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Hypoglycaemia and Cardiac Arrhythmias in Type 2 Diabetes (HYPO-HEART) 42 Beobachtend

Abgeschlossen
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Die klinische Studie NCT03150030 (HYPO-HEART) untersuchte Diabetes mellitus Typ 2, Herzrhythmusstörung als beobachtungsstudie und hat den Status abgeschlossen. Die Studie begann am 1. Februar 2017 mit 42 Teilnehmern. Sie wurde durchgeführt von University Hospital, Gentofte, Copenhagen und am 6. Januar 2020 abgeschlossen. Die Daten von ClinicalTrials.gov wurden zuletzt am 2. November 2020 aktualisiert.
Kurzbeschreibung
Twenty-one patients with insulin-treated type 2 diabetes with diabetic complications will be recruited to Part 1 of the study, a three-hour combined hyper- and hypoglycaemic clamp, along with a control group of twenty-one individuals with normal glucose tolerance matched for age, gender, and body mass index. Patients with type 2 diabetes will be scheduled for a three-week run-in period with LR and CGM prior to partic...Mehr anzeigen
Offizieller Titel

Hypoglycaemia and Cardiac Arrhythmias in Type 2 Diabetes

Erkrankungen
Diabetes mellitus Typ 2Herzrhythmusstörung
Publikationen
Wissenschaftliche Artikel und Forschungspapiere zu dieser klinischen Studie:
Weitere Studien-IDs
  • HYPO-HEART
  • H-16046212
NCT-Nummer
Studienbeginn (tatsächlich)
2017-02-01
Zuletzt aktualisiert
2020-11-02
Studienende (vorauss.)
2020-01-06
Geplante Rekrutierung
42
Studientyp
Beobachtungsstudie
Status
Abgeschlossen
Studienarme/Interventionen
Teilnehmergruppe/StudienarmIntervention/Behandlung
Patients with type 2 diabetes
Insulin-treated type 2 diabetes with diabetic complications
Combined hyper- and hypoglycaemic clamp
During the entire clamp, participants will be monitored by ECG, pulse oximetry, and blood pressure and plasma glucose will be measured bedside every fifth minute. Additionally, patients with type 2 diabetes will be monitored by a loop recorder (LR) and a continuous glucose monitor (CGM). Comparison of LR and CGM recordings with the recordings obtained by ECG Holter monitor and blood sampling will be used for validati...Mehr anzeigen
Loop recorder (Reveal LINQ, Medtronic, Minneapolis, MN, USA)
Implantation of a loop-recorder
Continuous glucose monitoring (iPro2, Medtronic, Minneapolis, MN, USA)
Monitoring with a continuous glucose monitor
Healthy controls
Healthy control subjects
Combined hyper- and hypoglycaemic clamp
During the entire clamp, participants will be monitored by ECG, pulse oximetry, and blood pressure and plasma glucose will be measured bedside every fifth minute. Additionally, patients with type 2 diabetes will be monitored by a loop recorder (LR) and a continuous glucose monitor (CGM). Comparison of LR and CGM recordings with the recordings obtained by ECG Holter monitor and blood sampling will be used for validati...Mehr anzeigen
Hauptergebnismessungen
ErgebnismessungBeschreibung der MessungZeitrahmen
Part 1: Clinically relevant arrhythmias
Composite endpoint including atrial fibrillation, brady-arrhythmias and tachy-arrhythmias. Clinically relevant brady-arrhythmias are defined as sinus arrest for more than 3 seconds, frequency below 30 beats per minute (bpm), or high grade atrioventricular (AV) block including Mobitz Type II and third-degree AV block. Clinically relevant tachy-arrhythmias are defined as sustained ventricular tachycardia (duration \>30 seconds), and non-sustained ventricular tachycardia.
0-240 min during the combined hyper- and hypoglycaemic clamp
Part 2: Prevalence of clinically relevant arrhythmias as defined above
Prevalence of clinically relevant arrhythmias as defined above
Within 12 months
Part 2: Clinically relevant arrhythmias during hypoglycaemia compared to euglycaemia
Clinically relevant arrhythmias during hypoglycaemia compared to euglycaemia
Within 12 months
Part 2: Difference in MAGE
Difference in mean amplitude of glycaemic excursions (MAGE) two hours preceding an arrhythmic event versus MAGE during non-event
Within 12 months
Nebenergebnismessungen
ErgebnismessungBeschreibung der MessungZeitrahmen
Part 1: Differences in mean corrected QT interval (QTc)
Differences in mean corrected QT interval (QTc) between patients with type 2 diabetes and matched normal glucose tolerant individuals during the combined hyper- and hypoglycaemic clamp
0-240 min during the combined hyper- and hypoglycaemic clamp
Part 1: Difference in counter regulatory hormonal response
Difference in counter regulatory hormonal response between patients with type 2 diabetes and matched normal glucose tolerant individuals during the combined hyper- and hypoglycaemic clamp
0-240 min during the combined hyper- and hypoglycaemic clamp
Part 1: Differences in haemodynamic regulation
Differences in haemodynamic regulation (measured by echocardiography) between patients with type 2 diabetes and matched normal glucose tolerant individuals during a combined hyper- and hypoglycaemic clamp
0-240 min during the combined hyper- and hypoglycaemic clamp
Part 2: Clinical relevant arrhythmias during low glucose variability compared to high glucose variability.
Clinical relevant arrhythmias during low glucose variability (LGV), defined as variations in plasma glucose below or equal to 5 mmol/l within two hours preceding an arrhythmic event, compared to high glucose variability (HGV), defined as variations in plasma glucose above 5 mmol/l within two hours preceding an arrhythmic event
Within 12 months
Part 2: The relationship between cardiovascular disease at baseline and clinically relevant arrhythmias in relation to hypoglycaemia and HGV
The relationship between cardiovascular disease (heart failure and ischaemic heart disease) at baseline and clinically relevant arrhythmias in relation to hypoglycaemia and HGV
Within 12 months
Part 2: The relationship between pharmacological treatment at baseline and clinically relevant arrhythmias in relation to hypoglycaemia and HGV
The relationship between pharmacological treatment at baseline and clinically relevant arrhythmias in relation to hypoglycaemia and HGV
Within 12 months
Part 2: The relationship between diabetes complication status at baseline and clinically relevant arrhythmias in relation to hypoglycaemia and HGV
The relationship between diabetes complication status (neuropathy, nephropathy, retinopathy) at baseline and clinically relevant arrhythmias in relation to hypoglycaemia and HGV
Within 12 months
Part 2: Correlation between prevalence and total duration of hypoglycaemia and risk of clinically relevant arrhythmias
Correlation between prevalence and total duration of hypoglycaemia and risk of clinically relevant arrhythmias
Within 12 months
Part 2: Correlation between plasma glucose variation and risk of clinical relevant arrhythmias
Correlation between plasma glucose variation (variation in plasma glucose (Δ mmol/l) within two hours of the event) and risk of clinical relevant arrhythmias
Within 12 months
Eignungskriterien

