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Lifestyle Patterns and Glycemic Control

Not Applicable
Recruiting
Conditions
Pre-diabetes
Interventions
Behavioral: Fixed Schedule
Registration Number
NCT05224986
Lead Sponsor
Columbia University
Brief Summary

The goal of the proposed study is to evaluate the feasibility and initial efficacy of stabilizing lifestyle behaviors to improve glucose control and body composition in patients with pre-diabetes.

The investigator proposes that following stable lifestyle behaviors will improve patients' glucose control, body composition, and liver fat. The results from this study has the potential to impact clinical practice and patient care.

Detailed Description

Variability in lifestyle behaviors has been associated with adverse health, specifically poor glucose control. The project proposes to test whether reducing this variability improves glycemia in patients with pre-diabetes. If successful, this simple positive lifestyle message to keep stable behaviors has the potential to improve the health of millions of adults worldwide.

This project will enroll participants with pre-diabetes who have erratic lifestyle behaviors and randomize them to either maintain their usual habits (control group) or stabilize their behaviors (stability group). Both groups will be followed for 12 weeks. Before the start of the 12-week period, all participants will track their sleep for 2 weeks and will wear a glucose monitor to measure their glucose levels. At the start and end of the 12-week period, they will come to the research lab to undergo a glucose tolerance test. This test will measure how their body reacts to a glucose load. They will also undergo magnetic resonance imaging and spectroscopy scanning. This scan will provide information on body composition and liver fat content.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
34
Inclusion Criteria
  • Pre-diabetic kg/m2 (hemoglobin A1c 5.7-6.9%)
  • 25 years or older
  • BMI between 25-39.9 kg/m2
  • Sleep duration ≥6 hours a night assessed with wrist actigraphy (for 14 nights)
  • Variable bedtime, SD≥45 minutes.
Exclusion Criteria
  • Chronic Kidney Disease (GFR<60)
  • Uncontrolled hypertension (≥160/100 mmHg)
  • Obstructive Sleep Apnea
  • Psychiatric or neurological disorder
  • Prevalent cardiovascular disease
  • Dyslipidemia (triglycerides≥200 mg/dL)
  • Medications that affect insulin sensitivity, glucose concentrations, and body weight
  • Non-day or rotating shift workers
  • Travel across time zones
  • Active participation in weight loss program or within past 3 months
  • Current or past alcohol/drug abuse

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Fixed ScheduleFixed ScheduleParticipants randomized to Fixed Schedule (FS) will be asked to stabilize their lifestyle behaviors for 12 weeks.
Primary Outcome Measures
NameTimeMethod
Adipose Tissue Measurement - Total12 weeks

Measuring total adiposity. Measured by MRI, includes both subcutaneous and visceral adipose tissue.

Adipose Tissue Measurement - Subcutaneous12 weeks

Measurement of subcutaneous adiposity using MRI.

Adipose Tissue Measurement - Visceral12 weeks

Measurement of visceral adiposity using MRI.

Mean Amplitude of Glycemic Excursion and Standard Deviation of Mean Glucose12 weeks

Testing glucose variability. The primary outcome variables are mean amplitude of glucose excursion and standard deviation of average glucose.

Glucose Area Under Curve12 weeks

Testing glycemic control.The primary outcome variable is glucose under the curve during the oral glucose tolerance test.

Secondary Outcome Measures
NameTimeMethod
Short-term Change in GlycemiaBaseline, up to 12 weeks

Assessing whether short-term glycemia is changed by measuring fructosamine using two-sample t-tests.

White blood cellsBaseline, 12 weeks

Leukocytes and neutrophils

Liver Fat Content12 weeks

This is to assess liver fat measured by MRS and MRI in %.

Endothelial cell inflammation (sub-set, n≤10)Baseline, 12 weeks

NF-κB nuclear fluorescence area for pilot study.

Endothelial cell oxidative stress (sub-set, n≤10)Baseline, 12 weeks

redox sensitive fluorogenic probe fluorescence intensity for pilot study.

Disposition Index12 weeks

This is to assess disposition index, measured using HOMA-IR. The disposition index is the product of the insulogenic index and homeostatic model of assessment for insulin resistance.

Long-term Change in GlycemiaBaseline, 12 weeks

Assessing whether long-term glycemia is changed by measuring hemoglobin A1c using two-sample t-tests.

Trial Locations

Locations (1)

Columbia University Irving Medical Center

🇺🇸

New York, New York, United States

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