A 12-week Pilot Nutrition Intervention for Children With New Diagnosis of Stage 3 Type 1 Diabetes (T1D)

NCT ID: NCT06640478

Last Updated: 2025-11-13

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

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-20

Study Completion Date

2026-06-30

Brief Summary

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The purpose of this research study is to investigate the effects of a combination of weekly distribution of healthy foods and intensive nutrition counseling as complementary therapies to the standard insulin therapy in children with new diagnosis of stage 3 type 1 diabetes (T1D). Feasibility, acceptability, and fidelity of this intervention will be measured. We will also explore the likelihood of prolonging the honeymoon phase of T1D in the intervention study group. Comparisons will be made between this combined nutrition intervention and free healthy foods vs. current standard nutrition counseling. Both study groups will receive standard of care treatment for T1D (insulin therapy).

The results of this study could inform future research that will ultimately lead to design of a larger clinical trial testing implementation of novel medical nutrition therapies for children newly diagnosed with stage 3 of T1D, and may lead to prolongation of the honeymoon phase. The overall goal is to promote the beta cell function survival and to reduce the progression to stage 4 of T1D.

Condition or Disease:

* Type 1 Diabetes Mellitus
* New Diagnosis of Stage 3 Type 1 Diabetes ≤ 60days

Intervention/Treatment:

\- Weekly Free Healthy Foods + Intensive Nutrition Counseling for 12 weeks

Detailed Description

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The proposed study is a 12-week pilot, single-blinded, randomized, controlled clinical trial in prepubertal children (6-17 years old) newly diagnosed with stage 3 of type 1 diabetes (T1D) within 60 days. The total duration of the study is 24 weeks, but the nutrition intervention is only delivered during 12 weeks with a 24-week follow up visit. We expect to enroll a total of 12-40 children (6-20 per study group).

We will be investigating the potential role of a frequent personalized nutrition counseling intervention (7 sessions in a hybrid model) in addition to weekly distribution of selected healthy foods. We expect the diet quality of the youth receiving the intervention (you) will improve during and after the study intervention.

There will be two study groups: intervention and control group.

The intervention group will receive a food bag containing specific healthy foods with high anti-inflammatory properties weekly for 12 weeks, in addition to seven nutrition counseling sessions. The provided foods are a combination of 6 types of foods including: a) seasonal fruits (containing high amounts of vitamin C and vitamin E), b) legumes, c) nuts, d) yogurt, e) vegetables and f) seafood. The portions of each food group component of the "healthy foods bag" will follow the current USDA dietary guidelines according to the age of the study participant. \[1\] By contrast, the control group will receive weekly grocery store gift cards of similar monetary value of the "healthy food bag" in addition to seven nutrition counseling sessions based on the standard MyHealthy plate model.

In regards to the nutrition counseling sessions, this counseling will be provided as a hybrid model with a combination of 4 in-person nutrition counseling sessions and 3 virtual dietary counseling sessions provided by a registered dietitian. In summary:

1. Intervention group will receive NUTRI-Beta foods basket + nutrition counseling (NUTRI-Beta dietary counseling) + standard insulin treatment (either insulin injections or insulin pump per patient preference)+ standard of care insulin therapy and use of a 24-hour continuous glucose monitor, and
2. Control group will receive the standard nutrition counseling per the American Dietary Association (ADA) Guidelines \[2\] + weekly grocery store gift cards + standard of care insulin therapy and use of a 24-hour continuous glucose monitor.

The NUTRI-Beta clinical trial study visits will include a total of 10 visits during the 24 weeks of the study: Screening visit (V0), baseline visit (enrolment visit= V1), nutrition counseling visit 2 (week 2 post enrollment), nutrition counseling visit 3 (V3-virtual, week 3), nutrition counseling visit 4 (V4-in person, week 4), nutrition counseling visit 5 (V5-virtual, week 6), nutrition counseling visit 6 (V6-in person, week 8), nutrition counseling visit 7 (V7-virtual, week 10), visit 8 ( 12 weeks after enrollment- end of nutrition intervention), and visit 9 (24 weeks after enrollment).

We expect that this nutrition intervention (NUTRI-Beta) will be acceptable to children with new diagnosis of clinical diabetes (stage 3 of T1D) and will improve their diet intake and quality, their nutrition status and may increase their likelihood of residual beta-cell function in the treatment group. Evaluation of the partial remission of T1D will be completed through the determination of the insulin dose-adjusted A1C (IDAA1C) and residual beta cell function through the measurement of peak C-peptide levels during a 2-hour mixed-meal tolerance test (MMTT) after 12 and 24 weeks of the nutrition intervention.

The treatment group is expected to have higher rates of partial remission of T1D measured by the IDAA1C, better diet quality, better glycemic metrics and reduced needs of total daily dose of insulin (TDD) (unit/kg/day).

