Type 1 DiabetesNCT07859943
Inspiratory Muscle Strength Training in Adults With Type 1 Diabetes
A study testing High-Resistance Inspiratory Muscle Strength Training in people with Type 1 Diabetes, run by Florida State University at 2 sites in United States.
Trial summary
Adults with type 1 diabetes have elevated cardiovascular disease risk, and systolic blood pressure is a leading modifiable contributor to that risk. Aerobic exercise lowers blood pressure but poses time and glycemic-management barriers for people with type 1 diabetes. Read more about this study
- Who is it for?
- Ages 18 to 35 years
- Conditions the study is for
- Type 1 Diabetes
- What is being tested?
- High-Resistance Inspiratory Muscle Strength Training
- Type of treatment
- Medical device
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 30 participants
- Where
- 2 sitesUnited States
- Study dates
- 1 Jan 2027to 1 Oct 2028
- 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 18 to 35 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age 18 to 35 years
- Type 1 diabetes diagnosed more than 1 year before screening
- Hemoglobin A1c (HbA1c) 10.0% or less within the last 3 months (may be measured at screening)- Body mass index 18 to 29.9 kg/m^2
- Stable insulin delivery method for the past 30 days
- Ability to read all device instructions and insulin pump settings
- Estimated glomerular filtration rate at least 60 mL/min/1.73 m^2 within the last 3 months (may be measured at screening)
- Use of an insulin pump or insulin delivery by multiple daily injections
- Attendance at 3 or more diabetes care visits over the past 12 months
Who cannot join
- Diabetes-related hospitalization, including for diabetic ketoacidosis or severe hypoglycemia, within 12 months of screening
- Poorly controlled hypertension, defined as systolic blood pressure at least 140 mmHg or diastolic blood pressure at least 90 mmHg
- Taking diabetes medications other than insulin
- Structured exercise more than 150 minutes per week for the last 3 months
- Pregnant, lactating, or planning to become pregnant within the study period
- Unstable weight, defined as more than 5% change in the last 3 months
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- Significant organ system dysfunction, such as severe pulmonary, renal, hepatic, or cardiovascular disease
- Diagnosed anemia or known hemoglobin less than 10 g/dL
- Diagnosed neuropathic or psychiatric illness
- Active nicotine or illegal drug use
- Alcohol consumption totaling more than 10 standard drinks per week
- Unable to grant voluntary informed consent
- Unable or unwilling to follow the study protocol
- Per the POWERbreathe device user manual: history of spontaneous pneumothorax; a collapsed lung that has not fully healed; a pacemaker or medical implant containing magnets or electronics; any condition of the eardrum, such as a burst eardrum that has not fully healed
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
United States2 sites
Cardiovascular and Applied Physiology Laboratory
Tallahassee, Florida, 32306
Joseph Watso, PhD, 8506441281, jwatso@fsu.edu
Florida State University
Tallahassee, Florida, 32306
About this study
Official title: Time-Efficient Inspiratory Muscle Strength Training as a New Approach to Improve Cardiovascular Function Among Adults With Type 1 Diabetes
Adults with type 1 diabetes have elevated cardiovascular disease risk, and systolic blood pressure is a leading modifiable contributor to that risk. Aerobic exercise lowers blood pressure but poses time and glycemic-management barriers for people with type 1 diabetes. Inspiratory muscle strength training is a brief, home-based, device-based intervention that takes about five minutes per day and has lowered systolic blood pressure in other adult populations.
This pilot trial will test whether eight weeks of daily high-resistance inspiratory muscle strength training lowers blood pressure and improves vascular function in adults with type 1 diabetes. Participants will be randomized 2:1 to high-resistance or very-low-resistance sham training using a POWERbreathe K3 device and will complete 30 training breaths per day at home for eight weeks. Outcomes are assessed before and after the training period.
Read the detailed description
Approximately two million Americans live with type 1 diabetes, and cardiovascular disease is the leading cause of death in this population. After glycemic control, systolic blood pressure is the leading modifiable cardiovascular risk factor. Traditional aerobic exercise lowers blood pressure and improves vascular function, but most adults with type 1 diabetes do not meet physical activity recommendations, citing time constraints and concern about exercise-associated hypoglycemia.
