Diabetes Mellitus, Type 1NCT04089462
Effects of Frequency and Duration of Exercise in People With Type 1 Diabetes A Randomized Crossover Study
A study testing "Five sessions per period" - "Two sessions per period" and "Two sessions per period" - "Five sessions per period" in people with Diabetes Mellitus, Type 1 and Insulin Hypoglycemia, run by Steno Diabetes Center Copenhagen at 1 site in Denmark.
Trial summary
According to the Standards of Medical Care in Diabetes by the American Diabetes Association, people with diabetes should aim for 30 minutes of moderate-to-vigorous intensity aerobic exercise at least 5 days a week or a total of 150 minutes per week and doing some type of strength training at least 2 times per week in… Read more about this study
- Who is it for?
- Ages 18 to 64 years
- Conditions the study is for
- Diabetes Mellitus, Type 1, Insulin Hypoglycemia
- What is being tested?
- "Five sessions per period" - "Two sessions per period" and "Two sessions per period" - "Five sessions per period"
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 26 participants
- Where
- 1 siteDenmark
- Study dates
- 30 Sep 2019to 1 Jan 2021
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 64 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Type 1 Diabetes ≥ 2 year
- Insulin pump ≥ 1 year.
- Use of carbohydrate counting and the insulin pump bolus calculator for all meals
Who cannot join
- Use of anti-diabetic medicine (other than insulin), per oral or injected corticosteroids or other drugs affecting glucose metabolism during the intervention period or within 30 days prior to study start
- Known or suspected alcohol or drug abuse
- Other concomitant medical or psychological condition that according to the investigator's assessment makes the participant unsuitable for study participation
- Females who are pregnant, breast-feeding or intend to become pregnant or are not using adequate contraceptive methods
- Inability to understand the participants' information and to give informed consent
- Chronic use or unable to stop acetaminophen (paracetamol) use
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- Allergy to the patch of CGM
- Hypoglycemia unawareness, quantified by Pedersen-Bjergaard
- Severe hypoglycemia within the last year
- Vigorous-intensity exercise for more than 60 minutes on 3 days or more per week
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Effects of Frequency and Duration of Exercise in People With Type 1 Diabetes - A Randomized Crossover Study
According to the Standards of Medical Care in Diabetes by the American Diabetes Association, people with diabetes should aim for 30 minutes of moderate-to-vigorous intensity aerobic exercise at least 5 days a week or a total of 150 minutes per week and doing some type of strength training at least 2 times per week in addition to aerobic activity. However, the effects of different forms and intervals of exercise on glycemic control are not well established. Exercise increases the risk of hypoglycemia both during and several hours after exercise.
There are several strategies to avoid hypoglycemia during exercise. The most common strategy is to reduce insulin and to take carbohydrates before the exercise starts. Short-acting insulin analogs have a duration of approximately four hours, thus reductions need to be planned and done well in advance before the exercise starts. Since different types of exercise (aerobic, strength training or high intensity training) affect blood glucose in different ways and most exercise sessions include a combination of the types, these strategies are often associated with difficulties in obtaining stable blood glucose. The American Diabetes Association guidelines do not explicitly recommend a daily workout routine but outline recommendations for weekly amounts of exercise as there is currently insufficient evidence on the ideal timing, frequency and duration of exercise for preventing hypoglycemia.
Read more
Hypothesis: in people with type 1 diabetes, time in hypoglycemia can be reduced if exercise is performed daily over five consecutive days compared to the same total amount of exercise performed at 2 days with at least 2 days interval.
Aim: to evaluate the impact of the same total amount of exercise split into either five consecutive sessions or two sessions with at least 2 days in between on percentage of time spent in hypoglycemia and other glycemic parameters in people with type 1 diabetes.
Read the detailed description
The participants will go through two interventions: Exercise one session per day for five consecutive days and Exercise one session per day for two days within five days. The exercise session will start with anaerobic (push-ups, back-curls, sit-ups, triceps-dips and jumps) exercise followed by aerobic exercise (moderate intensity of running, walking or cycling). Between the two intervention periods, there will be a wash-out period.
