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Trial registered on ANZCTR
Registration number
ACTRN12610000176066
Ethics application status
Approved
Date submitted
19/02/2010
Date registered
25/02/2010
Date last updated
10/02/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
What is the minimum amount of folic acid that improves blood vessel function in children with type 1 diabetes?
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Scientific title
What is the minimum dose of folic acid that improves vascular health in children with type 1 diabetes?
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Secondary ID [1]
1282
0
Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 1 diabetes
256533
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Endothelial dysfunction
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Condition category
Condition code
Metabolic and Endocrine
256704
256704
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0
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Diabetes
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Cardiovascular
256705
256705
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Randomised double blind crossover placebo controlled trial. Intervention consists of folic acid, in one of the three doses available (0.5mg, 2mg or 5mg), as a single dose only (10ml), administered orally, in a random order. The duration between interventions is 4 weeks.
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Intervention code [1]
255811
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Prevention
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Intervention code [2]
256045
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Treatment: Drugs
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Comparator / control treatment
Single 10ml dose of water, for oral administration.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Change in endothelial function measured by flow mediated dilatation (FMD)
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Assessment method [1]
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Timepoint [1]
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2 hours after folic acid in one of the three available doses or placebo, in random order, at 4 visits 4 weeks apart
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Secondary outcome [1]
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Nil
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Assessment method [1]
262855
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Timepoint [1]
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Nil
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Eligibility
Key inclusion criteria
Type 1 diabetes of longer than 1 year duration (attending the Diabetes clinic at Women's and Children's Hospital, Adelaide)
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Minimum age
10
Years
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Maximum age
16
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
History of smoking or serum cotinine level >28 nmol/l;
Coeliac disease, screened by transglutaminase immunoglobulin A (IgA);
Treatment with statins or angiotensin converting enzyme inhibitors;
Vitamin supplementation;
Vitamin B12 deficiency;
Intercurrent illness or ketosis at the time of the study.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
After recruitment, subjects will be assigned a unique identifying number. Randomisation with this identifying number will be performed by the Pharmacy Department at Women's and Children's Hospital, Adelaide.
Each subject will receive a single dose of folic acid (0.8mg, 2mg or 5mg) or placebo every month. Both folic acid and placebo will be prepared in identical liquid preparation and delivered from an amber coloured bottle.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be using a computerised sequence generator that creates random balanced permutations of treatments for subjects who are to receive all of the treatments in a random order.
Reference:
www.randomization.com
Author: Gerard E. Dallal
Last modified: 16 July 2008
Access date: 29 January 2010
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Pharmacokinetics / pharmacodynamics
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
2/03/2010
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Actual
20/03/2010
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Date of last participant enrolment
Anticipated
2/10/2010
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Actual
2/10/2010
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
256304
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Hospital
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Name [1]
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Women's and Children's Hospital Foundation
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Address [1]
256304
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72 King William Rd
North Adelaide SA 5006
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Country [1]
256304
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Australia
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Primary sponsor type
Individual
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Name
Dr Alexia Pena
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Address
Endocrinology and Diabetes Centre
Women's and Children's Hospital
72 King William Rd
North Adelaide SA 5006
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Country
Australia
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Women's and Children's Hospital
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Address [1]
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72 King William Rd
North Adelaide SA 5006
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Country [1]
251624
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
258388
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Children, Youth and Women's Health Service Human Research Ethics Committee
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Ethics committee address [1]
258388
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2nd level Samuel Way Building Women's and Children's Hospital 72 King William Road North Adelaide, SA 5006
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Ethics committee country [1]
258388
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Australia
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Date submitted for ethics approval [1]
258388
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16/11/2009
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Approval date [1]
258388
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10/02/2010
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Ethics approval number [1]
258388
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12/12/2232
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Summary
Brief summary
Children with type 1 diabetes have detectable arterial endothelial dysfunction and arterial intima-media thickening as first markers of accelerated atherosclerosis. They can be reliably measured to test the effectiveness of early intervention strategies. Folic acid supplementation significantly reduces the risk of stroke in adults, with most benefit in primary prevention. We have demonstrated that folic acid supplementation 5 mg daily rapidly normalizes endothelial function in children with type 1 diabetes, independent of homocysteine lowering. However there are no dose response studies of the benefit of folic acid to determine the minimum effective dose. This is relevant as while high dose folic acid does not have short term adverse effects, recent epidemiological data questions its long term safety in individuals with established vascular or early neoplastic disease. Determining the minimum dose of folic acid that improves endothelial function and the effect of endothelial nitric oxide synthase polymorphisms on the response to folic acid, will also inform future intervention trials for accelerated atherosclerosis in this age group.
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Trial website
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Trial related presentations / publications
- Pena AS, Maftei O, Gent R, Piotto L, Gaskin K, Dowling K, Couper J. (2011) The effects of folate supplementation on endothelial function in children with type 1 diabetes are abolished after introduction of folate fortification, XXII Annual Meeting of the Latin American Society of Pediatric Endocrinology, Cartagena, Colombia, September 7-10, Abstract P48, p.114. - Pena AS, Maftei O, Dowling K, Gent R et al. "Folate Fortification and Supplementation Do Not Provide Vascular Health Benefits in Type 1 Diabetes" (2013) Journal of Pediatrics Vol. 163, Issue 1, Pages 255-260
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Public notes
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Contacts
Principal investigator
Name
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Dr Alexia Pena
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Address
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Endocrinology and Diabetes Centre
Women's and Children's Hospital
72 King William Rd
North Adelaide SA 5006
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Country
30697
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Australia
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Phone
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+61 8 81618134
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Oana Maftei
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Address
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Endocrinology and Diabetes Centre
Women's and Children's Hospital
72 King William Rd
North Adelaide SA 5006
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Country
13944
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Australia
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Phone
13944
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+61 8 81618134
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Fax
13944
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Email
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[email protected]
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Contact person for scientific queries
Name
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Alexia Pena
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Address
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Endocrinology and Diabetes Centre
Women's and Children's Hospital
72 King William Rd
North Adelaide SA 5006
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Country
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Australia
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Phone
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+61 8 81618134
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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