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Trial registered on ANZCTR
Registration number
ACTRN12623001277639
Ethics application status
Approved
Date submitted
3/10/2023
Date registered
7/12/2023
Date last updated
26/05/2024
Date data sharing statement initially provided
7/12/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Efficacy of REducing cardiometabolic risk with SEmaglutide in Type 1 diabetes
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Scientific title
Evaluating the efficacy of REducing cardiometabolic risk with SEmaglutide by measuring arterial stiffness in overweight and obese adults aged over 25 with Type 1 diabetes
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Secondary ID [1]
310665
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None
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Universal Trial Number (UTN)
U1111-1289-8469
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Trial acronym
RESET1
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
type 1 diabetes
331567
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Condition category
Condition code
Metabolic and Endocrine
328302
328302
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0
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Diabetes
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Cardiovascular
328303
328303
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Subcutaneous injection semaglutide, self-administered according to the following dose titration schedule: 0.25mg weekly for 4 weeks, 0.5mg weekly for 4 weeks, then 1mg weekly (or maximum tolerated dose).
Total duration post initiation of treatment 26 weeks (18 weeks at 1mg or maximum tolerated dose).
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Intervention code [1]
327071
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Treatment: Drugs
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Comparator / control treatment
placebo subcutaneous injection (0.9% sodium chloride) with matching titration schedule, placebo injections appear identical to semaglutide injections
Sub-study:
an additional group without diabetes will be recruited for baseline studies of carotid femoral pulse wave velocity, pancreatic and gut hormones only, to form a comparison group to those with type 1 diabetes at baseline for these measures.
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Control group
Placebo
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Outcomes
Primary outcome [1]
336152
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Change in arterial stiffness
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Assessment method [1]
336152
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Carotid femoral pulse wave velocity using applanation tonometry of carotid artery and thigh cuff
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Timepoint [1]
336152
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baseline, 13 weeks and 26 weeks post initiation of treatment (primary endpoint), 12 weeks post cessation of treatment
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Secondary outcome [1]
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Change in arterial stiffness
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Assessment method [1]
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Augmentation index measured by radial artery applanation tonometry
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Timepoint [1]
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [2]
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Change in heart rate
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Assessment method [2]
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Digital sphygmomanometer
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Timepoint [2]
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [3]
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Change in blood pressure
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Assessment method [3]
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Digital sphygmomanometer
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Timepoint [3]
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [4]
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Change in weight
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Assessment method [4]
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Digital scales (kg)
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Timepoint [4]
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [5]
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Change in waist circumference
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Assessment method [5]
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tape measure (cm)
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Timepoint [5]
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [6]
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Change in waist:hip ratio
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Assessment method [6]
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tape measure (cm)
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Timepoint [6]
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [7]
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Change in insulin sensitivity
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Assessment method [7]
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glucose infusion rate during hyperinsulinaemic-euglycaemic clamp
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Timepoint [7]
427106
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [8]
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Change in fasting free fatty acid profile
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Assessment method [8]
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serum assay
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Timepoint [8]
427107
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [9]
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Change in fasting lipid profile
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Assessment method [9]
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serum assay
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Timepoint [9]
427108
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [10]
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Change in vascular inflammation
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Assessment method [10]
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soluble intercellular adhesion molecule-1 (sICAM-1), soluble E-selectin (sE-selectin), interleukin 6 (IL-6) via serum assay
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Timepoint [10]
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [11]
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Change in adiponectin
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Assessment method [11]
427113
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serum assay
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Timepoint [11]
427113
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [12]
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Change in high sensitivity C-reactive protein (hsCRP)
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Assessment method [12]
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serum assay
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Timepoint [12]
427123
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [13]
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Change in growth differentiation factor 15 (GDF-15)
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Assessment method [13]
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serum assay
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Timepoint [13]
427127
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [14]
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Change in energy expenditure
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Assessment method [14]
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Indirect calorimetry
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Timepoint [14]
427128
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [15]
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Change in hepatic steatosis
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Assessment method [15]
427130
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controlled attenuation parameter measured using transient elastography (Fibroscan)
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Timepoint [15]
427130
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [16]
427132
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Change in visceral adipose tissue