Intervention: 'Exercise one session per day for five consecutive days'. Duration per session: Anaerobic: 4 min, Aerobic: 30 min. Sessions per intervention period: Five. Total duration per intervention period: Anaerobic: 20 min. Aerobic: 150 min. Total: 170 min
Intervention:Exercise one session per day for two days within five days. Duration per session: Anaerobe: 10 min, Aerobe: 75 min. Sessions per intervention period: 2. Total duration per intervention period: Anaerob: 20 min Aerobe: 150 min Total: 170 min
- Conditions
- Diabetes Mellitus, Type 1, Insulin Hypoglycemia
- Being tested
- "Five sessions per period" - "Two sessions per period", "Two sessions per period" - "Five sessions per period"
- Keywords
- Exercise, Insulin pump, Diabetes Mellitus, Type 1, Guidelines
- Medical subject headings
- Diabetes Mellitus, Type 1, Motor Activity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
"Five sessions per period" - "Two sessions per period"Behavioural
Period 1: 5 exercise sessions on 5 consecutive days (4 min anaerobic exercise and 30 min aerobic exercise per session)
Period 2: 2 exercise sessions within a 5-day period (10 min anaerobic exercise and 75 min aerobic exercise per session)
"Two sessions per period" - "Five sessions per period"Behavioural
Period 1: 2 exercise sessions within a 5-day period (10 min anaerobic exercise and 75 min aerobic exercise per session)
Period 2: 5 exercise sessions on 5 consecutive days (4 min anaerobic exercise and 30 min aerobic exercise per session)
| Study group | Role | What they receive |
|---|---|---|
| 1. "Five sessions per period" - "Two sessions per period" | Other | Not described Receives: Behavioral: "Five sessions per period" - "Two sessions per period" |
| 2. "Two sessions per period" - "Five sessions per period" | Other | Not described Receives: Behavioral: "Two sessions per period" - "Five sessions per period" |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of time spent in the hypoglycemic range (CGM <3.9 mmol/l)
Intention-to-treat analysis (ITT).
Measured: The primary intervention period from 06:00h study day 1 - 06:00h study day 6 (ITT)
Secondary outcomes (105)
Percentage of time spent in the hypoglycemic range (CGM <3.9 mmol/l)
Per protocol analysis (PP)
Measured: Primary intervention period from 06:00h study day 1 - 06:00h study day 6 PP
Percentage of time spent in the alert and clinical hypoglycemic range
Level 1 (alert): CGM or SMBG value of 3.0-3.9 mmol/l with or without symptoms. Level 2 (clinical): CGM or SMBG value of < 3.0 mmol/l with or without symptoms. Outcome is compared between the two intervention periods in a per protocol analysis (PP) and intention-to-treat analysis (ITT)
Measured: Study day 1: The day when the first exercise session is performed and registered.
Percentage of time spent in the alert and clinical hypoglycemic range
Level 1 (alert): CGM or SMBG value of 3.0-3.9 mmol/l with or without symptoms. Level 2 (clinical): CGM or SMBG value of < 3.0 mmol/l with or without symptoms. Outcome is also compared between the two intervention periods in a per protocol analysis (PP) and intention-to-treat analysis (ITT)
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Percentage of time spent in the alert and clinical hypoglycemic range
Level 1 (alert): CGM or SMBG value of 3.0-3.9 mmol/l with or without symptoms. Level 2 (clinical): CGM or SMBG value of < 3.0 mmol/l with or without symptoms. Outcome is also compared between the two intervention periods in a per protocol analysis (PP) and intention-to-treat analysis (ITT)
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Percentage of time spent in the alert and clinical hypoglycemic range
Level 1 (alert): CGM or SMBG value of 3.0-3.9 mmol/l with or without symptoms. Level 2 (clinical): CGM or SMBG value of < 3.0 mmol/l with or without symptoms. Outcome is also compared between the two intervention periods in a per protocol analysis (PP) and intention-to-treat analysis (ITT)
Measured: Day time: 06:00-22:00h from during study day 1 to study day 6.
