NCT02321904

Brief Summary

The overall aim of this study is to confirm the utility of corneal confocal microscopy (CCM) as a new technique to rapidly and non-invasively assess diabetic neuropathy (DN) in children. This study will be divided into two phases: Phase 1 will be a cross-sectional study of children with type 1 diabetes and normal controls, while phase 2 will be a longitudinal assessment of a subgroup of children with type 1 diabetes recruited during Phase 1.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
176

participants targeted

Target at P50-P75 for all trials

Timeline
Completed

Started Jun 2008

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2008

Completed
5 years until next milestone

First Submitted

Initial submission to the registry

June 17, 2013

Completed
1.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 1, 2014

Completed
5 months until next milestone

First Posted

Study publicly available on registry

December 22, 2014

Completed
4.6 years until next milestone

Study Completion

Last participant's last visit for all outcomes

August 1, 2019

Completed
Last Updated

October 3, 2019

Status Verified

October 1, 2019

Enrollment Period

6.2 years

First QC Date

June 17, 2013

Last Update Submit

October 1, 2019

Conditions

Keywords

Confocal microscopyCorneaNeuropathyDetectionDiabetes

Outcome Measures

Primary Outcomes (1)

  • The utility of corneal confocal microscopy to assess diabetic neuropathy in children.

    To confirm the utility of corneal confocal microscopy (CCM) as a new technique to rapidly assess diabetic neuropathy (DN) in children. This non-invasive eye imaging method may be a superior alternative to traditional nerve conduction studies. This study will be divided into two phases: Phase 1 will be a cross-sectional study of children with Type 1 Diabetes (T1D) and normal controls, while phase 2 will be a longitudinal assessment of a subgroup of T1D children recruited during Phase 1.

    2 years

Secondary Outcomes (4)

  • Corneal nerve density (CND) by CCM

    Single time point

  • Changes in corneal nerve morphology two years after the initial CCM exam.

    2 years

  • Corneal nerve length (CNL) by CCM.

    Single time point

  • Corneal nerve branching density (CBD) by CCM

    Single time point

Study Arms (2)

Diabetic cases

Children with Type 1 Diabetes 8 to 18 years old followed at the Alberta Children's Hospital Diabetes Clinic with duration of diabetes for at least 5 years will undergo Corneal Confocal Microscopy, Nerve Conduction Studies, Quantitative sensory testing, Neuropathy Symptom Scoring and Clinical nerve examinations.

Procedure: Corneal Confocal MicroscopyProcedure: Nerve Conduction StudiesProcedure: Quantitative sensory testingProcedure: Neuropathy Symptom ScoreProcedure: Clinical nerve examination

Normal controls

Healthy children aged 8 to 18 years will undergo Corneal Confocal Microscopy, Nerve Conduction Studies, Quantitative sensory testing, Neuropathy Symptom Scoring and Clinical nerve examinations.

Procedure: Corneal Confocal MicroscopyProcedure: Nerve Conduction StudiesProcedure: Quantitative sensory testingProcedure: Neuropathy Symptom ScoreProcedure: Clinical nerve examination

Interventions

Close-up pictures of the front part of the eye (the cornea)

Diabetic casesNormal controls

The following assessments will be made: a) amplitude of nerve action potential (μV) and conduction velocity (m/s) of the sural sensory nerve by antidromic stimulation; b) motor nerve conduction velocity (m/s), maximum M-wave amplitude (mV) and motor nerve distal latency (ms) of the peroneal motor nerve; and c) tibial nerve conduction study will also be obtained if tolerated.

Diabetic casesNormal controls

Standardized vibratory and thermal stimulation levels applied to the subject's non-dominant big toe.

Diabetic casesNormal controls

A list of 18 motor, sensory and autonomic symptoms encountered in a diabetic patients with neuropathy obtained by interview.

Diabetic casesNormal controls

Summated score of the lower extremities. Neurological examination assessing muscle strength, knee and ankle reflexes, sensation in the great toes will be evaluated for light touch-pressure, temperature, pin-prick, vibratory sense and joint position sense.

Diabetic casesNormal controls

Eligibility Criteria

Age8 Years - 18 Years
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64)
Sampling MethodNon-Probability Sample
Study Population

Cases: Children seen at the Alberta Children's Hospital Diabetes Clinic in Calgary Controls: 8-18 year old healthy children

You may qualify if:

  • CASES: Children with Type 1 Diabetes 8 to 18 years old followed at the Alberta Children's Hospital Diabetes Clinic with a duration of diabetes of at least 5 years.
  • CONTROLS: Healthy children aged 8 to 18 years.

You may not qualify if:

  • Patients with known history of corneal abnormality, trauma, or surgery
  • Any other cause of neuropathy
  • Individuals with uncontrolled hypothyroidism
  • Individuals with celiac disease
  • Other serious chronic illnesses besides diabetes
  • Inability to cooperate with testing
  • Families unwilling to provide written informed consent

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Alberta Children's Hospital

Calgary, Alberta, T2M 1V5, Canada

Location

MeSH Terms

Conditions

Diabetes Mellitus, Type 1Retinal DiseasesCorneal DiseasesDiabetes Mellitus

Condition Hierarchy (Ancestors)

Glucose Metabolism DisordersMetabolic DiseasesNutritional and Metabolic DiseasesEndocrine System DiseasesAutoimmune DiseasesImmune System DiseasesEye Diseases

Study Officials

  • Danièle Pacaud, Md, FRCPC

    University of Calgary

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

June 17, 2013

First Posted

December 22, 2014

Study Start

June 1, 2008

Primary Completion

August 1, 2014

Study Completion

August 1, 2019

Last Updated

October 3, 2019

Record last verified: 2019-10

Locations