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Assessment method [16]
427132
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dual x-ray absorptiometry (DXA)
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Timepoint [16]
427132
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [17]
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Change in total fat mass
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Assessment method [17]
427133
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dual x-ray absorptiometry (DXA)
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Timepoint [17]
427133
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [18]
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Change in fat free mass
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Assessment method [18]
427134
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dual x-ray absorptiometry (DXA)
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Timepoint [18]
427134
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [19]
427135
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Change in % time in range
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Assessment method [19]
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Percentage of time that glucose is between 3.9-10.0 mmol/L, as measured by continuous glucose monitor
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Timepoint [19]
427135
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [20]
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Change in % time in tighter range
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Assessment method [20]
427136
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Percentage of time that glucose is between 3.9-7.8 mmol/L, as measured by continuous glucose monitor
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Timepoint [20]
427136
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [21]
427137
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Change in % time below range
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Assessment method [21]
427137
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Percentage of time that glucose is less than 3.9 mmol/L, as measured by continuous glucose monitor
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Timepoint [21]
427137
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [22]
427138
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Change in % time above range
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Assessment method [22]
427138
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Percentage of time that glucose is greater than 10.0 mmol/L, as measured by continuous glucose monitor
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Timepoint [22]
427138
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [23]
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Change in time below 3.0 mmol/L
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Assessment method [23]
427139
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Percentage of time that glucose is less than 3.0 mmol/L, as measured by continuous glucose monitor
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Timepoint [23]
427139
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [24]
427141
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Change in HbA1c
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Assessment method [24]
427141
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serum assay
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Timepoint [24]
427141
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [25]
427142
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Change in total daily insulin dose
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Assessment method [25]
427142
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Review of insulin diary or insulin pump output
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Timepoint [25]
427142
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [26]
427143
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Change in basal insulin dose
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Assessment method [26]
427143
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Review of insulin diary or insulin pump output
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Timepoint [26]
427143
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [27]
427144
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Change in bolus insulin dose
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Assessment method [27]
427144
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Review of insulin diary or insulin pump output
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Timepoint [27]
427144
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [28]
427251
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Change in glycaemic variability
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Assessment method [28]
427251
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Continuous glucose monitoring
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Timepoint [28]
427251
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [29]
427252
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Change in C peptide
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Assessment method [29]
427252
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serum assay
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Timepoint [29]
427252
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [30]
427253
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Change in glucagon
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Assessment method [30]
427253
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serum assay
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Timepoint [30]
427253
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [31]
427277
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Mean 24-hour glucose
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Assessment method [31]
427277
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Measured by continuous glucose monitor
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Timepoint [31]
427277
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [32]
427278
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Mean overnight glucose
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Assessment method [32]
427278
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Measured by continuous glucose monitor (midnight to 6.00am)
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Timepoint [32]
427278
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Baseline and 26 weeks post initiation of treatment
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Secondary outcome [33]
427279
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Mean daytime glucose
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Assessment method [33]
427279
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Measured by continuous glucose monitor (6.00am to midnight)
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Timepoint [33]
427279
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Baseline and 26 weeks post initiation of treatment
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Eligibility
Key inclusion criteria
Main study:
1. type 1 diabetes of greater than or equal to 2 years duration
2. body mass index greater than or equal to 25 kg/m2
3. HbA1c greater than or equal to 7.0%
4. at least one cardiovascular risk factor:
- history of microalbuminuria [urinary albumin:creatinine ratio greater than 2.5 mg/mmol for males, greater than 3.5 mg/mmol for females]
- hypertension [Blood pressure (BP) greater than 140/90mmHg] or anti-hypertensive treatment
- hyperlipidemia [Total Cholesterol(TC):High Density Lipoprotein (HDL) ratio greater than 6] or lipid lowering therapy
- current smoking
Sub-study (Pancreatic hormones and carotid femoral pulse wave velocity only in people without diabetes to provide comparative data for baseline measures in type 1 diabetes group):
1. body mass index greater than or equal to 25 kg/m2
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Minimum age
25
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
Main and sub-study:
1. treatment with a GLP1 receptor agonist, metformin or SGLT2 inhibitor in the last 3 months
2. current or planned treatment with medications that affect glucose metabolism (i.e. glucocorticoids, antipsychotics, immunosuppressants)
3. previous or planned bariatric surgery during study period
4. diabetic ketoacidosis or severe hypoglycaemia in the last 12 months
5. eGFR less than 45 ml/min/1.73m2