Percentage of time spent in the alert and clinical hypoglycemic range
Level 1 (alert): CGM or SMBG value of 3.0-3.9 mmol/l with or without symptoms. Level 2 (clinical): CGM or SMBG value of < 3.0 mmol/l with or without symptoms. Outcome is compared between the two intervention periods in a per protocol analysis (PP) and intention-to-treat analysis (ITT)
Measured: Night time: 22:00-06:00h from during study day 1 to study day 6.
Percentage of time spent in the alert and clinical hypoglycemic range
Level 1 (alert): CGM or SMBG value of 3.0-3.9 mmol/l with or without symptoms. Level 2 (clinical): CGM or SMBG value of < 3.0 mmol/l with or without symptoms. Outcome is compared between the two intervention periods in a per protocol analysis (PP) and intention-to-treat analysis (ITT)
Measured: The time the participant has recorded start and end of exercise session during study day 1 to study day 6
Number of alert and clinical hypoglycemia events
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Number of alert and clinical hypoglycemia events
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Number of alert and clinical hypoglycemia events
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1 - study day 6
Number of alert and clinical hypoglycemia events
Per protocol analysis and intention-to-treat analysis
Measured: Night time: 22:00-06:00h during study day 1 - study day 6
Number of alert and clinical hypoglycemia events
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 study day 6
Number of severe hypoglycemia events during
Per protocol analysis and intention-to-treat analysis
Measured: Study day 1: The day when the first exercise session is performed and registered
Number of severe hypoglycemia events
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Number of severe hypoglycemia events
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Number of severe hypoglycemia events
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1 - study day 6
Number of severe hypoglycemia events
Per protocol analysis and intention-to-treat analysis
Measured: Night time: 22:00-06:00h during study day 1 - study day 6
Number of severe hypoglycemia events
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 - study day 6
Percentage of time in range (3.9-10 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Study day 1: The day when the first exercise session is performed and registered
Percentage of time in range (3.9-10 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Percentage of time in range (3.9-10 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Percentage of time in range (3.9-10 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Percentage of time in range (3.9-10 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Night time: 22:00-06:00h during study day 1 -study day 6
Percentage of time in range (3.9-10 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Percentage of time in good range (3.9-7.8 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Study day 1: The day when the first exercise session is performed and registered.
Percentage of time in good range (3.9-7.8 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Percentage of time in good range (3.9-7.8 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Percentage of time in good range (3.9-7.8 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h and Night time: 22:00-06:00h during study day 1-study day 6
Percentage of time in good range (3.9-7.8 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1-study day 6
Percentage of time in hyperglycemia (>10 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Study day 1: The day when the first exercise session is performed and registered.
Percentage of time in hyperglycemia (>10 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Percentage of time in hyperglycemia (>10 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Percentage of time in hyperglycemia (>10 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Night time: 22:00-06:00h during study day 1 -study day 6
Percentage of time in hyperglycemia (>10 mmol/l)
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1-study day 6
Percentage of time in hyperglycemia (>10 mmol/l) during all the predefined time blocks. Per protocol analysis and intention-to-treat analysis
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Glycemic variability measured as standard deviation (SD), coefficient of variation (CV) and low and high blood glucose index (LBGI/HBGI) during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Study day 1: The day when the first exercise session is performed and registered.
Glycemic variability measured as standard deviation (SD), coefficient of variation (CV) and low and high blood glucose index (LBGI/HBGI) during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Glycemic variability measured as standard deviation (SD), coefficient of variation (CV) and low and high blood glucose index (LBGI/HBGI) during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Glycemic variability measured as standard deviation (SD), coefficient of variation (CV) and low and high blood glucose index (LBGI/HBGI) during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Night time: 22:00-06:00h during study day 1 -study day 6
Glycemic variability measured as standard deviation (SD), coefficient of variation (CV) and low and high blood glucose index (LBGI/HBGI) during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Mean CGM glucose level du during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Study day 1: The day when the first exercise session is performed and registered.
Mean CGM glucose level du during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Mean CGM glucose level du during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Mean CGM glucose level du during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Mean CGM glucose level du during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Night time: 22:00-06:00h during study day 1 -study day 6
Mean CGM glucose level du during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
CGM estimated eA1c during the primary intervention period
Per protocol analysis and intention-to-treat analysis
Measured: The Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Total carbohydrate intake registered from the insulin pumps during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Study day 1: The day when the first exercise session is performed and registered.