Inspiratory muscle strength training (IMST) requires about five minutes per day, is performed seated at home with a commercially available handheld device, and is unlikely to provoke hypoglycemia. A retrospective analysis of five independent trials in 128 adults reported a 9 mmHg reduction in casual systolic blood pressure following high-resistance IMST compared with sham training, with effects that appear consistent across age, sex, health status, and baseline blood pressure. No study has examined IMST in people with type 1 diabetes.
Participants are randomized in a 2:1 ratio to high-resistance IMST or very-low-resistance sham IMST. Randomization uses a computer-generated sequence held by an unmasked team member who is responsible only for setting device resistance; participants, investigators, and outcome assessors remain masked to group assignment. All participants complete approximately 56 daily training sessions over eight weeks, each consisting of five bouts of six forceful inhalations with about 30 seconds of rest between bouts.
Maximal inspiratory pressure is measured at weeks 0, 2, 4, 6, and 8. For the high-resistance group, device resistance is set to a graded percentage of the participant's current maximal inspiratory pressure: 55% during weeks 1-2, 65% during weeks 3-4, and 75% during weeks 5-8. The sham group trains at 15% of maximal inspiratory pressure throughout. Participants are debriefed on their group assignment at the end of the post-training visit.
Testing visits at week 0 and week 8 include laboratory blood pressure, brachial artery flow-mediated dilation and post-occlusion reactive hyperemia by high-resolution ultrasound, central blood pressure and arterial stiffness by applanation tonometry, and isometric handgrip exercise testing with post-exercise circulatory occlusion. Participants measure their blood pressure at home once weekly on a provided automated monitor during weeks without a laboratory visit. Brief check-in contacts occur on odd weeks and device adjustment visits on even weeks. An optional follow-up visit repeating all assessments is offered at week 12.
- Conditions
- Type 1 Diabetes
- Being tested
- High-Resistance Inspiratory Muscle Strength Training, Sham Inspiratory Muscle Strength Training
- Keywords
- inspiratory muscle strength training, respiratory muscle training, blood pressure, hypertension, vascular function, flow-mediated dilation, arterial stiffness, type 1 diabetes
- Medical subject headings
- Diabetes Mellitus, Type 1, Hypertension
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
High-Resistance Inspiratory Muscle Strength TrainingDevice
Daily home-based inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks, at 55% of maximal inspiratory pressure during weeks 1-2, 65% during weeks 3-4, and 75% during weeks 5-8. Maximal inspiratory pressure is re-measured at weeks 0, 2, 4, 6, and 8 and resistance is adjusted accordingly.
Sham Inspiratory Muscle Strength TrainingDevice
Daily home-based inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks, at 15% of maximal inspiratory pressure throughout.
| Study group | Role | What they receive |
|---|---|---|
| High-Resistance Inspiratory Muscle Strength Training | Experimental | Participants complete daily inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks. Each session consists of five bouts of six forceful inhalations against resistance, with approximately 30 seconds of rest between bouts, for 30 training breaths per day. Resistance is set to a graded percentage of the participant's current maximal inspiratory pressure: 55% during weeks 1-2, 65% during weeks 3-4, and 75% during weeks 5-8. Receives: Device: High-Resistance Inspiratory Muscle Strength Training |
| Sham Inspiratory Muscle Strength Training | Sham comparator | Participants complete daily inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks. Each session consists of five bouts of six forceful inhalations against resistance, with approximately 30 seconds of rest between bouts, for 30 training breaths per day. Resistance is set to 15% of the participant's maximal inspiratory pressure throughout the eight weeks. Receives: Device: Sham Inspiratory Muscle Strength Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change From Baseline in Laboratory-Measured Seated Systolic Blood Pressure at 8 Weeks
Seated brachial systolic blood pressure measured in the laboratory with an automated oscillometric monitor after a period of quiet rest. This is the powered primary outcome.
Measured: Baseline and 8 weeks
Secondary outcomes (1)
Change From Baseline in Home Systolic Blood Pressure at 8 Weeks
Self-measured seated brachial systolic blood pressure recorded at home once weekly on a provided automated monitor, following American Heart Association home-monitoring recommendations.
Measured: Baseline and 8 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Oct 2026
- Study start1 Jan 2027 (estimated)
- Primary completion1 Sep 2028 (estimated)
- Study completion1 Oct 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Type 1 DiabetesStudies of the same condition, open and under way.
