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Trial registered on ANZCTR
Registration number
ACTRN12614001150639
Ethics application status
Approved
Date submitted
15/10/2014
Date registered
30/10/2014
Date last updated
18/12/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Understanding the utilisation of protein in a restricted carbohydrate environment in Type 1 diabetes
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Scientific title
Understanding the utilisation of dietary protein in type 1 diabetes patients on a restricted carbohydrate diet - developing a tool for protein counting.
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Secondary ID [1]
285499
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None
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Universal Trial Number (UTN)
none
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Trial acronym
none
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 1 Diabetes
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Condition category
Condition code
Metabolic and Endocrine
293556
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The hypothesis: once habituated to a low carbohydrate diet (75g carbohydrate per day for 4 weeks), an insulin bolus for protein intake is required to maintain glycaemic control, due to gluconeogenesis from protein. The starting point for this bolus is that it will be twice the carbohydrate to insulin ratio. For example, if a patient uses a ratio of 1 unit insulin to 10g carbohydrate, they will use 1 unit to 20g protein. To test this each participant (habituated to a low carbohydrate diet) will undergo 6 meal tests/. The intervention meal tests are meal tests 4-6 (identical): 40g protein + 8g carbs from a protein shake and giving a bolus for carbohydrate and protein. Participants will have baseline glucose checked before starting the meal test, if blood glucose is outside of 4-8mmol then test will be postponed. Meal and insulin bolus will be administered at time 0, blood will be taken at 10, 20, 30, 60, 90, 120, 150, 180 mins. Washout period between meal tests will be 48 hrs.
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Intervention code [1]
290437
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Lifestyle
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Comparator / control treatment
The comparator meal tests are meal tests 1-3 (identical): 40g protein + 8g carbs from a protein shake and giving an insulin bolus for carbohydrate only, as bolusing for carbohydrate is the standard treatment.
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Control group
Active
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Outcomes
Primary outcome [1]
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Area under the curve for glucose. Glucose is assessed by serum assay.
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Assessment method [1]
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Timepoint [1]
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Serum Glucose taken at baseline (time 0), 10, 20, 30, 60, 90, 120, 150, 180 mins post administration of meal and insulin bolus.
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Secondary outcome [1]
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Glucose excursion above 8mmol/L. Glucose is assessed by serum assay, and also blood glucometer.
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Assessment method [1]
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Timepoint [1]
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Serum Glucose taken at baseline (time 0), 10, 20, 30, 60, 90, 120, 150, 180 mins post administration of meal and insulin bolus. Blood glucometer taken at time 0, 60, 120 and 180 mins post administration of meal and insulin bolus.
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Eligibility
Key inclusion criteria
Type 1 diabetes mellitus on a basal/bolus insulin regimen
Good understanding of carbohydrate counting and insulin ratios
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Minimum age
18
Years
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Maximum age
70
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
Pregnant or breastfeeding women
Unstable glycaemic control – HbA1c greater than or equal to
85
Renal failure - eGFR greater than or equal to 30mls/min or urinary macroalbumin:creatinine greater than or equal to 30
Use of an insulin pump
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Study design
Purpose of the study
Treatment
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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)
All participants will undertake all meal tests, but in random order. allocation will be concealed by opaque envelope.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random order will be computer generated using random.org
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Masking / blinding
Open (masking not 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
Not Applicable
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Type of endpoint/s
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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
4/04/2016
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Actual
5/09/2016
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Date of last participant enrolment
Anticipated
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Actual
2/08/2017
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Date of last data collection
Anticipated
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Actual
13/09/2017
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Sample size
Target
16
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Accrual to date
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Final
16
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Wellington
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Cranfylde Trust
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Address [1]
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107 Hanson Street
Newtown
Wellington
6021
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Country [1]
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New Zealand
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Primary sponsor type
Government body
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Name
Capital and Coast District Health Board
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Address
Riddiford St,
Newtown
Wellington 6021
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
288804
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Country [1]
288804
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Health and Disability Ethics Committee
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Ethics committee address [1]
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Ministry of Health No 1 The Terrace PO Box 5013 Wellington 6021
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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12/11/2014
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Approval date [1]
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07/01/2015
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Ethics approval number [1]
291806
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Summary
Brief summary
This exploratory study aims to understand the relationship between protein and insulin requirements in differing carbohydrate environments in participants with type 1 diabetes. The hypothesis: once habituated to a low carbohydrate diet, an insulin bolus for protein intake is required to maintain glycaemic control, due to gluconeogenesis from protein. The starting point for this bolus is that it will be twice the carbohydrate to insulin ratio. For example, if a patient uses a ratio of 1 unit insulin to 10g carbohydrate, they will use 1 unit to 20g protein.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Amber Parry Strong
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Address
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Wellington Hospital
Riddiford St
Wellington 6021
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Country
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New Zealand
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Phone
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+64 4 8062458
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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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Amber Parry Strong
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Address
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Wellington Hospital
Riddiford St
Wellington 6021
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Country
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New Zealand
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Phone
52103
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+64 4 8062458
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Fax
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Email
52103
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[email protected]
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Contact person for scientific queries
Name
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Amber Parry Strong
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Address
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Wellington Hospital
Riddiford St
Wellington 6021
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Country
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New Zealand
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Phone
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+64 4 8062458
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Fax
52104
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Email
52104
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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.
Download to PDF