Total carbohydrate intake registered from the insulin pumps during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Total carbohydrate intake registered from the insulin pumps during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Total carbohydrate intake registered from the insulin pumps during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Total carbohydrate intake registered from the insulin pumps during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Night time: 22:00-06:00h during study day 1 -study day 6
Total carbohydrate intake registered from the insulin pumps during all the predefined time blocks in the intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Carbohydrate interventions for prevention and treatment of hypoglycemia registered by the participants in the booklet for the primary and total intervention period
Per protocol analysis and intention-to-treat analysis c) Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Carbohydrate interventions for prevention and treatment of hypoglycemia registered by the participants in the booklet for the primary and total intervention period
Per protocol analysis and intention-to-treat analysis c) Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days)
Change in total daily insulin dose (basal and bolus insulin) of 7 days prior to screening day and during the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Change in total daily insulin dose (basal and bolus insulin) of 7 days prior to screening day and during the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Actigraph wrist wear time during all predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Actigraph wrist wear time during all predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Actigraph wrist wear time during all predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Actigraph wrist wear time during all predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Night time: 22:00-06:00h during study day 1 -study day 6
Actigraph wrist wear time during all predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Physical activity energy expenditure (accelerometer and heart rate based) measured as kcal during all predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Physical activity energy expenditure (accelerometer and heart rate based) measured as kcal during all predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Physical activity energy expenditure (accelerometer and heart rate based) measured as kcal during all predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Physical activity energy expenditure (accelerometer and heart rate based) measured as kcal during all predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Night time: 22:00-06:00h during study day 1 -study day 6
Physical activity energy expenditure (accelerometer and heart rate based) measured as kcal during all predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Metabolic expenditure rate for the primary intervention periods
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Metabolic expenditure rate for the primary intervention periods
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Number of exercise (light to vigorous) and sedentary bouts in the primary intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Number of exercise (light to vigorous) and sedentary bouts in the primary intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days)
Time in sedentary during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Time in sedentary during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Time in sedentary during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Time in sedentary during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Night time: 22:00-06:00h during study day 1 -study day 6
Time in sedentary during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Time in light physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Time in light physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Time in light physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Time in light physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Time in moderate physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Time in moderate physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Time in moderate physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Time in moderate physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Time in vigorous physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Time in vigorous physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days)
Time in vigorous physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Time in vigorous physical activity during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Number of steps during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Number of steps during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days)
Number of steps during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Day time: 06:00-22:00h during study day 1-study day 6
Number of steps during predefined time blocks
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Heart rate during exercise sessions
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
R-R intervals during exercise sessions (f)
Per protocol analysis and intention-to-treat analysis
Measured: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Sleep latency (min) during the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Sleep latency (min) during the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days)
Total sleep time (min) during the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Total sleep time (min) during the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days)
Sleep efficiency (%) during the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Sleep efficiency (%) during the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days)
Number of awakening during sleep in the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Number of awakening during sleep in the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days)
Time of awakening during sleep in the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Time of awakening during sleep in the primary and total intervention period
Per protocol analysis and intention-to-treat analysis
Measured: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days)
Question about patient preference regarding the two study arms
Per protocol analysis and intention-to-treat analysis
Measured: At the end of study. Study day 6 the last interventions period.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Sep 2019
- Study start30 Sep 2019
- Primary completion15 Oct 2020
- Study completion1 Jan 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Diabetes Mellitus, Type 1Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Model description
- An open-labelled randomized controlled crossover study will be performed. The participants will go through the following elements: 1. Screening day 2. Run-in period 3. Intervention period 4. Wash-out period 5. Intervention period
- Masking
- None (open label)
- Enrolment
- 26 participants (actual)
Sponsor and investigators
- Lead sponsor
- Steno Diabetes Center Copenhagen
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Isabelle IK Steineck, MD, Principal investigator, Steno Diabetes Center Copenhagen
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04089462
- Sponsor's protocol ID
- H-19035830
- Status last verified
- Jun 2020
- First submitted
- 5 Sep 2019
- Last updated
- 28 Sep 2021
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Data are processed and merged into at least one scientific article published in international peer-reviewed scientific journal. Positive, negative and inconclusive results will be published as soon as scientifically justifiable.