Zugelassene Altersgruppen
Erwachsene, Ältere Erwachsene
Mindestalter
18 Years
Zugelassene Geschlechter
Alle
Akzeptiert gesunde Freiwillige
Ja

Patients with type 2 diabetes

  • Informed and written consent
  • Type 2 diabetes diagnosed according to the criteria of the World Health Organization (WHO)
  • Treatment with insulin
  • Glycated haemoglobin A1c (HbA1c) ≤58 mmol/mol
  • One or more clinical relevant complications to diabetes defined as: peripheral neuropathy with vibration perception threshold of > 25 volt determined by biothesiometry, moderate to severe retinopathy, nephropathy (creatinine >130 μmol/l and/or albuminuria), and/or macrovascular disease. Macrovascular disease is defined as coronary disease (stable angina pectoris or previous unstable angina pectoris or myocardial infarct), cerebrovascular disease (previous stroke or transitional cerebral ischaemia), and peripheral vascular disease (previous intermittent claudication or prior acute ischemia)
  • Well-functioning LR during run-in period (acceptable readings judged by an arrhythmologist)
  • Participation in the extended study

Healthy individuals

  • HbA1c ≤42 mmol/mol
  • Fasting plasma glucose ≤6.1 mmol/l

Patients with type 2 diabetes

  • Arrhythmia diagnosed prior to or at the time of inclusion
  • Implantable cardioverter defibrillator (ICD) or pacemaker at the time of inclusion
  • Severe heart failure (left ventricular ejection fraction <25%)
  • Structural heart disease (Wolf-Parkinson-White syndrome, congenital heart disease, severe valve disease)
  • Insulin naïve patients with type 2 diabetes
  • Thyroid dysfunction (except for well-regulated eltroxine substituted myxoedema)
  • Unable to comply with daily CGM during run-in period
  • Anemia (male: hemoglobin < 8.0; female: hemoglobin < 7.0 mmol/l)

Healthy individuals

  • Type 1 or type 2 diabetes
  • Prediabetes (HbA1c >42 mmol/l and/or fasting plasma glucose >6.1 mmol/l)
  • Family history of diabetes (type 1 og type 2 diabetes)
  • Arrhythmia diagnosed prior to or at the time of inclusion
  • ICD or pacemaker at the time of inclusion
  • Severe heart failure (left ventricular ejection fraction <25%)
  • Structural heart disease (Wolf-Parkinson-White syndrome, congenital heart disease, severe valve disease)
  • Thyroid dysfunction (except for well-regulated eltroxine substituted myxoedema)
  • Anemia (male: hemoglobin < 8.0; female: hemoglobin < 7.0 mmol/l)
University Hospital, Gentofte, Copenhagen logoUniversity Hospital, Gentofte, Copenhagen
Verantwortliche Partei
Andreas Andersen, Hauptprüfer, MD, PhD-student, University Hospital, Gentofte, Copenhagen
Keine Kontaktdaten vorhanden
1 Studienstandorte in 1 Ländern
Gentofte Hospital, Hellerup, 2900, Denmark