View clinical trials related to Type 2 Diabetes.
Filter by:The purpose of this study is to compare the effect of a fixed dose combination of vildagliptin plus metformin versus combination therapy of glimepiride plus metformin in glycemic variability in patients with type 2 diabetes who have not achieved adequate control of their disease prior to treatment with metformin monotherapy in optimal doses.
This study is a prospective, randomized, open label trial to compare the safety and efficacy of linagliptin (an oral anti diabetic medication) given orally once daily to an insulin regimen of glargine once daily plus rapid-acting insulin before meals. Both of these treatment groups will be given corrective doses of rapid-acting insulin analogs (aspart, lispro or glulisine) before meals if their blood sugars are > 140 mg/dl. The patients will be monitored for their blood sugars while the hospital. If patients are agreeable to participate in the discharge part of the study, the investigators will randomized them to a treatment group based on their admission HbA1c. The investigators will follow these patients for 3 months with phone calls and clinic visits, and will monitor their blood sugars. This is to compare the efficacy of linagliptin and our discharge treatment algorithm in controlling blood sugars as out patients.
The investigators wish to compare very active runners in healthy untrained control subjects on a number of parameters. The project aims to understand the underlying mechanisms by which physical inactivity causes diseases. This the investigators will study the full spectrum of physical activity, from the most inert of the most active people. The investigators have already collected muscle biopsies and established stem cells from people with Type 2 diabetes, obese healthy and normal weight healthy. In this study, the investigators will establish a cohort of highly physically active marathon runners. In a case-control design, the investigators compare muscle stem cell function across the entire spectrum of physical activity / inactivity.
Type II diabetes (T2D) is characterized by endothelial dysfunction, resulting in a poor tissue perfusion and function as well as an increased risk of cardiovascular events. ATP, which is released from the red blood cells, contributes to the regulation of the blood flow and studies have shown that red blood cells taken from T2D patients have an impaired ability to release ATP. However, it is not known whether the changes in the ATP system is an underlying cause of the poor tissue perfusion observed in T2D. The purpose of project 1 is to test the hypothesis that the deterioration in blood flow in T2D is caused by a reduced release ATP from red blood cells, and to test if pharmacological manipulation of cAMP will normalize ATP release, plasma ATP levels and thereby blood flow. Furthermore, epidemiological studies show a clear link between regular exercise and a reduced risk of serious cardiovascular disease. The extent to which a physically active lifestyle may improve endothelial function in T2D is unknown. Regular physical activity improves vascularization and induces an anti-inflammatory environment. Both the angiogenic and anti-inflammatory effects of physical activity is in part mediated by substances released from the active muscle. These muscle-derived substances are classified as myokines and have paracrine, autocrine and endocrine effects and may thereby affect distant tissues. The purpose of the project 2 is to investigate whether high intensity interval training may reverse endothelial dysfunction in T2D through increased release of ATP and myokines. In individuals with T2D we will determined blood flow in the muscle tissue using advanced ultrasound. In addition, using intravascular and intramuscular microdialysis we will determine ATP levels in blood and in the muscle interstitium.
Magnetic resonance (MR) imaging is a widely used and well-established noninvasive medical diagnostic imaging tool. By using a static and a gradient magnetic field in combination with a radiofrequency field (RF), MR provides excellent contrast among different tissues of the body. Although long-term effects on human health from exposure to strong static magnetic fields seem unlikely, acute effects such as vertigo, nausea, change in blood pressure, reversible arrhythmia, and neurobehavioural effects have been documented from occupational exposition to 1.5 T. Cardiac MR (CMR) imaging requires some of the strongest and fastest switching electromagnetic gradients available in MR exposing the patients to the highest administered energy levels accepted by the controlling authorities. Studies focusing on experimental teratogenic or carcinogenic effects of MR revealed conflicting results. Since CMR is emerging as one of the fastest growing new fields of broad MR application, it is of particular concern that a recent in vitro study with CMR sequences has reported on CMR-induced DNA damages in white blood cells up to 24 h after exposure to 1.5 T CMR. Therefore, we hypothesized that CMR can induce the damage of endothelium and endothelial progenitor cells in type 2 diabetes
Background Paleolithic diet is a modern dietary regimen based on food eaten during the Paleolithic (2.5 million-10.000 years before present); lean meats, fish, shellfish, fruits, vegetables, root vegetables, eggs and nuts. Food that was not eaten during the Paleolithic is avoided; cereals, dairy products, salt, refined sugar and fat. The rationale for Paleolithic diet is based on the lack of type 2 diabetes and associated diseases among hunter-gatherer populations. Our group have previously studied effects of Paleolithic diet in an observational study in humans, an intervention study in animals and two intervention studies in patients with type 2 diabetes or lowered glucose tolerance and ischaemic heart disease. Our intervention studies showed significant improvement of glucose tolerance, HbA1c, blood lipids, blood pressure, weight, waist circumference and satiety on Paleolithic diet compared with a Mediterranean-type diet and diabetes diet. Studies by other research groups on healthy individuals found that Paleolithic diet lowered weight, waist circumference, blood pressure, PAI-1, blood lipids and ectopic lipid deposition, and also improved glucose tolerance