View clinical trials related to Type 1 Diabetes.
Filter by:Patients with type 1 diabetes have poorer glycemic control that could lead to macrovascular or neuropathic complications; in addition to an optimal treatment, prevention of diabetes complications requires to control associated risk factors, such as hypertension or dyslipidemia. Sleep apnea syndrome is a public health problem due to its high prevalence and marked morbidity and mortality, one increasingly interesting aspect is its relationship with metabolic disorders, specifically diabetes.Obstructive sleep apnea syndrome seems to be underestimated in this population. In this context, it appears to be important to estimate the prevalence of sleep respiratory diseases in patients with type 1 diabetes.
Stigma related to chronic disease is rejection or judgement or exclusion by others that is related to the chronic disease itself and is unwarranted. We are trying to figure out what proportion of young people with type 1 diabetes experience stigma in Canada. By young people, we mean teenagers and young adults; specifically, people who are between 14 and 25 years of age. This is a challenging period in life when identities are developed and peer opinions are felt to be particularly important. Experiencing stigma in this life period may be especially hurtful and may have bad effects on taking care of type 1 diabetes. This may lead to important medical problems like dangerously low or high blood sugar values. By understanding how common stigma is, we can figure out the need for programs and strategies to deal with it. We will ask young people with type 1 diabetes to help us study this problem by completing an online survey. We will 'advertise' our study through type 1 diabetes clinics, websites, and social media. People who are eligible and interested will click on an internet link and be directed to the survey. Staff at clinics in Montreal, Calgary, and Vancouver will also draw their attention to the posters and/or provide small flyers with the internet link for the study. Participants will be asked about their general sense of well-being, their habits and behaviours, and their blood sugar control, including frequency of both lows and highs. They will also be asked if they are willing to mail in a small blood sample. If yes, they will receive a kit with a small lancing device and instructions on how to clean their finger tip, prick it, and express a few drops of blood into a small container. They will then mail this back to us in a postage-paid envelope. We will use this to measure their hemoglobin A1c, an overall measure of blood sugar control. We will use this information to (1) calculate the proportion of young people with type 1 diabetes who experience stigma; (2) figure out what factors and behaviours might predict or signal the experience of stigma; (3) see if there is a link between stigma and A1c control and/or frequent lows by report; (4) explore challenges and solutions voiced through the open-ended questions.
Subjects with type 1 diabetes are invited to provide usual blood glucose monitoring and a blood glucose profile (Pre/ post prandial Blood Glucose + Night Blood Glucose) on 3 occasions in a 2 week time period, in addition to the filling of 5 questionnaires including fear of hypoglycemia-2 questionnaire.
Eight adolescent and young adult subjects with type 1 diabetes, age 16−24 years, will be recruited for this study on the basis of informed consent. Participants will be invited to attend the Wellcome Trust Clinical Research Facility at Addenbrooke's Hospital, Cambridge, on two occasions. On each occasion participants will arrive at the unit at 9am having controlled their diabetes with short acting insulin for 24 hours and they will remain in the unit until 8am the next morning. During the day, between 9am and 6pm participants will remain fasting and their blood glucose levels will be controlled by intravenous insulin, the dose being determined by 15−30 minute blood glucose estimations. At 1800hr on visit 1 the subjects will be asked to ingest an evening meal enriched by a cold isotope glucose tracer (non radioactive). The variable insulin infusion will be adjusted to allow for the meal in order to achieve good glycaemic control after the meal until 0200hr. From then until 0800hr in the morning the study team will again adjust the infusion rates to maintain normal glycemia until the participants are ready to go home on their normal insulin regimen. On the second visit the protocol will be identical until 1800hr when instead of giving the meal variable amounts of glucose will be infused to ensure the glucose levels are identical to those observed on visit 1. After 0200hr the study will be effectively finished but the study team will continue to vary the insulin infusion to keep blood glucose levels normal until the subjects can go home on their normal insulin regime at 8am. In order to achieve sufficient information to make all the calculations needed other cold isotope glucose tracers will be infused during the study period. These safe non radioactive isotope tracers will enable us to assess glucose being produced by the body, its distribution and utilization. Throughout both study periods the subjects will be monitored very closely by a Clinical Research Fellow, assisted by a Research Nurse, in order to avoid any risk of low blood glucose levels.
1. To compare levels of ketone bodies (beta-hydroxybutyrate and acetoacetate) in plasma and urine following a single dose treatment of either liraglutide 1.8mg, dapagliflozin 10mg or placebo in insulinopenic state. 2. To compare plasma levels of free fatty acid, glucagon, hs-CRP, Ll-6 and IL-1 before and after administration of liraglutide/placebo.
