Type 2 Diabetes Mellitus Clinical Trial
Official title:
Osteopathic Manipulative Treatment of Somatic Dysfunction and Chronic Low Back Pain in Patients With Type 2 Diabetes Mellitus
The study hypothesis is based on osteopathic medical philosophy that: 1) the body is a unit; 2) the body has inherent self-regulatory mechanisms; 3) structure and function are interrelated; and 4) rational treatment is based on an understanding and integration of these concepts. Patients with type 2 diabetes mellitus often report more aches and pains than people without diabetes. Because osteopathic manual medicine addresses dysfunction in the musculoskeletal system, patients with both chronic low back pain and type 2 diabetes mellitus may benefit from this non-pharmacological treatment to reduce their pain, thereby reducing their stress and perhaps providing better clinical control for diabetes as demonstrated by key markers such as hemoglobin A1c and kidney function. This study is an extension of research completed in the OSTEOPATHIC Trial. Results of that study were published in the Annals of Family Medicine in March/April 2013.
SPECIFIC AIM 1:
To conduct a randomized controlled trial (RCT) to determine the efficacy of osteopathic
manual treatment (OMT) vs sham OMT in subjects with type 2 diabetes mellitus (T2DM) and
comorbid chronic low back pain (LBP). This will involve a 12-week protocol to study changes
in response to OMT in such outcomes as LBP severity (primary outcome measure), somatic
dysfunction, renal function, glycemic control, and other biomarkers potentially related to
T2DM.
SPECIFIC AIM 2:
Within the RCT, to corroborate previous findings indicating that patients with T2DM have a
high prevalence of tissue texture abnormalities in the T11-L2 spinal segmental region and to
determine if such findings can be statistically associated with the presence of diabetic
nephropathy using such laboratory measures as serum creatinine, urinary microalbuminuria and
macroalbuminuria, and the glomerular filtration rate.
SPECIFIC AIM 3:
Within the RCT, to explore potential mechanisms of action of OMT by longitudinally measuring
concentrations of biomarkers such as insulin, glucagon, cortisol, hemoglobin A1c, tumor
necrosis factor-α,interleukin (IL)-1β, IL-6, IL-10, and IL-18 in subjects with T2DM and
comorbid chronic LBP over 12 weeks. Significant changes in biomarker concentrations may help
explain the effects of OMT and whether such effects are mediated by changes in somatic
dysfunction.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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