and insulin sensitivity. Purpose and aims Our goal is to study effects of Paleolithic diet compared to recommended diet on risk factors, morbidity and mortality from type 2 diabetes and associated diseases in a sufficiently large and well executed study to be included in basis for future dietary recommendations. Project descriptions SwePaD is a study with an initial 18 month long randomized cross-over dietary intervention on 150 patients with type 2 diabetes where the whole study population upon finishing the initial dietary intervention is studied as a cohort for another 5 years. The initial 18 month long dietary intervention compares 6 months on Paleolithic diet with 6 months on recommended diabetes diet separated by 6 months wash-out period. After the initial 18 month long dietary intervention the study participants are recommended to follow recommended diabetes diet with implementation of optional elements from a Paleolithic diet for the remaining 5 years of the study. The intervention, in the form of diet information, will be given orally and written by the study participant's own diabetes nurse or doctor, based on similarly designed written information on the two diets. The same intervention was successfully used in our pilot study. The study participants will otherwise receive usual treatment. Power calculations show that 126 participants are needed to obtain significant results with 80% power at the 95% significance level for the primary outcome HbA1c. The pilot study with the same intervention but slightly healthier participants than the average patient in Diabetesregistret showed significant results on HbA1C with only 13 participants. Secondary outcomes are fasting glucose levels, weight, waist circumference, blood pressure, blood lipids, urinary albumin, diabetes retinopathy, smoking, physical activity, monofilaments (detection of peripheral neuropathy) and health related quality of life assessed by the health survey questionnaire SF-36. Primary and secondary outcomes as well as medication will be registered before and after each intervention diet. Data on primary and secondary outcomes, morbidity and mortality from type 2 diabetes and associated diseases will be retrieved for up to five years after participants' completion of the dietary intervention from the Diabetes register, Cause of Death Register (Dödsorsaksregistret) and the Hospital Discharge Register (Patientregistret) and compared to expected outcome from a statistical model based on the Diabetes register (A new model for 5-year risk of cardiovascular disease Cederholm et al 2011) and/or a matched control group from the Diabetes register. Participants will be recruited nationwide through information to health care personnel in primary health care and hospital diabetes clinics and to patient organisations. Participants' registration, intervention and data gathering will be administered by the participants' own diabetes nurse or doctor via REDCap, a web based tool for secure electronic data capture hosted on secure servers with daily back-up by the Library and IKT department of the medical faculty at Lund University. Dietary evaluation will be made using four day weighed food records on paperforms before and after each intervention diet and 6 months after the last intervention.
Besides causing weight loss Roux-en-Y gastric bypass (RYGB) has profound effect on glucose metabolism leading to remission of type 2 diabetes early after surgery. However the mechanisms for this improvement remain uncertain. The aim of this study is to investigate the changes in insulin sensitivity and beta-cell function 1 week and 3 months following RYGB using oral and intravenous test.
The objective of the current proposal is to evaluate the importance of blood vessel dysfunction and heart dysfunction to overall exercise impairments in type 2 diabetes and their contribution to the gender differences observed in exercise capacity. Importantly, treatments that improve blood vessel function in persons with type 2 diabetes can be used to directly assess whether impairment in blood vessel function and ultimately exercise performance, can be improved and whether the degree of improvement differs between the sexes. Hypothesis 1. Uncomplicated type 2 diabetes more adversely affects exercise capacity in women than men. Hypothesis 2. Blood vessel function and cardiac function are more significantly impaired in women with type 2 diabetes than men and contribute to the gender differences in exercise capacity. Hypothesis 3. Restoration of blood vessel function will improve exercise capacity more in women than men with type 2 diabetes.
This four center international study will include two United Kingdom National Health Service centers, and two centers in Melbourne, Australia. The objective of the study is to evaluate subject acceptance of a new insulin pump and transmitter together with the accompanying training materials. Descriptive data from participant questionnaires and device uploads will be evaluated. Pediatric subjects between the ages of 7 - 18 years and adults from the age of 19 years of age upwards, who currently use an insulin pump in the management of their type 1 or type 2 diabetes, will be invited to participate. Each subject will be trained on the study device and then use it for approximately four weeks. During this time there will be three in-clinic visits and four follow-up phone calls, scheduled at the subjects' convenience. At the end of this period, they will revert back to their original insulin pump and complete a questionnaire on the study pump training materials, features and usability.
Obesity is a growing epidemic throughout the world and is followed by increasing incidence of type 2 diabetes that accounts for 90-95% of all cases of diabetes. Weight loss is a major objective, although difficult to achieve with medical treatments. Many recent studies demonstrated that bariatric surgery has the potency to achieve marked and sustained weight loss, and is also associated with a significant improvement in control of type 2 diabetes. The principal aim of this study is to compare two types of bariatric procedures, the Roux-en-Y gastric bypass (RYGBP) and sleeve gastrectomy (SG). The study hypothesis is that these procedures have equal efficacy with regard to resolution of type 2 diabetes.