View clinical trials related to Type 2 Diabetes.
Filter by:Background : Regular exercise is a cornerstone in the prevention and the management of comorbidities. Unfortunately, the metabolic benefit of exercise training is not universal and varies among individuals. A main factor likely to explain the exercise training variability is the lack of empirical evidence on the determinants of exercise training. A series of muscle-derived cytokines have recently been discovered that (1) are released during exercise and (2) exert positive effects on peripheral tissues. Irisin is one of these novel "myokines" and might contributes to the metabolic adaptations to exercise training. Methods: The investigators will perform a pilot cohort study in which obese adolescents will perform resistance exercise training for 6 weeks. The main exposure variable will be the acute release of irisin during resistance exercise. The main outcome measures will be the change in hepatic triglyceride content and glucose area under the curve during a 75g, 2-hour oral glucose tolerance test. Study Hypothesis: The primary overall hypothesis is that the change in plasma Irisin with a single bout of exercise will be associated with the metabolic adaptations to 6 weeks of resistance training, specifically, the reductions in hepatic triglyceride content and post-prandial glucose excursions, in obese adolescents.
40 patients with Type 2 Diabetes Mellitus who also have sleep disorders and mild depression in the community will be recruited and stochastically divided into the intervention group and the control group. Both groups will take the same group education courses including DSME (Diabetes Self-management Education), psychological support, improvement in sleep. Patients in the intervention group will receive peer support and yoga music therapy before bed. The observation period will last for 6 months so as to evaluate the benefits of peer support and yoga music therapy in sleep quality improvement and glycemic control of type 2 diabetic patients with sleep disorders and mild depression.
Type 2 diabetes is a chronic disease that has reached epidemic proportions. In order to improve our strategies for preventing and treating type 2 diabetes the investigators need to better understand the mechanism of this disease, and the way in which current therapies, such as the drug liraglutide, work to control blood sugar. It is known that liraglutide acts via increasing the secretion of the hormone insulin from the pancreas, hormone that in turn controls blood sugar. However, it is not known whether liraglutide also has actions on the liver. Animal studies have suggested that liraglutide might act by controlling the liver enzyme glucokinase (GCK), an enzyme that increases blood sugar uptake by the liver. This could be a crucial mechanism in which liraglutide controls blood sugar independently of insulin, thus making it beneficial not only in type 2 but also in type 1 diabetes. The effect of liraglutide on GCK activity has not been yet measured in humans. The investigators propose to investigate the acute and chronic effect of liraglutide on GCK by using a simple, widely used procedure (an IntraVenous Glucose Tolerance Test-IVGTT) and a novel approach (mathematical modeling of data obtained from this procedure), to assess GCK activity in people with type 2 diabetes. The investigators will first compare data obtained form 2 IVGTTs (with and without liraglutide) performed 1 week apart (acute effect). The investigators will then give liraglutide to patients for 6 weeks and do another IVGTT to measure GCK activity (chronic effects). Data obtained from this study will be used to further understand the mechanism of liraglutide action and how to better employ our current therapeutic options and develop new strategies for preventing and treating diabetes.
A characteristic of Type 2 diabetes is a high blood glucose level, which is partly caused by the inability of insulin to stimulate glucose uptake into our muscles (insulin resistance). Insulin resistance can be caused by the accumulation of fat within muscle of overweight individuals. The aim of the present research is to test whether a novel nutritional intervention containing L-carnitine can increase the amount of carnitine within muscle of individuals recently diagnosed with Type 2 diabetes. Carnitine is essential for 'burning fat' within our muscles and it is hoped that increasing the amount of carnitine within muscle can increase fat burning, lower muscle fat, reverse insulin resistance and ultimately lower blood glucose levels and wellbeing. We also aim to investigate the cellular mechanisms underlying any observed effects in a hope to identify further targets to lower muscle fat.
The study aims to assess the impact of the P4 approach on established markers of glucose metabolism in type 2 diabetics. Secondary objectives are examination of the changes in physical characteristics, quality of life and the indices for beta cell function, hepatic insulin resistance and muscle insulin resistance .
