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NCT03956173 | COMPLETED | Diabetes type1


Hypoglycemia and Cardiac Arrhythmias in Type 1 Diabetes
Sponsor:

Steno Diabetes Center Copenhagen

Brief Summary:

The investigators hypothesise that following episodes of hypoglycemia, rebound hyperglycemia may result in a prolonged period of increased QTc and, thereby, increased susceptibility to serious cardiac arrhythmias in patients with type - 1 diabetes.

Condition or disease

Diabetes type1

Hypoglycemia

Arrhythmias, Cardiac

Intervention/treatment

Hypoglycemic combined with either normo or hyperglycemic clamp.

Detailed Description:

In this study, changes in cardiac rhythm, haemodynamic regulation, and hormonal response will be evaluated during insulin-induced hypoglycemia followed by hyperglycemia and euglycemia, respectively, on two separate experimental days. Twenty-four patients with type-1 diabetes are included. Patients are randomised 1:1 to start with either the combined hypo- and hyperglycemic or the hypo- and euglycemic clamp. After an overnight 10 hour fast, participants are admitted for a 255 minute clamp. An individualised insulin infusion will be initiated targeting a plasma glucose level of 5.0-8.0 mmol/l. When the targeted plasma glucose level is achieved, the hyperinsulinemic euglycemic clamp will be initiated at time 0. The insulin infusion will be fixed at an infusion rate 80 mU/m2/min and a 20% glucose infusion will be initiated in order to regulate plasma glucose levels. After 45 min of monitoring at euglycemic plasma glucose level, plasma glucose will be decreased over a period of 30 minutes, targeting 2.5 mmol/l for a period of 60 min in a hyperinsulinemic hypoglycemic clamp. From 135 min to 195 min, plasma glucose levels will be increased to either hyperglycemic level or euglycemic level and will be kept constant for 105 minutes. Echocardiography is performed at baseline, at hypoglycemic level and at hyper-or normoglycemic level. Blood samples are taken every 15 minutes throughout the entire clamp, however bedside plasma glucose is analysed every fifth minute. A Holter-ECG is obtained throughout the entire clamp.

Study Type : OBSERVATIONAL
Estimated Enrollment : 24 participants
Official Title : Hypoglycemia and Cardiac Arrhythmias in Type 1 Diabetes
Actual Study Start Date : 2018-12-01
Estimated Primary Completion Date : 2021-12-01
Estimated Study Completion Date : 2021-12-01

Information not available for Arms and Intervention/treatment

Ages Eligible for Study: 18 Years to 80 Years
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
Criteria
Inclusion Criteria
  • * Informed and written consent
  • * Type 1 diabetes diagnosed according to the criteria of the World Health Organization (WHO)
  • * Age 18-70 years
  • * Insulin treatment for ≥3 years
Exclusion Criteria
  • * Arrhythmia diagnosed prior to the screening visit
  • * 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)
  • * Thyroid dysfunction (except for well-regulated eltroxin substituted myxoedema)
  • * Anemia (male: hemoglobin \<8.0; female: hemoglobin \<7.0 mmol/l)

Hypoglycemia and Cardiac Arrhythmias in Type 1 Diabetes

Location Details

NCT03956173


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Locations


Not yet recruiting

Denmark,

Clinical Metabolic Physiology, SDCC

Copenhagen, Denmark, 2900

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