Dynamic Parameters of Glucose Control in Relation to Biomarkers in Serum and Intraocular Fluid in Patients With Diabetes

NCT ID: NCT05944640

Last Updated: 2023-07-13

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

Total Enrollment

213 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-04-01

Study Completion Date

2026-06-01

Brief Summary

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Our project investigates the new characteristics of diabetic retinopathy using liquid eye biopsy in combination with novel parameters of glucose control obtained with continuous glucose monitoring. This approach will bring new knowledge and implications for future therapies.

Detailed Description

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Diabetic retinopathy is one of the most common causes of blindness in developed countries. The short-term glucose fluctuations have been suggested as a factor contributing to the risk of diabetic complications including ocular complications. We hypothesize that modulatory and other biological abilities of miRNAs and inflammatory chemokines/cytokines have a significant impact on the development and the progression of diabetic retinopathy. Our main goal is to identify the biomarkers that will in time be used for new screening, diagnostic, and treatment strategies for patients with diabetic retinopathy, bring a better prevention and early treatment to them and thus improve their quality of life while saving the cost associated with advanced forms of retinopathy.

Conditions

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Diabetes Complications

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients with DR

Adult patients with T1DM or T2DM with any form of diabetic retinopathy and diabetic macular edema, indicated for ocular surgical procedure as standard of care. Blood samples and samples of intraocular fluids will bee taken during the ocular surgery.

Intraocular surgery

Intervention Type PROCEDURE

Pars plana vitrectomy or cataract surgery.

Patients without DR

Adult patients with T1DM or T2DM without any signs of diabetic retinopathy, indicated for ocular surgical procedure from other reasons as standard of care. Blood samples and samples of intraocular fluids will bee taken during the ocular surgery.

Intraocular surgery

Intervention Type PROCEDURE

Pars plana vitrectomy or cataract surgery.

Control group

Subjects without diabetes mellitus indicated for ocular surgery from other reasons (cataract, retinal detachment, macular hole, idiopathic epiretinal membrane) as standard of care. Blood samples and samples of intraocular fluids will bee taken during the ocular surgery.

Intraocular surgery

Intervention Type PROCEDURE

Pars plana vitrectomy or cataract surgery.

Interventions

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Intraocular surgery

Pars plana vitrectomy or cataract surgery.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* type 1 or type 2 diabetes
* ≥ 18 years old
* treatment with insulin for at least 5 years prior baseline
* any form of diabetic retinopathy and macular edema
* HbA1c \< 10%
* written informed consent prior to starting study related activity

Exclusion Criteria

* any active intraocular or periocular infectious or non-infectious inflammation in study eye
* uncontrolled glaucoma
* history of intraocular inflammation or trauma in study eye
* intravitreal anti-VEGF therapy in study eye during a 3-month perido prior to baseline
* use of corticosteroid intravitreal implant in study eye at any time
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Czech Health Research Council

UNKNOWN

Sponsor Role collaborator

Charles University, Czech Republic

OTHER

Sponsor Role lead

Responsible Party

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Martin Prázný

Prof.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Martin Prázný, Prof.

Role: PRINCIPAL_INVESTIGATOR

Charles University and General University Hospital in Prague

Locations

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General University Hospital in Prague

Prague, , Czechia

Site Status RECRUITING

Countries

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Czechia

Central Contacts

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Martin Prázný, Prof.

Role: CONTACT

+420737122570

Petra Svozílková, Prof.

Role: CONTACT

+420604801153

Facility Contacts

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Martin Prázný, Prof.

Role: primary

+420737122570

References

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Ceriello A, Esposito K, Piconi L, Ihnat MA, Thorpe JE, Testa R, Boemi M, Giugliano D. Oscillating glucose is more deleterious to endothelial function and oxidative stress than mean glucose in normal and type 2 diabetic patients. Diabetes. 2008 May;57(5):1349-54. doi: 10.2337/db08-0063. Epub 2008 Feb 25.

