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Prediabetic StateTIMEDNCT05123963

Restoring 24-hour Substrate Rhythmicity to Improve Glycemic Control by Timing of Lifestyle Factors

A study testing High-intensity interval training in people with Prediabetic State, run by Université de Sherbrooke at 1 site in Canada.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Exercise is well-known to improve skeletal muscle energy metabolism and is an established intervention to improve muscle insulin sensitivity and to counter the development of type 2 diabetes (T2D). Read more about this study

Who is it for?
Ages 45 to 75 years
Conditions the study is for
Prediabetic State
What is being tested?
High-intensity interval training
Could I receive a placebo?
No, everyone receives an active treatment
How many people
48 participants
Where
1 siteCanada
Study dates
15 Sep 2021to 30 Dec 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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 45 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Pre-diabetes:
  • Fasting plasma glucose: 6.1 to 6.9 mmol/L or
  • 2-hour plasma glucose post 75g OGTT: 7.8 to 11.0 mmol/L and
  • HbA1c: 6.0 to 6.4%
  • or Insulin resistant: glucose clearance rate ≤ 360 ml/kg/min as determined using the Oral Glucose Insulin Sensitivity Index at Time 120 min.
  • BMI > 25 kg/m2
  • To be willing and able to adhere to the specifications of the protocol;
  • To have signed an informed consent document indicating that they understood the purpose of and procedures required for the study and were willing to participate in the study.

Who cannot join

  • overt cardiovascular disease as assessed by medical history, physical exam, and abnormal ECG
  • Treatment with any drug known to affect lipid or carbohydrate metabolism, except statins (to be stopped 3 weeks prior to study A), metformin or anti-hypertensive drugs (to be stopped 7 days prior to the studies);
  • presence of liver or renal disease other than uncomplicated NASH or mild isolated proteinuria; uncontrolled thyroid disorder;
  • Uncontrolled severe hypertension, systolic pressure ≥ 180 mm Hg or diastolic pressure ≥ 110 mm Hg;
  • History of ischemic heart disease, tachyarrhythmia, QT interval prolongation, risk factors for torsade de pointes (eg hypokalemia), or taking any medication known to prolong the QT interval;
  • History of serious gastrointestinal disorders (malabsorption, peptic ulcer, gastroesophageal reflux requiring surgery, etc.);
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  • Presence of a pacemaker;
  • Having undergone a PET study or CT scan in the past year;
  • Any contraindication to stopping statins for 3 months and stopping an anti-hypertensive medication and metformin for 7 days;
  • smoking (>1 cigarette/day) and/or consumption of >2 alcoholic beverages per day;
  • No blood donation two month prior the study;
  • prior history or current fasting plasma cholesterol level > 7 mmol/l or fasting TG > 6 mmol/l.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Canada1 site, 1 recruiting
  • Centre de recherche du CHUS

    Sherbrooke, Quebec, J1H 5N4

    Frédérique Frisch, 819-346-1110, frederique.frisch@usherbrooke.ca

    Denis Blondin

    Recruiting

Other trials in Canada

About this study

Exercise is well-known to improve skeletal muscle energy metabolism and is an established intervention to improve muscle insulin sensitivity and to counter the development of type 2 diabetes (T2D). However, given the 24h rhythmicity in substrate metabolism previously observed in healthy, lean men and the lack of such rhythmicity in men with insulin-resistance, the investigator hypothesize that appropriate timing of exercise training can maximize the metabolic health effects of exercise. Indeed, a preliminary study in humans revealed that afternoon high-intensity interval training (HIIT) exercise was more effective than morning exercise in improving 24h blood glucose levels in men with T2D. Another recent study in mice showed that the time of day is a critical factor in augmenting the beneficial effects of exercise on the skeletal muscle metabolome as well as on whole-body energy homeostasis. However, human studies that specifically target the impact of timing of exercise training on glucose homeostasis and metabolic health are scarce and the potential underlying mechanisms largely unknown.

The overarching goals of this project is to improve 24-hour rhythmicity of metabolism in men and women with prediabtes by appropriate timing of exercise and to assess its effect on metabolic health and immune response. Acute and prolonged exercise interventions timed in the morning vs late afternoon will be carried out in individuals with prediabetes to determine whether acute exercise in the afternoon and prolonged exercise training in the afternoon can improve peripheral insulin sensitivity, compared to exercise in the morning, and positively affect adipose tissue dietary fatty acid storage and partitioning of dietary fatty acids in skeletal muscles.

Read the detailed description

Three metabolic studies A, B and C using PET imaging will be carried out at the CRCHUS. The 12-week exercise training intervention will consist of supervised cycling high-intensity interval training (i.e. short bouts of high-intensity exercise interspersed with short periods of rest) every other day at the CRCHUS. Continuous glucose monitoring will be used to measure 24h glucose profiles over 3-4 days prior to and following the acute exercise bout and again during the last week of the intervention. Continuous blood pressure monitoring will be used over 18-24 h, at the beginning and at the end of the 12 week-training.

