTIGATOR

Göteborg University

Katarina Ejeskär, PhD

Role: STUDY_DIRECTOR

University of Skövde

Locations

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Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status NOT_YET_RECRUITING

University of Skövde

Skövde, , Sweden

Site Status RECRUITING

Countries

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Sweden

Central Contacts

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Åsa Torinsson Naluai, PhD

Role: CONTACT

(0046)768-979149

Katarina Ejeskär Ejeskär, PhD

Role: CONTACT

Facility Contacts

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Åsa Torinsson Naluai, PhD

Role: primary

+46768979149

Katarina Ejeskär, PhD

Role: primary

Other Identifiers

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GFREE

Identifier Type: -

Identifier Source: org_study_id

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