Continuous Glucose Monitoring in Type 2 Diabetes Mellitus
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Purpose
It is well known that lowering average blood glucose decreases the risk of diabetic complications involving the small vessels, such as those found in the eyes, nerves and kidney. It is less clear however, if controlling fluctuations in blood glucose will further help to prevent such complications.
The purpose of this study is to examine the relationship between extreme fluctuations in glucose and damage to the blood vessel lining.
| Condition |
|---|
|
Diabetic Vascular Complications |
| Study Type: | Observational |
| Study Design: | Observational Model: Case-Only Time Perspective: Prospective |
| Official Title: | Glycemic Variability Predicts Endothelial Dysfunction |
- Serum levels of endothelial dysfunction biomarkers and glycemic variability [ Time Frame: Day 3 of study enrollment ] [ Designated as safety issue: No ]The following biomarkers are studied: soluble e-selectin, vascular cell adhesion molecule-1, intercellular adhesion molecule-1 and asymmetric dimethylarginine. These analytes are highly correlated to endothelial dysfunction.
- Metabolic parameters and glycemic variability [ Time Frame: Day 3 of study enrollment ] [ Designated as safety issue: No ]Blood pressure, body mass index, fasting glucose, highly sensitive CRP, HbA1c, lipid panel, adiponectin level, urine microalbumin/creatinine ratio will be measured and correlated to glycemic variability.
Biospecimen Retention: Samples Without DNA
Serum samples
| Enrollment: | 28 |
| Study Start Date: | December 2006 |
| Study Completion Date: | March 2011 |
| Primary Completion Date: | March 2011 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
| Type 2 Diabetes Mellitus |
Detailed Description:
Studies have shown that glycemic variability is associated with oxidative stress which in turn has been correlated with endothelial damage. Further, endothelial damage has been identified as a critical event lending way to the vascular complications seen in many disease states.
The specific aim of this study is to investigate the relationship between short-term glycemic variability and biomarkers of endothelial dysfunction while analyzing the influence of different variables and adjusting for covariates.
Data obtained from a continuous glucose monitoring system(CGMS), a device that continuously records interstitial glucose for a 72 hour period, is used to calculate glycemic variability. Serology for the determination of endothelial dysfunction biomarkers is obtained on day three.
Pearson and Spearman Rank Order correlations are utilized to determine whether there are any significant correlations between measures of glycemic variability and biomarker levels of endothelial dysfunction. Multiple regression analysis would also determine if glycemic variability predicts elevated biomarker levels even after controlling for other variables.
Provided the high prevalence of diabetic complications and their staggering socioeconomic costs, it is important to elucidate the relationship between glycemic variability and endothelial dysfunction.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Non-Probability Sample |
Adult subjects with Type 2 Diabetes Mellitus from an outpatient Endocrinology Practice
Inclusion Criteria:
- Adult subjects with Type 2 Diabetes Mellitus and glycosylated hemoglobin <8.0%
Exclusion Criteria:
- Age <18 or >65
- BMI >35
- Pregnant
- Baseline glycosylated hemoglobin <6.0% or >8.0%
- Winthrop University Hospital Employee or Staff member
- Vulnerable subject
- Uncontrolled hypertension(defined as systolic blood pressure >130 or diastolic blood pressure >80mmHg)
- Uncontrolled dyslipidemia (defined as LDL >130mg/dL; HDL <30mg/dL or triglycerides >199mg/dL)
- Current smoker or significant smoke exposure(defined as greater than 2 hours of exposure to second-hand smoke within the preceding 48hrs)
- Sympathomimetic use within the past week
- History of cardiovascular disease
- History of paroxysmal nocturnal hemoglobinuria
- History of thrombotic thrombocytopenic purpura
- History of stage II-V Chronic Kidney Disease
Contacts and Locations| United States, New York | |
| Winthrop University Hospital | |
| Mineola, New York, United States, 11501 | |
| Principal Investigator: | Lawrence E Shapiro, MD | Winthrop University Hospital |
More Information
Publications:
| Responsible Party: | Cindy Bredefeld, Prinicipal Investigator, Winthrop University Hospital |
| ClinicalTrials.gov Identifier: | NCT01083043 History of Changes |
| Other Study ID Numbers: | 06035 |
| Study First Received: | March 5, 2010 |
| Last Updated: | January 15, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Winthrop University Hospital:
|
Glycemic Variability Endothelial Dysfunction |
Additional relevant MeSH terms:
|
Diabetes Mellitus Diabetes Mellitus, Type 2 Diabetic Angiopathies Glucose Metabolism Disorders Metabolic Diseases |
Endocrine System Diseases Vascular Diseases Cardiovascular Diseases Diabetes Complications |
ClinicalTrials.gov processed this record on June 18, 2013