6. evidence of significant liver disease (known cirrhosis, LFTs greater than 3x upper limit of normal)
7. known gastroparesis
8. history of pancreatitis or cholecystitis
9. pregnant, breastfeeding or female of childbearing potential not using adequate contraception
10. coronary event or stroke in the last 3 months
11. active or untreated proliferative diabetic retinopathy
12. personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2
13. previous adverse reaction to semaglutide necessitating discontinuation
Sub-study:
1. diabetes mellitus
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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)
Allocation performed by a physician not involved in the study and communicated to the dispensing pharmacy
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Dynamic random allocation using minimisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
5/02/2024
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Actual
12/03/2024
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Date of last participant enrolment
Anticipated
5/01/2026
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Actual
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Date of last data collection
Anticipated
29/06/2026
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Actual
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Sample size
Target
76
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Accrual to date
7
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
314883
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Charities/Societies/Foundations
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Name [1]
314883
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Diabetes Australia Research Trust
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Address [1]
314883
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19/23 Moore St, Turner ACT 2612
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Country [1]
314883
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Australia
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Funding source category [2]
314911
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Charities/Societies/Foundations
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Name [2]
314911
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Garvan Research Foundation
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Address [2]
314911
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384 Victoria Street Darlinghurst NSW 2010
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Country [2]
314911
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Australia
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Primary sponsor type
Other
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Name
Garvan Institute of Medical Research
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Address
384 Victoria St Darlinghurst NSW 2010
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Country
Australia
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Secondary sponsor category [1]
316896
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None
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Name [1]
316896
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Address [1]
316896
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Country [1]
316896
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
313881
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St Vincent's Hospital Sydney Human Research Ethics Committee
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Ethics committee address [1]
313881
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390 Victoria Street Darlinghurst NSW 2010
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Ethics committee country [1]
313881
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Australia
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Date submitted for ethics approval [1]
313881
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28/11/2022
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Approval date [1]
313881
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02/02/2023
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Ethics approval number [1]
313881
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Summary
Brief summary
Premature cardiovascular disease is the leading cause of death in people living with type 1 diabetes. Semaglutide, a long-acting glucagon-like peptide-1 receptor agonist, has been shown to reduce cardiovascular events and improve weight and glycaemia in type 2 diabetes. Semaglutide may offer cardioprotective and metabolic benefits in type 1 diabetes. Our study hypothesis is that semaglutide will reduce carotid femoral pulse wave velocity, a measure of arterial stiffness. Arterial stiffness has been shown to be an appropriate surrogate marker of cardiovascular risk in this population. Subjects will receive semaglutide 1.0mg weekly or matched placebo for 26 weeks. Potential mechanisms for metabolic changes will also be explored including insulin sensitivity determined by hyperinsulinaemic-euglycaemic clamp; and incretin and pancreatic hormone levels determined by mixed meal tolerance test. We will also study incretin and pancreatic hormones determined by mixed meal tolerance test in a group without diabetes to compare to the group with type 1 diabetes.
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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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Prof Jerry Greenfield
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Address
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Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst NSW 2010
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Country
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Australia
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Phone
129654
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+61 2 8382 2622
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Fax
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Email
129654
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[email protected]
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Contact person for public queries
Name
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Ruth Frampton
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Address
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Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst NSW 2010
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Country
129655
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Australia
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Phone
129655
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+61 0491 731 769
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Fax
129655
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Email
129655
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[email protected]
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Contact person for scientific queries
Name
129656
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Ruth Frampton
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Address
129656
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Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst NSW 2010
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Country
129656
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Australia
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Phone
129656
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+61 0491 731 769
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Fax
129656
0
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Email
129656
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All individual participant data collected during the trial, after de-identification.
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When will data be available (start and end dates)?
Immediately following publication (ending 5 years following main results publication).
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Available to whom?
On a case-by-case basis at the discretion of the primary sponsor and pending ethics committee approval, investigators whose proposed use of the data has been approved by an independent review committee (“learned intermediary”) identified for this purpose.
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Available for what types of analyses?
Only to achieve the aims in the approved proposal
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How or where can data be obtained?
Access subject to approvals by the Principal Investigator (Professor Jerry Greenfield). Enquiries should be directed to
[email protected]
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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