Publications
Steineck IIK, Ranjan AG, Schmidt S, Norgaard K. Time spent in hypoglycemia is comparable when the same amount of exercise is performed 5 or 2 days weekly: a randomized crossover study in people with type 1 diabetes. BMJ Open Diabetes Res Care. 2021 Jan;9(1):e001919. doi: 10.1136/bmjdrc-2020-001919.
PubMed 33509935
Study at a glance
From the registry record, last updated by the sponsor on 28 Sep 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Frequency and Duration of Exercise in People With Type 1 Diabetes - A Randomized Crossover Study
- ClinicalTrials.gov ID
- NCT04089462
- Acronym / sponsor ID
- H-19035830
- Conditions
- Diabetes Mellitus, Type 1, Insulin Hypoglycemia
- Keywords
- Exercise, Insulin pump, Diabetes Mellitus, Type 1, Guidelines
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 26 participants (actual)
- Lead sponsor
- Steno Diabetes Center CopenhagenUniversity, hospital or other
- Study start
- 30 Sep 2019 (actual)
- Primary completion
- 15 Oct 2020 (actual)
- Study completion
- 1 Jan 2021 (actual)
- First posted
- 13 Sep 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
According to the Standards of Medical Care in Diabetes by the American Diabetes Association, people with diabetes should aim for 30 minutes of moderate-to-vigorous intensity aerobic exercise at least 5 days a week or a total of 150 minutes per week and doing some type of strength training at least 2 times per week in addition to aerobic activity. However, the effects of different forms and intervals of exercise on glycemic control are not well established. Exercise increases the risk of hypoglycemia both during and several hours after exercise.
There are several strategies to avoid hypoglycemia during exercise. The most common strategy is to reduce insulin and to take carbohydrates before the exercise starts. Short-acting insulin analogs have a duration of approximately four hours, thus reductions need to be planned and done well in advance before the exercise starts. Since different types of exercise (aerobic, strength training or high intensity training) affect blood glucose in different ways and most exercise sessions include a combination of the types, these strategies are often associated with difficulties in obtaining stable blood glucose. The American Diabetes Association guidelines do not explicitly recommend a daily workout routine but outline recommendations for weekly amounts of exercise as there is currently insufficient evidence on the ideal timing, frequency and duration of exercise for preventing hypoglycemia.
Hypothesis: in people with type 1 diabetes, time in hypoglycemia can be reduced if exercise is performed daily over five consecutive days compared to the same total amount of exercise performed at 2 days with at least 2 days interval.
Aim: to evaluate the impact of the same total amount of exercise split into either five consecutive sessions or two sessions with at least 2 days in between on percentage of time spent in hypoglycemia and other glycemic parameters in people with type 1 diabetes.
Detailed description
The participants will go through two interventions: Exercise one session per day for five consecutive days and Exercise one session per day for two days within five days. The exercise session will start with anaerobic (push-ups, back-curls, sit-ups, triceps-dips and jumps) exercise followed by aerobic exercise (moderate intensity of running, walking or cycling). Between the two intervention periods, there will be a wash-out period.
Intervention: 'Exercise one session per day for five consecutive days'. Duration per session: Anaerobic: 4 min, Aerobic: 30 min. Sessions per intervention period: Five. Total duration per intervention period: Anaerobic: 20 min. Aerobic: 150 min. Total: 170 min
Intervention:Exercise one session per day for two days within five days. Duration per session: Anaerobe: 10 min, Aerobe: 75 min. Sessions per intervention period: 2. Total duration per intervention period: Anaerob: 20 min Aerobe: 150 min Total: 170 min
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- An open-labelled randomized controlled crossover study will be performed. The participants will go through the following elements: 1. Screening day 2. Run-in period 3. Intervention period 4. Wash-out period 5. Intervention period
| Arm | Type | Receives |
|---|---|---|
| 1. "Five sessions per period" - "Two sessions per period" | Other | Behavioral: "Five sessions per period" - "Two sessions per period" |
| 2. "Two sessions per period" - "Five sessions per period" | Other | Behavioral: "Two sessions per period" - "Five sessions per period" |
Who may qualify
- Ages
- 18 to 64 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Type 1 Diabetes ≥ 2 year
- Insulin pump ≥ 1 year.