The purpose of the study is to compare two closed-loop strategies in terms of glycemic control in Type 1 Diabetes during a camp setting. The proposed study is a four-segment feasibility study. One segment is a proof of concept study (with two parts) conducted as in-patient clinic study ,the second segment is two-arms, cross-over, randomized and single-center and the third segment is four-arms, parallel, randomized and single-center, in diabetes camp study in subjects with type 1 diabetes on insulin pump therapy and the forth segment is a single arm feasibility in a diabetes camp setting followed by a 3 weeks period at home. Segment 1 will be divided into two parts: part 1 is a single arm pilot study aim to asses logistical and safety issues in 12 patients and part 2 is a randomized cross over study aim to evaluate glucose performance using closed-loop control. Part 2-is a randomized cross-over (two arms) in-patient study: A total of 12 patients will participate in this part of the study. Following the run-in period subjects will be randomized to participate in two periods of closed-loop treatment, each period will last 36 hours in hospital setting. During the first period, glycemic control will be controlled by the Hybrid closed-loop system and during the second period by Hybrid Logic closed-loop system. The sequence of treatment first period HCL therapy than AHCL or vice versa will be randomly assigned. Segment 2 is a randomized cross-over (two arms) Camp Study including up to 30 patients. Following the run-in period subjects will be randomized to participate in two periods of closed-loop treatment, each period will last 2days in a camp setting, the total duration of the camp will be up to 6 days. In one period, glycemic control will be controlled by the Hybrid closed-loop system and another period by Hybrid Logic closed-loop system. The sequence of treatment first period HCL therapy than AHCL or vice versa will be randomly assigned. Segment 3 is a randomized, parallel (four arm) Camp Study including up to 80 patients. Following the run-in period subjects will be randomized to participate in one of 4 intervention arms of closed-loop treatment in camp settings. The duration of the camp will be 12 days in which glycemic control will be controlled by one of 4 versions of closed-loop system: Hybrid Closed Loop (HCL) or one of 3 versions of Advanced Hybrid Closed Loop (AHCL). Segment 4 is a single arm, feasibility study in a diabetes camp setting followed by a three week period at home. After the completion of segments 1-3, the AHCL system will be optimized and a new version of the system will be created for use in segment 4. Up to 20 subjects will participate in this part of the study. Following a minimum of 5 days run-in period, subjects will be placed in a camp setting and closed loop will be initiated. Subjects will remain in closed loop for 5 days and will have 3 days of challenges, including missed meal bolus, late meal bolus and moderate-intensity exercise. At the conclusion of the camp, subjects will continue to use the system at home in Auto Mode for a period of 21 days.
The Libre- flash glucose monitoring system is an episodic real-time data on demand device. This means that patients can measure their glucose level when they choose by scanning the device, while at the same time a sensor automatically measures and continuously stores glucose readings day and night. Every scan shows the current glucose reading and the last 8 hours of glucose. There are no alarms and the system does not require calibration. In the present study we aim to evaluate treatment satisfaction and comfort using the Libre flash glucose monitoring system compared to conventional Self Measurement of Blood Glucose (SMBG) in adolescents with type 1 diabetes that discontinued using continuous glucose monitoring. The second aim of the study is to evaluate the rate of use and the impact of Libre use compared to Self-Measurement of Blood Glucose among adolescents who are sub-optimally controlled and stopped using Continuous Glucose Monitoring. The study is an investigator initiated study, single-center, randomized, parallel study of 12 weeks with an optional cross-over 12 weeks extension period .
Carbohydrates are the main determinant of post-meal glucose excursion. However, fat and protein have been shown to also impact the postprandial glucose control, adding to the complexity of meal insulin calculation. Few studies have looked at the effect of macronutrients other than carbohydrates on postprandial glucose excursions with the closed-loop strategy. The objective of this study is to test whether the single-hormone closed-loop strategy can achieve similar post-meal glucose control with meals with a fixed carbohydrate content, but high in protein and/or fat when compared to a meal with a fixed carbohydrate content only.
This study trials a prototype artificial pancreas system that consists of a Roche insulin pump, a Dexcom continuous glucose monitor (CGM), and an experiential MMPPC (multiple model probabilistic predictive control) algorithm housed on an android cell phone. The system doses insulin based on CGM sensor glucose levels and the experimental algorithm. The aim of this clinical study is to determine the efficacy of the MMPPC controller in adolescents and adults with type 1 diabetes in a hotel setting.
Adolescence and young adulthood may be particularly stressful developmental periods due to the numerous transitions into new roles and the need for increased independence. Stress can affect metabolic control in older adolescents and young adults with T1D directly through its impact on cortisol and other hormones that affect insulin metabolism. The proposed study is a pilot randomized clinical trial using a three-group randomized, repeated measures design to assess the efficacy of two treatments (Mindfulness Based Stress Reduction (MBSR) and Cognitive Behavioral Therapy or (CBT) versus an attention control condition for older adolescents and young adults with poorly controlled Type 1 diabetes. As a pilot study, the goal of the research is to test recruitment and retention procedures, finalize intervention measures, training, and fidelity protocols, and estimate effect sizes for a larger clinical trial.