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Trial registered on ANZCTR
Registration number
ACTRN12606000432516
Ethics application status
Approved
Date submitted
22/09/2006
Date registered
6/10/2006
Date last updated
6/10/2006
Type of registration
Retrospectively registered
Titles & IDs
Public title
Carbohydrate Distribution
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Scientific title
A randomized crossover trial to investigate the effect of the distribution of carbohydrates over the day on postprandial glucose excursions in individuals with type 2 diabetes using continuous glucose monitoring for a 72 hour period.
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Secondary ID [1]
307
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Commonwealth Scientific Industrial Research Organisation (CSIRO): AD29F
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Universal Trial Number (UTN)
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Trial acronym
postprandial glucose
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 2 diabetics with HbA1c greater than 6.5mmol/L
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Condition category
Condition code
Metabolic and Endocrine
1499
1499
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The trial will consist of four treatments with 40% of the total energy from carbohydrate.
Treatment 1: Carbohydrates evenly distributed throughout the day.
Treatment 2: Carbohydrates (~ 64%) loaded at breakfast.
Treatment 3: Carbohydrates (~ 62%) loaded at lunch.
Treatment 4: Carbohydrates (~ 62%) loaded at dinner.
In the treatment 1, the carbohydrates will be evenly distributed across the day while the energy distribution for breakfast, lunch and dinner will be approximately 25%, 25% and 50% of total energy for the day which reflects what is commonly observed in Australia. The remaining three treatments (2,3&4 will contain a meal which is “loaded” with carbohydrates i.e. the majority of carbohydrates (~ 63%) consumed for the day are consumed in that meal. To enable this to occur, the energy level of the “loaded” breakfast and lunch meals will be increased by ~ 11% and the corresponding remaining meals reduced by ~ 6% relative to treatment 1 & 4.
Participants will be allocated the four treatments in a randomised order. Each 24 hour treatment will be repeated on three consecutive days (72 hours).
The CGMS (Continuous Glucose Monitoring system) sensor will be inserted on Monday afternoon. Participants will be free to consume food of their choice for the remained of the day and asked to fast from 8pm that evening. The following day they will commence a given treatment for 72 hours. They will then return to the clinic on Friday morning to have the CGMS sensor removed and the data downloaded to a computer. All food and dietary advice will be provided to aid compliance. This process will complete one treatment. The following Monday they will return to the clinic and the routine repeated. The study should be completed in four consecutive weeks.
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Intervention code [1]
1371
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Lifestyle
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Comparator / control treatment
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Control group
Active
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Outcomes
Primary outcome [1]
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Data from the CGMS (Continuous Glucose Monitoring System)
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Assessment method [1]
2070
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Timepoint [1]
2070
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Continuously monitored and will be downloaded and analyzed. This is an acute study running for 72 hours. An average blood glucose value will be automatically recorded every 5 minutes while wearing the monitor.
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Secondary outcome [1]
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1. Body height and mass. Body height will be measured using a stadiometer (SECA, Hamburg, Germany) and body mass will be measured using calibrated electronic digital scales (Mercury, AMZ 14, Tokyo, Japan).
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Assessment method [1]
3571
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Timepoint [1]
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This will be measured at the beginning and end of each treatment.
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Secondary outcome [2]
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2.Weighed food records and time of eating episodes.
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Assessment method [2]
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Timepoint [2]
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This will be recorded for the 72hour duration of each treatment.
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Secondary outcome [3]
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3.VAS (Visual Analogue Scale)degree of hunger questionnaire: Participants will complete a Visual Analogue Scale degree of hunger questionnaire each hour the volunteer is awake.
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Assessment method [3]
3573
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Timepoint [3]
3573
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This will be completed each waking hour on each treatment.
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Secondary outcome [4]
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4.Blood measurements. Fasting plasma will be collected and sent to the Institute of Medical and Veterinary Science (IMVS) for analysis of HbA1c by high-performance liquid chromatography.
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Assessment method [4]
3574
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Timepoint [4]
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This will be measured at screening only.
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Eligibility
Key inclusion criteria
Diagnosed with Type 2 Diabetes and have HAb1C greater than 6.5% (this will be tested)• Not have type 1 diabetes• Participants must understand the procedures involved and agree to participate in the study by giving full informed, written consent• No abnormality of clinical significance on medical history• If female, not pregnant or breast feeding.
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Minimum age
30
Years
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Maximum age
75
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
Unable to maintain current supplements or drug use at a stable dose for the 4 week period. (We will accept volunteers taking metformin, but exclude those taking appetite suppressants). • Have a malignancy, or a history of metabolic disease such as liver, kidney, or gastrointestinal disease• Inability to prepare meals or meet diet requirements• Unable to comprehend or cope with study requirements.
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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)
Volunteers will be randomly allocated by computer generated sequence to study treatments. The treatments are coded alphabetically. Locked computer files indicate treatment allocation numerically and the treatment code is concealed from research staff.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
random allocation using computer software clinstat
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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
Phase 4
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Type of endpoint/s
Efficacy
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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
6/03/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
24
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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]
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Government body
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Name [1]
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Commonwealth Scientific Industrial Research Organisation
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
Commonwealth Scientific Industrial Research Organisation, Human Nutrition
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Address
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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n/a
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Address [1]
1441
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Country [1]
1441
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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CSIRO Human Nutrition
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Ethics committee address [1]
3080
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Ethics committee country [1]
3080
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Australia
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Date submitted for ethics approval [1]
3080
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Approval date [1]
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15/02/2006
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Ethics approval number [1]
3080
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05/22
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Summary
Brief summary
The overall aim of this proposal is to demonstrate that blood sugar elevations are minimized through an even consumption of carbohydrates throughout the day. The study aims to clinically evaluate using an energy balanced diet, the effects of an even distribution of carbohydrate across the day in comparison with an uneven distribution on blood sugar elevations and the subsequent degree of hunger. Evaluation will primarily be based on continuous glucose monitoring using a Minimed continuous glucose monitoring system (CGMS) to provide a very detailed picture of the blood glucose profile.
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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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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Anne McGuffin
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Address
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CSIRO Human Nutrition
PO Box 10041
Adelaide BC SA 5000
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Country
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Australia
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Phone
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+61 8 83038988
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Fax
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+61 8 8303 8899
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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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Associate Prof Peter Clifton
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Address
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CSIRO Human Nutrition
PO Box 10041
Adelaide BC SA 5000
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Country
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Australia
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Phone
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+61 8 83038826
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Fax
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+61 8 8303 8899
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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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