- More trials run by Florida State UniversityThe sponsor's other registered studies.
- 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
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Participants are randomized 2:1 to high-resistance or sham inspiratory muscle strength training for eight weeks.
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 30 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Florida State University
- Sponsor type
- University, hospital or other
- Collaborators
- National Heart, Lung, and Blood Institute (NHLBI)
- Responsible party
- Principal investigator, Joseph Watso, Florida State University
- Investigators
- Joseph C Watso, Principal investigator, Florida State University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07859943
- Sponsor's protocol ID
- STUDY00007503
- Other IDs
- R03HL183276
- Status last verified
- Oct 2026
- First submitted
- 30 Sep 2026
- Last updated
- 8 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- Yes: De-identified individual participant-level data (IPD) that correspond directly to the key outcomes reported in peer-reviewed publications will be preserved and shared.
Study at a glance
From the registry record, last updated by the sponsor on 8 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Time-Efficient Inspiratory Muscle Strength Training as a New Approach to Improve Cardiovascular Function Among Adults With Type 1 Diabetes
- ClinicalTrials.gov ID
- NCT07859943
- Acronym / sponsor ID
- STUDY00007503
- Conditions
- Type 1 Diabetes
- Keywords
- inspiratory muscle strength training, respiratory muscle training, blood pressure, hypertension, vascular function, flow-mediated dilation, arterial stiffness, type 1 diabetes
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 30 participants (estimated)
- Lead sponsor
- Florida State UniversityUniversity, hospital or other
- Collaborators
- National Heart, Lung, and Blood Institute (NHLBI)
- Study start
- 1 Jan 2027 (estimated)
- Primary completion
- 1 Sep 2028 (estimated)
- Study completion
- 1 Oct 2028 (estimated)
- First posted
- 6 Oct 2026 (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.
Adults with type 1 diabetes have elevated cardiovascular disease risk, and systolic blood pressure is a leading modifiable contributor to that risk. Aerobic exercise lowers blood pressure but poses time and glycemic-management barriers for people with type 1 diabetes. Inspiratory muscle strength training is a brief, home-based, device-based intervention that takes about five minutes per day and has lowered systolic blood pressure in other adult populations.
This pilot trial will test whether eight weeks of daily high-resistance inspiratory muscle strength training lowers blood pressure and improves vascular function in adults with type 1 diabetes. Participants will be randomized 2:1 to high-resistance or very-low-resistance sham training using a POWERbreathe K3 device and will complete 30 training breaths per day at home for eight weeks. Outcomes are assessed before and after the training period.
Detailed description
Approximately two million Americans live with type 1 diabetes, and cardiovascular disease is the leading cause of death in this population. After glycemic control, systolic blood pressure is the leading modifiable cardiovascular risk factor. Traditional aerobic exercise lowers blood pressure and improves vascular function, but most adults with type 1 diabetes do not meet physical activity recommendations, citing time constraints and concern about exercise-associated hypoglycemia.
Inspiratory muscle strength training (IMST) requires about five minutes per day, is performed seated at home with a commercially available handheld device, and is unlikely to provoke hypoglycemia. A retrospective analysis of five independent trials in 128 adults reported a 9 mmHg reduction in casual systolic blood pressure following high-resistance IMST compared with sham training, with effects that appear consistent across age, sex, health status, and baseline blood pressure. No study has examined IMST in people with type 1 diabetes.
Participants are randomized in a 2:1 ratio to high-resistance IMST or very-low-resistance sham IMST. Randomization uses a computer-generated sequence held by an unmasked team member who is responsible only for setting device resistance; participants, investigators, and outcome assessors remain masked to group assignment. All participants complete approximately 56 daily training sessions over eight weeks, each consisting of five bouts of six forceful inhalations with about 30 seconds of rest between bouts.
Maximal inspiratory pressure is measured at weeks 0, 2, 4, 6, and 8. For the high-resistance group, device resistance is set to a graded percentage of the participant's current maximal inspiratory pressure: 55% during weeks 1-2, 65% during weeks 3-4, and 75% during weeks 5-8. The sham group trains at 15% of maximal inspiratory pressure throughout. Participants are debriefed on their group assignment at the end of the post-training visit.
