Lifestyle and Glucose Lowering Medication in T2DM

Rigshospitalet

Status: Completed

Conditions: Diabetes Mellitus, Type 2

Treatments: Behavioral: Standard care; Behavioral: U-TURN

Study type: Interventional

Funder types: Other

Identifiers

NCT02417012

U-TURN

Details and patient eligibility

About

This study evaluates the effect of a lifestyle intervention maintenance of glycemic control while reducing glucose lowering drugs in patients with type 2 diabetes mellitus. The intervention group receives an intensive lifestyle intervention including exercise and diet lifestyle modifications. The reference group receives diabetes educational advice. Both groups will have their pharmacological treatment regulated across the study. The primary hypothesis is that lifestyle change is sufficient to maintain glycemic control while decreasing the anti-diabetic medication in a sample patients with type 2 diabetes mellitus.

Full description

Adherence to lifestyle modifications including increased exercise and healthy diet improves glycemic control in patients with type 2 diabetes mellitus. However, few have investigated the combined effects of these lifestyle changes on maintenance of glycemic control while decreasing the usage of anti-diabetic medications.

The primary hypothesis is that lifestyle change is equivalent in maintaining glycemic control (Hba1c) compared to the standard pharmacological treatment,

The U-TURN trial also tests the effects on one key secondary outcome (glucose lowering medication) and examines the effects on sleep quality, fatigue sleepiness, sleep pattern, cardio vascular disease risk factors, psychological outcomes, blood pressure and cholesterol lowering medication. The participants (N=120) is randomized into a experimental group (N=80) and a standard care group (N=40).

Additionally, the effects of the study will be evaluated 24 month post randomization.

Enrollment: 97 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Less than three anti-diabetic medications.
• Diabetes 2 duration of max 10 years
• BMI >25 but <40 kg/m2,
• Accept of medical regulation by the UTURN endocrinologists only
• Accept of purchasing a fitness club membership through U-TURN collaborator

Exclusion criteria

• Hba1c> 9% (75 mmol/mol)
• Insulin usage
• Presence of one or more of the following micro- and macrovascular complications of T2DM; a.Diabetic retinopathy (except mild nonproliferative retinopathy or early proliferative retinopathy) b. Macro-albuminuria or nephropathy c. Diabetic neuropathy (except mild affected vibratory testing (<50 Volt)) d. Arterial insufficiency e. Ischemic heart disease
• Steroid treatment (inhalation) until three months before the medical examination
• TSH raised/below the normal range
• Liver disease (ALAT/ASAT thrice normal range)
• Inability or contraindication to increased levels of physical activity (Pedersen BK and Saltin B)
• Evidence of anaemia
• Lung disease (except mild asthma and mild chronic obstructive pulmonary disease)
• Heart disease
• Kidney disease (creatinine above 130 µM or macro albuminuria)
• Pregnancy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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97 participants in 2 patient groups

U-TURN intervention

Experimental group

Description:

The intervention group will receive an intensive lifestyle intervention including partly supervised aerobic and strength exercise, diet plans and counseling by clinical dietitians. All exercise will be supervised initially and the supervision will be reduced gradually across the 12-month intervention. Additionally, the participants will be offered educational classes on implementation of a healthy lifestyle and diabetes education and support by trained nurses. Participants in this group will have their pharmacological treatment regulated by the study endocrinologists using a standardized pharmacological treatment. The treatment is in accordance with the Danish guidelines.

Treatment:

Behavioral: U-TURN

Standard care

Active Comparator group

Description:

The reference group will receive diabetes education and support by trained nurses. Participants in this group will have their pharmacological treatment regulated by the study endocrinologists using a standardized pharmacological treatment. The treatment is in accordance with the Danish guidelines.

Treatment:

Behavioral: Standard care