Participants will take part in three postprandial metabolic studies: 1) before (A); 2) 18-24h after an acute exercise bout (B), and; 3) after 12-weeks of exercise training (C). Experiments will be conducted between 07:30 AM and 5:00 PM, following a 12 hr fast. Adipose tissue dietary fatty acid storage and partitioning of dietary fatty acids in skeletal muscles will be measured by the oral [18F-]-FTHA PET method. Changes in lean tissue mitochondrial function in vivo will be determined using magnetic resonance spectroscopy (MRS). Participants will complete Visit A (baseline), followed 7 to 14-days later by a pre-breakfast (9 AM) or pre-dinner (4PM) exhaustive glycogen lowering exercise bout. The following day (18-24h after the exercise bout), participants will return for a second metabolic visit (Visit B). Participants will then begin a 12-week supervised high-intensity interval training program, performed either only in the morning or only in the afternoon (9 AM vs. 4 PM), on every other day. At the end of the 12 weeks, and at least 48h after the last exercise bout, participants will return for their final metabolic visit (Visit C).

Being tested
High-intensity interval training
Keywords
Postprandial metabolism, High-intensity interval training
Medical subject headings
Prediabetic State

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • High-intensity interval trainingBehavioural

    3 times per week high-intensity interval training (HIIT) on a cycle ergometer for 12 weeks.

Study groups in NCT05123963
Study groupRoleWhat they receive
Morning exerciseActive comparatorParticipant to perform high-intensity interval training in the morning (~9 am)
Receives: Behavioral: High-intensity interval training
Afternoon exerciseExperimentalParticipant to perform high-intensity interval training in the morning (~4 pm)
Receives: Behavioral: High-intensity interval training

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Adipose tissue dietary fatty acid (DFA) partitioning

    Determined using oral administration of [18F]-Fluoro-6-Thia-Heptadecanoic Acid (FTHA) during whole-body acquisition

    Measured: Measured 180 minutes, 240 minutes, 300 minutes and 360 minutes after liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  2. Change in lean organ (heart, liver, skeletal muscle) DFA partitioning

    Determined using oral administration of [18F]-Fluoro-6-Thia-Heptadecanoic Acid (FTHA) during whole-body acquisition

    Measured: Measured 180 minutes, 240 minutes, 300 minutes and 360 minutes after liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  3. Change in skeletal muscle ATP fluxes in vivo

    Determined using phosphorus-31 magnetic resonance spectroscopy.

    Measured: Measured 170 minutes before and 30 minutes following liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  4. Change in glucose control.

    Determined using continuous glucose monitoring and repeated blood samples obtained during metabolic visit.

    Measured: Measured continuously 2-3 days before and 2-3 days after first and final exercise session, after 12-week exercise intervention.

Secondary outcomes (11)
  1. Change in adipose tissue nonesterified fatty acid (NEFA) metabolism.

    Determined using [11C]-palmitate with dynamic PET acquisition

    Measured: Measured 150 minutes before and 60 minutes following liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  2. Change in lean organ (heart, liver, skeletal muscle) NEFA metabolism.

    Determined using [11C]-palmitate with dynamic PET acquisition

    Measured: Measured 150 minutes before and 60 minutes following liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  3. Change in insulin sensitivity

    Determined by measuring circulating glucose, NEFA, insulin and C-peptide following the liquid meal.

    Measured: Measured every 60 minutes following liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  4. Change in dietary fatty acid oxidation

    Determined by measuring breath [13C]-carbon dioxide enrichment.

    Measured: Measured every 60 minutes following liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  5. Change in total substrate utilisation

    Determined using indirect calorimetry

    Measured: Measured every 60 minutes following liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  6. Change in postprandial plasma NEFA turnover.

    Determined using continuous infusion of [7,7,8,8-2H]-palmitate.

    Measured: Blood sample collected every 60 min following liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  7. Change in postprandial plasma glucose turnover

    Determined using continuous infusion of [1-3H]-glucose

    Measured: Blood sample collected every 60 minutes following liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  8. Change in left ventricular function by Positron Emitting Positron (PET) ventriculography

    Determined using [11C]-palmitate combined with ECG-gated cardiac dynamic PET acquisition.

    Measured: Measured 150 minutes before and 60 minutes following liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  9. Change in plasma distribution of DFA metabolites

    Determined using oral administration of [18F]-FTHA to quantify the incorporation of 18F-labeled fatty acids given with the liquid meal, into triglyceride-rich lipoproteins and NEFA.

    Measured: Blood sample collected every 60 minutes following liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  10. Change in composition and activation status of immune cell subsets

    Determined by extensive Fluorescence Activated cell Sorting (FACS) analysis

    Measured: Blood sample collected before and after liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

  11. Change in plasma cytokine levels

    Determined by ELISA

    Measured: Blood sample collected before and after liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Nov 2021
  2. Study start15 Sep 2021
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion30 Dec 2027 (estimated)

Resources

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
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Two randomized groups in parallel (Exercise training in the morning versus exercise training in the evening). In each group, the protocol will be carried out as a within-subject in which each subject will serve as his/her own control (before/after acute or prolonged exercise).
Masking
None (open label)
Enrolment
48 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05123963
Sponsor's protocol ID
MP-31-2021-4011
Acronym
TIMED
Status last verified
Jul 2025
First submitted
14 Oct 2021
Last updated
11 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing High-intensity interval training in people with Prediabetic State, run by Université de Sherbrooke at 1 site in Canada.

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 8 inclusion and 12 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: looking for participants now, as of the sponsor's last update on 11 May 2026. 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 Canada. 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Frédérique Frisch (819-346-1110 ext. 12394, frederique.frisch@usherbrooke.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Adipose tissue dietary fatty acid (DFA) partitioning (time frame: Measured 180 minutes, 240 minutes, 300 minutes and 360 minutes after liquid meal at baseline visit, 18-24hours after acute exercise bout and >48hours after final exercise bout (after 12 week intervention).). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 11 May 2026.

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