Reference Type BACKGROUND
PMID: 18299315 (View on PubMed)

Soupal J, Skrha J Jr, Fajmon M, Horova E, Mraz M, Skrha J, Prazny M. Glycemic variability is higher in type 1 diabetes patients with microvascular complications irrespective of glycemic control. Diabetes Technol Ther. 2014 Apr;16(4):198-203. doi: 10.1089/dia.2013.0205. Epub 2014 Jan 8.

Reference Type BACKGROUND
PMID: 24401008 (View on PubMed)

Zoppini G, Verlato G, Targher G, Casati S, Gusson E, Biasi V, Perrone F, Bonora E, Muggeo M. Is fasting glucose variability a risk factor for retinopathy in people with type 2 diabetes? Nutr Metab Cardiovasc Dis. 2009 Jun;19(5):334-9. doi: 10.1016/j.numecd.2008.02.007. Epub 2008 Jun 20.

Reference Type BACKGROUND
PMID: 18571393 (View on PubMed)

Takao T, Ide T, Yanagisawa H, Kikuchi M, Kawazu S, Matsuyama Y. The effects of fasting plasma glucose variability and time-dependent glycemic control on the long-term risk of retinopathy in type 2 diabetic patients. Diabetes Res Clin Pract. 2011 Feb;91(2):e40-2. doi: 10.1016/j.diabres.2010.10.009. Epub 2010 Oct 29.

Reference Type BACKGROUND
PMID: 21035886 (View on PubMed)

Vujosevic S, Aldington SJ, Silva P, Hernandez C, Scanlon P, Peto T, Simo R. Screening for diabetic retinopathy: new perspectives and challenges. Lancet Diabetes Endocrinol. 2020 Apr;8(4):337-347. doi: 10.1016/S2213-8587(19)30411-5. Epub 2020 Feb 27.

Reference Type BACKGROUND
PMID: 32113513 (View on PubMed)

Meister G, Landthaler M, Dorsett Y, Tuschl T. Sequence-specific inhibition of microRNA- and siRNA-induced RNA silencing. RNA. 2004 Mar;10(3):544-50. doi: 10.1261/rna.5235104.

Reference Type BACKGROUND
PMID: 14970398 (View on PubMed)

Martinez B, Peplow PV. MicroRNAs as biomarkers of diabetic retinopathy and disease progression. Neural Regen Res. 2019 Nov;14(11):1858-1869. doi: 10.4103/1673-5374.259602.

Reference Type BACKGROUND
PMID: 31290435 (View on PubMed)

Boss JD, Singh PK, Pandya HK, Tosi J, Kim C, Tewari A, Juzych MS, Abrams GW, Kumar A. Assessment of Neurotrophins and Inflammatory Mediators in Vitreous of Patients With Diabetic Retinopathy. Invest Ophthalmol Vis Sci. 2017 Oct 1;58(12):5594-5603. doi: 10.1167/iovs.17-21973.

Reference Type BACKGROUND
PMID: 29084332 (View on PubMed)

Wu H, Hwang DK, Song X, Tao Y. Association between Aqueous Cytokines and Diabetic Retinopathy Stage. J Ophthalmol. 2017;2017:9402198. doi: 10.1155/2017/9402198. Epub 2017 Jun 7.

Reference Type BACKGROUND
PMID: 28680705 (View on PubMed)

Mastropasqua R, D'Aloisio R, Di Nicola M, Di Martino G, Lamolinara A, Di Antonio L, Tognetto D, Toto L. Relationship between aqueous humor cytokine level changes and retinal vascular changes after intravitreal aflibercept for diabetic macular edema. Sci Rep. 2018 Nov 8;8(1):16548. doi: 10.1038/s41598-018-35036-9.

Reference Type BACKGROUND
PMID: 30410092 (View on PubMed)

Other Identifiers

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NU22-01-00077

Identifier Type: -

Identifier Source: org_study_id

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