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Adherence to Mediterranean Diet in Type 1 Diabetes Initiating Minimed 780G: Glucose Metrics vs Insulin Metrics, is There a Difference

Not yet recruiting
Conditions
Type1diabetes
Registration Number
NCT06646107
Lead Sponsor
Attikon Hospital
Brief Summary

In this observaltional study, 240 patients aged \>12 years old with T1DM who are on multiple daily injections or insulin pump and are scheduled to start using MiniMed 780G system will be included.We aim to compare patients' adherence to Mediterranean diet (MD) before and 12 weeks after initiation of MiniMed 780G and its association with CGM and insulin metrics, as well as anthropometric measurements, BMI, body composition, lipid levels, blood pressure and gut microbioma. Moreover, at baseline, at six and 12 months, markers of endothelial and cardiovascular function will be also assessed and associated with the use of Minimed 780G and the adherence to MD.

Detailed Description

This observational study will include 240 participants (80 participants per country) from IGI region (Italy, Greece and Israel), children adolescents and young adults (12\> years old) with T1D that are on multiple daily injections or insulin pump and are scheduled to start using MiniMed 780G system. After a 7-day run-in period, participants will be evaluated with food intake log and adherence to Meditteranean Diet (MD) with PREDIMED questionnaire. One hour session on MD and healthy impact on Diabetes will be provided to all participants and will be assigned to initiate MiniMed 780G and followed for 12 weeks. HbA1c, CGM and Insulin Metrics, anthropometric measurements, body composition, blood pressure and lipid leves as well a gut microbioma will be performed at baseline and 12 weeks, after MiniMed 780G initiation. A 7-day food diary logbook will be collected to identify the amount and type of the food at baseline and at the end of the study. At baseline, at 6 and at 12 months, markers of endothelial and cardiovascular function will also be assessed. An extension phase will include additional 3 and 6, which concludes one year of follow-up.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
240
Inclusion Criteria
  1. Clinical diagnosis of type 1 diabetes >1 year prior to consent date. Diagnosis of type 1 diabetes is based on the investigator's judgment; C peptide level and antibody determinations are not required.
  2. HbA1c < 12.5%
  3. Age >7years at the initiation of the system
  4. Multiple Daily Injections (Basal Bolus therapy) with Total daily insulin use of great than 8.0 units per day over a 1-week period
  5. Clinically able to start the AHCL system
  6. History of 3 clinic visits in the last year
Exclusion Criteria
  1. Diabetic Ketoacidosis in the 6 months prior to screening visits

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Changes in Hba1cBaseline, 3 months

Differences in HbA1c at baseline and 3 months after the initiation of MiniMed 780G

Changes in TIRBaseline, 3 months

Changes in TIR at baseline and 3 months after the initiation of MiniMed 780G

Changes in TBRBaseline, 3 months

Changes in TBR at baseline and 3 months after the initiation of MiniMed 780G

Changes in TARBaseline, 3 months

Changes in TAR at baseline and 3 months after the initiaton of MiniMed 780G

Changes in bolus dosesBaseline, 3 months

Changes in bolus dosed at baseline and 3 months after the initiation of MiniMed 780G

Changes in basal dosesBaseline, 3 months

Changes in basal doses at baseline and 3 months after the initiation of MiniMed 780G

Changes in autocorrection dosesBaseline, 3 months

Changes in autocorrection doses between baseline and 3 months after the initiation of MiniMed 780G:

Secondary Outcome Measures
NameTimeMethod
Changes in pulse wave velocity(m/s)Baseline, 6 months, 12 months

Changes in pulse wave velocity at baseline and at 6 and 12 months after the initiation of MiniMed 780G

Changes in endothelial glycocalyx thickness (μm)Baseline, 6 months, 12 months

Changes in endothelial glycocalyx thickness at baseline and at 6 and 12 months after the initiation of MiniMed 780G

Changes in global longidutinal strain (%)Baseline, 6 months, 12 months

Changes in global longidutinal strain at baseline and at 6 and 12 months after the initiation of MiniMed 780G

Changes in CAP (dB/m)Baseline, 6 months, 12 months

Changes in liver steatosis at baseline and at 6 and 12 months after the initiation of MiniMed 780G as assessed by the measurement of CAP. CAP score will be used as an index of liver fat content, with normal values being \< 238 dB/m. \<237 dB/m (S0, no steatosis), 237 -259 dB/m (S1, mild steatosis), 259 -291 dB/m (S2, moderate steatosis), and 291 -400 dB/m (S3,severe steatosis). E score will be used as an index of liver fibrosis. The cut-off values for fibrosis (F) were as follows:(1) \<5.5 kPa (F0, no fibrosis), (2) 5.5-8.0 kPa (F1, mild fibrosis), (3) 8.0-10.0 kPa (F2, moderate fibrosis),(4) 11.0-16.0 kPa (F3, severe fibrosis), and (5) \>16.0 kPa (F4, cirrhosis).

Changes in gut microbiomaBaseline,3 months

Changes in gut microbioma at baseline and at 3 months after the initiation of MiniMed 780G.

Changes in coronary flow reserveBaseline, 6 months, 12 months

Changes in coronary flow reserve at baseline, at six months and at 12 months after the initiation of MiniMed 780G.

Changes in central aortic blood pressure (mmHg)Baseline, 6 months, 12 months

Changes in central aortic blood pressure at baseline and at 6 and 12 months after the initiation of MiniMed 780G.

Changes in Ε score (Kpa)Baseline, 6 months, 12 months

Changes in liver steatosis at baseline and at 6 and 12 months after the initiation of MiniMed 780G as assessed by E score. E score will be used as an index of liver fibrosis. The cut-off values for fibrosis (F) were as follows:(1) \<5.5 kPa (F0, no fibrosis), (2) 5.5-8.0 kPa (F1, mild fibrosis), (3) 8.0-10.0 kPa (F2, moderate fibrosis),(4) 11.0-16.0 kPa (F3, severe fibrosis), and (5) \>16.0 kPa (F4, cirrhosis).

Trial Locations

Locations (1)

Attikon University General Hospital

🇬🇷

Chaidari, Greece

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