- Use of carbohydrate counting and the insulin pump bolus calculator for all meals
Key exclusion criteria (10 listed)
- Use of anti-diabetic medicine (other than insulin), per oral or injected corticosteroids or other drugs affecting glucose metabolism during the intervention period or within 30 days prior to study start
- Known or suspected alcohol or drug abuse
- Other concomitant medical or psychological condition that according to the investigator's assessment makes the participant unsuitable for study participation
- Females who are pregnant, breast-feeding or intend to become pregnant or are not using adequate contraceptive methods
- Inability to understand the participants' information and to give informed consent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| "Five sessions per period" - "Two sessions per period"Period 1: 5 exercise sessions on 5 consecutive days (4 min anaerobic exercise and 30 min aerobic exercise per session) Period 2: 2 exercise sessions within a 5-day period (10 min anaerobic exercise and 75 min aerobic exercise per session) | Behavioural | 1. "Five sessions per period" - "Two sessions per period" |
| "Two sessions per period" - "Five sessions per period"Period 1: 2 exercise sessions within a 5-day period (10 min anaerobic exercise and 75 min aerobic exercise per session) Period 2: 5 exercise sessions on 5 consecutive days (4 min anaerobic exercise and 30 min aerobic exercise per session) | Behavioural | 2. "Two sessions per period" - "Five sessions per period" |
Primary outcome
Percentage of time spent in the hypoglycemic range (CGM <3.9 mmol/l)
Time frame: The primary intervention period from 06:00h study day 1 - 06:00h study day 6 (ITT)
Intention-to-treat analysis (ITT).
105 secondary outcomes
Percentage of time spent in the hypoglycemic range (CGM <3.9 mmol/l)
Time frame: Primary intervention period from 06:00h study day 1 - 06:00h study day 6 PP
Percentage of time spent in the alert and clinical hypoglycemic range
Time frame: Study day 1: The day when the first exercise session is performed and registered.
Percentage of time spent in the alert and clinical hypoglycemic range
Time frame: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Percentage of time spent in the alert and clinical hypoglycemic range
Time frame: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Percentage of time spent in the alert and clinical hypoglycemic range
Time frame: Day time: 06:00-22:00h from during study day 1 to study day 6.
Percentage of time spent in the alert and clinical hypoglycemic range
Time frame: Night time: 22:00-06:00h from during study day 1 to study day 6.
Percentage of time spent in the alert and clinical hypoglycemic range
Time frame: The time the participant has recorded start and end of exercise session during study day 1 to study day 6
Number of alert and clinical hypoglycemia events
Time frame: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Number of alert and clinical hypoglycemia events
Time frame: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Number of alert and clinical hypoglycemia events
Time frame: Day time: 06:00-22:00h during study day 1 - study day 6
Number of alert and clinical hypoglycemia events
Time frame: Night time: 22:00-06:00h during study day 1 - study day 6
Number of alert and clinical hypoglycemia events
Time frame: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 study day 6
Number of severe hypoglycemia events during
Time frame: Study day 1: The day when the first exercise session is performed and registered
Number of severe hypoglycemia events
Time frame: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Number of severe hypoglycemia events
Time frame: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Number of severe hypoglycemia events
Time frame: Day time: 06:00-22:00h during study day 1 - study day 6
Number of severe hypoglycemia events
Time frame: Night time: 22:00-06:00h during study day 1 - study day 6
Number of severe hypoglycemia events
Time frame: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 - study day 6
Percentage of time in range (3.9-10 mmol/l)
Time frame: Study day 1: The day when the first exercise session is performed and registered
Percentage of time in range (3.9-10 mmol/l)
Time frame: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Percentage of time in range (3.9-10 mmol/l)
Time frame: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Percentage of time in range (3.9-10 mmol/l)
Time frame: Day time: 06:00-22:00h during study day 1-study day 6
Percentage of time in range (3.9-10 mmol/l)
Time frame: Night time: 22:00-06:00h during study day 1 -study day 6
Percentage of time in range (3.9-10 mmol/l)
Time frame: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Percentage of time in good range (3.9-7.8 mmol/l)
Time frame: Study day 1: The day when the first exercise session is performed and registered.