Rationale: Mediterranean style diets and diets rich in green leafy vegetables protect against the risk of developing type 2 diabetes and a wide range of cardiovascular disease. These diets are rich in nitrate. Numerous studies have shown that nitrate from the diet can have a wide range of beneficial effects. These include relaxing blood vessels and improving their function. It has been shown that following a meal with added nitrate, blood flow to the stomach increases more than would be expected if the same meal is given without nitrate. This is because when we eat nitrate the body concentrates it and recycles it through the digestive system. As it cycles through it is converted into nitrite and nitric oxide which cause blood vessels to relax. The nitrite and nitric oxide also seem to protect against infection from food sources such as E.coli. What we do not know is whether this nitrite and nitric oxide has any effect on the small intestine and the liver. Some nitrite reaches the small intestine and may have the same effect on blood flow there as it does in the stomach. This could be very important because the small intestine releases hormones called incretins which we now know play a very important role in controlling blood sugar every time we eat. These incretin hormones regulate insulin release and the body's sensitivity to insulin. When we eat blood containing the substances we have absorbed from the gut, such as sugars and fats, goes to the liver for processing. The blood then leaves the liver and enters the circulation. This means the blood supply to the liver will have much higher concentrations of nitrite than the blood circulating in the rest of the body. High concentrations of nitrite appear to cause blood vessels to open up. This means more blood vessels in the liver should be opened after a nitrate rich meal. It seems likely that this will help the liver to control blood sugar more effectively. Purpose To find out if supplementation by inorganic nitrate as found in beetroot or green leafy vegetables increases liver (hepatic) microvascular perfusion and increases incretin secretion. Plan of investigations: We will recruit 16 individuals for each of the three groups (Young adults, older adults and individuals with type 2 diabetes). Participants will be recruited from a database of volunteers who have consented to being contacted for research studies which are held by the NIHR Exeter Clinical Research Facility. This is a double blind, placebo controlled crossover design study (nitrate rich beetroot juice vs a placebo, nitrate depleted beetroot juice). Three visits will be required for participants to complete this study. Visit 1. Screening and consent. The experimenter will explain to the participant what the study is designed to test. If the participant is completely clear on the study and understand what they are agreeing to, they will sign a consent form. In addition a standard medical history and clinical examination will be undertaken by a research nurse and or Anthony Shepherd. A venous blood sample will be taken using standard aseptic procedures. Following consent participants will be assigned a study number. Study numbers will be previously assigned (by a research statistician) to a randomisation order to begin either the beetroot juice or placebo arm of the study first. Visit 2. Visit 2 will require the participant to fast over night from 10pm. Only water will be admissible from this time. The following morning participants will arrive at the laboratory in a fully hydrated and rested state at ~ 7.30am. This visit will take ~ 5 hours and will require 4 MRI scans. Participants will have the first MRI scan after a short acclimatisation period. Participants will then be provided with a concentrated 140 mL nitrate drink or placebo with a standardised breakfast (2 slices of toast with butter). Three subsequent MRI scans will be required (one per hour for three hours). Venous blood samples taken from cannulas will be sampled, in order to assess glucose, insulin, incretins and nitrate/nitrite prior to each scan. Visit 3. Visit 3 will take place after a minimum washout period of 7 days from Visit 2. Visit 3 will be identical in nature to visit 2; however, it will be with the opposite supplement (either nitrate rich or placebo beetroot juice). Impact: Dietary nitrate appears to offer a simple, low cost means of modifying cardiovascular risk. This study will deepen our understanding of the role of the nitrate/nitrite/nitric oxide pathway in normal physiology. By understanding what effect inorganic nitrate from the diet has on hepatic perfusion and other pathways involved in glucose homeostasis this may lead to a range of simple, low cost therapeutic strategies to prevent and treat type 2 diabetes.
Type 2 diabetes mellitus is a chronic metabolic disorder characterized by progressive deterioration in the function of the pancreatic beta-cells, which are the cells that produce and secrete insulin (the hormone primarily responsible for the handling of glucose in the body). The investigators propose a randomized controlled trial to determine whether combining basal insulin with a new medication called exenatide is a therapeutic strategy that can preserve beta-cell function early in the course of type 2 diabetes.
Type 2 diabetes mellitus is a chronic metabolic disorder characterized by progressive deterioration in the function of the pancreatic beta-cells, which are the cells that produce and secrete insulin (the hormone primarily responsible for the handling of glucose in the body). The investigators propose a randomized controlled trial to determine whether intermittent intensive insulin therapy is an effective therapeutic strategy that can preserve pancreatic beta-cell function and maintain glycemic control early in the course of type 2 diabetes.
This study examined whether dietary-induced reductions in lipoprotein-associated phospholipase A2 (Lp-PLA2) activity in peripheral blood mononuclear cells (PBMC) and plasma affected metabolic profiles in PBMCs and plasma.
This proposal seeks to gather continuous blood glucose and physical activity data from individuals with and without diabetes.