Effect of Cognitive Behavioral Therapy and Phototherapy on Glycosylated Hemoglobin, CLOCK Genes and Quality of Life in Patients With Type 2 Diabetes Mellitus and Insomnia

Not Applicable

Completed

• Conditions: Type 2 Diabetes

• Registration Number: NCT06264661
• Lead Sponsor: Centro Interdisciplinario de Ciencias de la Salud Unidad Santo Tomás

Brief Summary

Purpose: To analyze the efficiency of Cognitive Behavioral Intervention in combination with phototherapy to reduce insomnia and improve glycemic control, quality of life, and CLOCK genes expression in patients with type 2 diabetes mellitus. Methods: Clinical, quasi-experimental, pre-post, explanatory, non-probability sampling. Subjects were invited to participate in Hospital Juárez de México. They received eight sessions of Cognitive Behavioral Therapy in combination with phototherapy. The assessment was carried out with validated instruments for Mexican population and gene expression was evaluated by real-time PCR.

Detailed Description

Not available

Study Timeline

• Study Start: 2022-08-08
• Primary Completion: 2022-09-30
• Study Completion: 2022-11-30
• Study First Submitted: 2024-01-22
• Status Verified: 2024-02
• Study First Submitted QC: 2024-02-09
• Last Update Submitted: 2024-02-09
• Study First Posted: 2024-02-20
• Last Update Posted: 2024-02-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 23

Inclusion Criteria

Have a medical record in the Endocrinology service at the Hospital Juarez de Mexico

• Patients with type 2 diabetes mellitus
• Age between 40 and 60 years
• Present Insomnia based on the criteria of The Diagnostic and Diagnostic Manual Statistics of Mental Disorders (DSM-V) which defines insomnia such as predominant dissatisfaction with the quantity or quality of sleep, associated with one (or more) of the following symptoms: a) Difficulty starting the dream,or b) Difficulty maintaining sleep, characterized by awakenings frequent and c) Waking up early in the morning with inability to return to sleep; with clinically significant distress or social impairment, work, educational, academic, behavioral or other important areas of operation, at least three nights a week, for a minimum of three months even with favorable sleeping conditions.
• Sign an informed consent letter and agree to participate in the study.
• Accept taking a blood sample pre and post intervention
• HbA1c level above 6.1% (120 mg/dL;7 mmol/L) or BMI less than 34.9 units

Exclusion Criteria

• Do not agree to sign the informed consent
• Have a previous psychiatric diagnosis
• Have neurological disorders
• Be diagnosed with type 1 diabetes mellitus or BMI greater than 35 units
• Missing more than 20% of the sessions (2 sessions)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Primary Outcome Measures

Name	Time	Method
Quality of life	0 and 3 months	Quality of life questionnaire D39, contains 39 closed items that are grouped into five sections: Energy-Mobility (15 items: 3, 7, 9, 10, 11, 12, 13, 16, 25, 29, 32, 33, 34, 35 and 36), Diabetes control (12 items: 1, 4, 5, 14, 15, 17, 18, 24, 27, 28, 31 and 39); Anxiety-worry (four items: 2, 6, 8 and 22), Social burden (five items: 19, 20, 26, 37 and 38) and Sexual functioning (three items: 21, 23 and 30)
Sleep quality	0 and 3 months	Pittsburg sleep quality questionnaire,It provides a global rating in 7 components, in no problem, good quality, poor quality and very poor quality of sleep, it consists of 19 multiple option items.
Glycosylated hemoglobin	0 and 3 months	A venous blood sample will be taken and analyzed in the clinical analysis laboratory.
Insomnia	0 and 3 months	The Insomnia Scale Athens is made up of eight items, with a scale of Likert type with four response options that ranges of 0 (no sleep-related problem) to 3 (high presence of sleep problems). The first five items identify insomnia and the last three are aimed at identifying consequences of insomnia to the next day

Secondary Outcome Measures

Name	Time	Method
Gene expression analysis of BMAL1	0 and 3 months	The determination of gene expression is carried out through the Trizol technique and real-time Polymerase Chain Reaction (PCR-RT) in a 4 ml blood sample taken in tubes with EDTA.
Gene expression analysis of PER1	0 and 3 months	The determination of gene expression is carried out through the Trizol technique and real-time Polymerase Chain Reaction (PCR-RT) in a 4 ml blood sample taken in tubes with EDTA.
Gene expression analysis of CLOCK	0 and 3 months	The determination of gene expression is carried out through the Trizol technique and real-time Polymerase Chain Reaction (PCR-RT) in a 4 ml blood sample taken in tubes with EDTA.
Gene expression analysis of PER2	0 and 3 months	The determination of gene expression is carried out through the Trizol technique and real-time Polymerase Chain Reaction (PCR-RT) in a 4 ml blood sample taken in tubes with EDTA.

Trial Locations

Locations (1)

Centro Interdisciplinario de Ciencias de la Salud Unidad Santo Tomás; 🇲🇽 Cdmx, México, Mexico