Percentage of time in good range (3.9-7.8 mmol/l)
Time frame: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Percentage of time in good range (3.9-7.8 mmol/l)
Time frame: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Percentage of time in good range (3.9-7.8 mmol/l)
Time frame: Day time: 06:00-22:00h and Night time: 22:00-06:00h during study day 1-study day 6
Percentage of time in good range (3.9-7.8 mmol/l)
Time frame: Exercise time: The time the participant has recorded start and end of exercise session during study day 1-study day 6
Percentage of time in hyperglycemia (>10 mmol/l)
Time frame: Study day 1: The day when the first exercise session is performed and registered.
Percentage of time in hyperglycemia (>10 mmol/l)
Time frame: Secondary intervention period: 08:00h day 1 - 08:00h day 8 (= 7 x 24-hour days).
Percentage of time in hyperglycemia (>10 mmol/l)
Time frame: Day time: 06:00-22:00h during study day 1-study day 6
Percentage of time in hyperglycemia (>10 mmol/l)
Time frame: Night time: 22:00-06:00h during study day 1 -study day 6
Percentage of time in hyperglycemia (>10 mmol/l)
Time frame: Exercise time: The time the participant has recorded start and end of exercise session during study day 1-study day 6
Percentage of time in hyperglycemia (>10 mmol/l) during all the predefined time blocks. Per protocol analysis and intention-to-treat analysis
Time frame: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Glycemic variability measured as standard deviation (SD), coefficient of variation (CV) and low and high blood glucose index (LBGI/HBGI) during all the predefined time blocks in the intervention period
Time frame: Study day 1: The day when the first exercise session is performed and registered.
Glycemic variability measured as standard deviation (SD), coefficient of variation (CV) and low and high blood glucose index (LBGI/HBGI) during all the predefined time blocks in the intervention period
Time frame: Primary intervention period: 06:00h study day 1 - 06:00h study day 6 (= 5 x 24-hour days)
Glycemic variability measured as standard deviation (SD), coefficient of variation (CV) and low and high blood glucose index (LBGI/HBGI) during all the predefined time blocks in the intervention period
Time frame: Day time: 06:00-22:00h during study day 1-study day 6
Glycemic variability measured as standard deviation (SD), coefficient of variation (CV) and low and high blood glucose index (LBGI/HBGI) during all the predefined time blocks in the intervention period
Time frame: Night time: 22:00-06:00h during study day 1 -study day 6
Glycemic variability measured as standard deviation (SD), coefficient of variation (CV) and low and high blood glucose index (LBGI/HBGI) during all the predefined time blocks in the intervention period
Time frame: Exercise time: The time the participant has recorded start and end of exercise session during study day 1 -study day 6
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Sep 2021.
- Derived from this study: PubMed 33509935Steineck IIK, Ranjan AG, Schmidt S, Norgaard K. Time spent in hypoglycemia is comparable when the same amount of exercise is performed 5 or 2 days weekly: a randomized crossover study in people with type 1 diabetes. BMJ Open Diabetes Res Care. 2021 Jan;9(1):e001919. doi: 10.1136/bmjdrc-2020-001919.
- Individual participant dataSharing planned: Yes. Data are processed and merged into at least one scientific article published in international peer-reviewed scientific journal. Positive, negative and inconclusive results will be published as soon as scientifically justifiable.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Isabelle IK Steineck, MD principal investigator
Steno Diabetes Center Copenhagen
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing "Five sessions per period" - "Two sessions per period" and "Two sessions per period" - "Five sessions per period" in people with Diabetes Mellitus, Type 1 and Insulin Hypoglycemia, run by Steno Diabetes Center Copenhagen at 1 site in Denmark.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 28 Sep 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percentage of time spent in the hypoglycemic range (CGM <3.9 mmol/l) (time frame: The primary intervention period from 06:00h study day 1 - 06:00h study day 6 (ITT)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04089462, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Sep 2021.