Status:
COMPLETED
Improving Neuropathy and Mobility in People With Early Diabetes
Lead Sponsor:
VA Office of Research and Development
Collaborating Sponsors:
University of Maryland, College Park
University of Michigan
Conditions:
Diabetes
Physical Activity
Eligibility:
All Genders
30-80 years
Phase:
NA
Brief Summary
The purpose of this study is to determine if an individually tailored diet and physical enhancement program can improve mobility, physical activity, and neuropathy in people with early diabetes.
Detailed Description
Neuropathy is the most common complication of diabetes mellitus. Impaired glucose regulation (IGR) is associated with development of peripheral neuropathy coupled with gait and mobility impairment tha...
Eligibility Criteria
Inclusion
- IGR at the time of screening or within three months of screening. This definition includes patients with impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and early diabetes. Patients can be included if they have an increased risk for diabetes with a HBA1C \> or = 5.7% (using a method certified by the National Glycohemoglobin Standardization Program), or they have diabetes with a HBA1C \> or equal to 6.5%, or an abnormal fasting venous glucose, or abnormal venous glucose values following a 75 gram oral load. Glucose values are as defined (mg/dl): IFG fasting greater than 100 mg/dl, IGT- fasting less than 126, 2 h 140-199, or diabetes - fasting glucose \> 126, 2 h \> 200 based on the Standards for Medical Care in Diabetes 2010 by the American Diabetes Association.
- The HbA1c may be normal, but must be \<8%.
- If diabetic subjects are on medication, they should be stable on medication for at least 3 months prior to entering the study. Addition or change in antidiabetic medications after enrollment does not affect participation or group assignment.
- No risk factors for other causes for neuropathy (determined by a medical history, family history, history of medications, occupational history, history of exposure to toxins, physical and neurological examinations, and laboratory studies).
- Clinical signs or symptoms of neuropathy as determined by the treating neurologists history and physical exam, plus an abnormality of one of the following: nerve conduction studies (NCS), Quantitative Sudomotor Autonomic Reflex Testing (QSART), Quantitative Sensory Testing (QST), or IENFD.
- Age range from 30 to 80 years inclusive at the time of screening
- Medically stable at the time of enrollment.
- Able to participate in a standing exercise program without constant standby monitoring.
- Women of childbearing potential must be using an acceptable method of contraception to prevent pregnancy when they are enrolled in the study and must agree to continue to practice an acceptable method of contraception for the duration of their participation in the study.
- Patient must agree to taking an alternative medication to coumadin when undergoing a skin biopsy
- Willing to complete weekly self-report questionnaires.
- Willing to accept assignment to either training group.
- Willing and able to increase activity level and exercise independently at home.
Exclusion
- Pregnant women, prisoners, institutionalized subjects and other at risk subjects will not be included in this study.
- Taking insulin.
- Etiology of sensorimotor neuropathy other than IGR based on careful clinical and laboratory evaluation.
- Current severe medical conditions that are active on the day of enrollment and would affect a patient's ability to complete study. This may include active advanced current ischemic heart disease (e.g., angina or congestive heart failure), permanent residual lower extremity weakness or loss of balance resulting from a stroke, active severe obstructive or restrictive pulmonary disease, ongoing cancer treatment, renal failure currently requiring dialysis, or severe ongoing peripheral vascular disease.
- An inability to understand or cooperate with the procedures of the trial or refusal to sign the informed consent.
- Patients who are unable to answer questions correctly on the Evaluation to Sign Consent (ESC) tool.
- Significant other neurologic, rheumatological, neuromuscular, or other extremity conditions that limit safe exercise or weight bearing.
Key Trial Info
Start Date :
November 1 2009
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
February 8 2018
Estimated Enrollment :
72 Patients enrolled
Trial Details
Trial ID
NCT00780559
Start Date
November 1 2009
End Date
February 8 2018
Last Update
April 9 2021
Active Locations (3)
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1
University of Maryland
Baltimore, Maryland, United States, 20742
2
Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MD
Baltimore, Maryland, United States, 21201
3
VA Ann Arbor Healthcare System, Ann Arbor, MI
Ann Arbor, Michigan, United States, 48105