Conditions

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Type 1 Diabetes

Keywords

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T1D Healthy foods Children Youth Nutrition Counseling Diabetes mellitus type 1 Nutrition Honeymoon phase partial remission of diabetes new diagnosis of type 1 diabetes healthy eating Nutrition Intervention

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Investigators
Sub-investigators, research assistants

Study Groups

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NUTRI-Beta Intervention Group

We will provide healthy foods (NUTRI-Beta Food bag) to the intervention group weekly for 12 weeks, in addition to an intensive nutrition counseling program (NUTRI-Beta Counseling) and close 24-hour continuous glucose monitoring. The healthy foods bag will contain a combination of 6 types of foods including:

1. seasonal fruits (containing high amounts of vitamin C and E)
2. legumes,
3. nuts,
4. yogurt, and
5. seasonal vegetables (carotenoids, tomatoes, broccoli, celery, etc.).
6. seafood or seafood-related products

The portions of each food group component of the NUTRI-Beta basket will follow the current USDA dietary guidelines according to the age of the participant: a) Intervention group will receive NUTRI-Beta foods bag + intensive nutrition counseling (NUTRI-Beta dietary counseling) + standard insulin treatment (either insulin injections or insulin pump per patient preference) and T1D technology use

Group Type ACTIVE_COMPARATOR

NUTRI-Beta Counseling

Intervention Type OTHER

Dietary Counseling focused on anti-inflammatory foods

Free weekly produce foods

Intervention Type DIETARY_SUPPLEMENT

Free weekly produce

Standard of care nutrition counseling (MyHealthy plate model and ADA clinical guidelines)

STANDARD OF CARE NUTRITION COUNSELING:

1. A 12-week distribution of weekly grocery store gift cards of similar monetary value of the NUTRI-Beta food bag in addition to
2. MyPlate USDA model with similar frequency of nutrition counseling visits but following the American Dietary Association (ADA) Guidelines, and
3. Standard insulin treatment (either insulin injections or insulin pump per patient preference) and 24-hour continuous glucose monitor

Group Type OTHER

Standard dietary counseling

Intervention Type DIETARY_SUPPLEMENT

Standard of Care therapy: Nutrition counseling per the ADA clinical guidelines and USDA MyPlate model

Interventions

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NUTRI-Beta Counseling

Dietary Counseling focused on anti-inflammatory foods

Intervention Type OTHER

Standard dietary counseling

Standard of Care therapy: Nutrition counseling per the ADA clinical guidelines and USDA MyPlate model

Intervention Type DIETARY_SUPPLEMENT

Free weekly produce foods

Free weekly produce

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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NUTRI-Beta Intervention Standard

Eligibility Criteria

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Inclusion Criteria

1. Willing and able to give assent and to have a parent or legal guardian to provide informed consent
2. Less or equal than 60 days from T1D diagnosis based on American Diabetes Association criteria, and metabolically stable per study physician assessment
3. Boys and girls (Any Tanner stage), 6-17 years of age, at time of enrollment visit
4. Evidence of at least one positive T1D autoantibody (excluding insulin antibodies in those who have received ≥ 2 weeks of exogenous insulin therapy) either through clinically obtained labs at time of diagnosis or as obtained at the screening visit
5. Children with new diagnosis of T1D need to be established patients from Penn State Health- Pediatric diabetes clinic at the time of the enrollment visit
6. Capability to eat different types of food by mouth
7. Daily use of a 24-hour continuous glucose monitor by the time of the enrollment visit
8. Willing and being able to give assent and have a parent or legal guardian provide informed consent

Exclusion Criteria

1. Children with new diagnosis of T1D who are not metabolically stable (E.g. acute dehydration, severe hyperglycemia with moderate/large ketones at the time of the enrollment visit)
2. Concurrent or recent (within the past 30 days of screening) use of non-insulin therapies to control hyperglycemia including immunosuppressive therapies
3. Chronic inflammatory or autoimmune diseases with exception of stable autoimmune thyroid disease
4. Children requiring enteral feeds or parenteral nutrition support
5. Diagnosis of celiac disease or being actively evaluated for possible celiac disease, inflammatory bowel disease or any underlying illness cause acute or chronic intestinal malabsorption.
6. Use of glucocorticoids or other immunosuppressive agents within 30 days of T1D diagnosis
7. Use of medications known to influence glucose intolerance within 30 days of T1D diagnosis
8. Food allergies (nuts, soy, seafood, milk-protein, or as deemed by the principal investigator) that are a barrier for consumption of a balanced diet that meets nutrient requirements
9. Prior diagnosis or positive screening of food sensory disorders
10. Any condition that, in the investigator's opinion, may compromise study participation or may confound the interpretation to the study results
Minimum Eligible Age

6 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Milton S. Hershey Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Lina Huerta-Saenz

Assistant Professor Department of Pediatrics

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lina Huerta Saenz, MD, FAAP

Role: PRINCIPAL_INVESTIGATOR

Pediatric Endocrinologist, Assistant Professor of Pediatrics, Penn State Health Milton Hershey Medical Center, Penn State College of Medicine

Locations

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Penn State Health Children's

Hershey, Pennsylvania, United States

Site Status RECRUITING

Penn State Milton S. Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Lina Huerta Saenz, MD

Role: CONTACT

Phone: 717-531-1481

Email: [email protected]

Erica N Miller, LPN, CCRC

Role: CONTACT

Phone: 717-531-5656

Email: [email protected]

Facility Contacts

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Erica N. Miller, LPN, CCRC

Role: primary

Clare M. Robel, RN

Role: backup

Other Identifiers

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STUDY00020631

Identifier Type: -

Identifier Source: org_study_id