Testing visits at week 0 and week 8 include laboratory blood pressure, brachial artery flow-mediated dilation and post-occlusion reactive hyperemia by high-resolution ultrasound, central blood pressure and arterial stiffness by applanation tonometry, and isometric handgrip exercise testing with post-exercise circulatory occlusion. Participants measure their blood pressure at home once weekly on a provided automated monitor during weeks without a laboratory visit. Brief check-in contacts occur on odd weeks and device adjustment visits on even weeks. An optional follow-up visit repeating all assessments is offered at week 12.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- Participants are randomized 2:1 to high-resistance or sham inspiratory muscle strength training for eight weeks.
| Arm | Type | Receives |
|---|---|---|
| High-Resistance Inspiratory Muscle Strength Training | Experimental | Device: High-Resistance Inspiratory Muscle Strength TrainingParticipants complete daily inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks. Each session consists of five bouts of six forceful inhalations against resistance, with approximately 30 seconds of rest between bouts, for 30 training breaths per day. Resistance is set to a graded percentage of the participant's current maximal inspiratory pressure: 55% during weeks 1-2, 65% during weeks 3-4, and 75% during weeks 5-8. |
| Sham Inspiratory Muscle Strength Training | Sham comparator | Device: Sham Inspiratory Muscle Strength TrainingParticipants complete daily inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks. Each session consists of five bouts of six forceful inhalations against resistance, with approximately 30 seconds of rest between bouts, for 30 training breaths per day. Resistance is set to 15% of the participant's maximal inspiratory pressure throughout the eight weeks. |
Who may qualify
- Ages
- 18 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (8 listed)
- Age 18 to 35 years
- Type 1 diabetes diagnosed more than 1 year before screening
- Hemoglobin A1c (HbA1c) 10.0% or less within the last 3 months (may be measured at screening)- Body mass index 18 to 29.9 kg/m^2
- Stable insulin delivery method for the past 30 days
- Ability to read all device instructions and insulin pump settings
Key exclusion criteria (14 listed)
- Diabetes-related hospitalization, including for diabetic ketoacidosis or severe hypoglycemia, within 12 months of screening
- Poorly controlled hypertension, defined as systolic blood pressure at least 140 mmHg or diastolic blood pressure at least 90 mmHg
- Taking diabetes medications other than insulin
- Structured exercise more than 150 minutes per week for the last 3 months
- Pregnant, lactating, or planning to become pregnant within the study period
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 |
|---|---|---|
| High-Resistance Inspiratory Muscle Strength TrainingDaily home-based inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks, at 55% of maximal inspiratory pressure during weeks 1-2, 65% during weeks 3-4, and 75% during weeks 5-8. Maximal inspiratory pressure is re-measured at weeks 0, 2, 4, 6, and 8 and resistance is adjusted accordingly. | Device | High-Resistance Inspiratory Muscle Strength Training |
| Sham Inspiratory Muscle Strength TrainingDaily home-based inspiratory muscle strength training using a POWERbreathe K3 device for eight weeks, at 15% of maximal inspiratory pressure throughout. | Device | Sham Inspiratory Muscle Strength Training |
Primary outcome
Change From Baseline in Laboratory-Measured Seated Systolic Blood Pressure at 8 Weeks
Time frame: Baseline and 8 weeks
Seated brachial systolic blood pressure measured in the laboratory with an automated oscillometric monitor after a period of quiet rest. This is the powered primary outcome.
1 secondary outcome
Change From Baseline in Home Systolic Blood Pressure at 8 Weeks
Time frame: Baseline and 8 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 Oct 2026.
- Individual participant dataSharing planned: Yes. De-identified individual participant-level data (IPD) that correspond directly to the key outcomes reported in peer-reviewed publications will be preserved and shared.
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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.
Joseph C Watso principal investigator
Florida State University
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing High-Resistance Inspiratory Muscle Strength Training in people with Type 1 Diabetes, run by Florida State University at 2 sites in United States.
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 14 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: opening soon, as of the sponsor's last update on 8 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in United States. 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. Some participants in this study may receive a placebo. 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 Jonathan Hoch (8506441281, chhs-cap@fsu.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change From Baseline in Laboratory-Measured Seated Systolic Blood Pressure at 8 Weeks (time frame: Baseline and 8 weeks). 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 8 Oct 2026.