Abnormal Glucose Metabolism in HIV-infected Patients

NCT03545217 | Unknown

• 1 other identifier: ID066011
• Study Type: interventional
• Target: 75
• Locations: 1 country
• Sites: 1

Brief Summary

HIV is a major health problem worldwide especially in low-to middle-income countries including Thailand. Fortunately, a significant reduction in morbidity and mortality has been observed due to the use of combination antiretroviral therapy. As the natural history of the disease is modified, non-communicable diseases are becoming recognized complications of HIV infection, including insulin resistance, dyslipidemia and type 2 diabetes. The prevalence of type 2 diabetes in HIV-infected patients is significantly higher than in the general population, likely contributed by antiretroviral regimen and an ongoing, usually subclinical, inflammation. People with prediabetes, a condition which blood sugars are elevated but not yet meeting the criteria for diabetes, represent a high risk group for future diabetes development. Lifestyle interventions, including diet and exercise, are effective in reducing the future diabetes risk by as much as 58%, including in Thailand. The knowledge whether these interventions are effective in HIV-infected patients, given their unique characteristics, is not available at this time but urgently needed. Moreover, the program tailored to each country's local values, culture and socioeconomic status is essential as participants' acceptability is one of the keys to program's success. This current proposal will adapt a 6-month intensive lifestyle intervention program and evaluate its feasibility and acceptability in HIV-infected individuals with prediabetes in Thailand. The knowledge gained will be highly relevant for Thailand and for other low-to-middle-income countries. Furthermore, gut microbiota and insufficient sleep are novel factors shown to affect individual's metabolic health. Insufficient sleep is recognized as a risk factor for incident diabetes. Gut microbiota composition differs between those with and without diabetes. The current proposal will examine how gut microbiota and sleep duration differ between HIV-infected individuals with and without prediabetes, and now there change or modulate the metabolic response to the 6-month intensive lifestyle interventions. Lastly, HIV and diabetes are global epidemics, research capacity building among countries is essential to battle these health problems. This proposal will aim to build research capacities among three international institutions: University of Illinois at Chicago, Illinois, U.S.A.; Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand, one of the top medical schools in Thailand; and a newly formed medical school, Navamindradhiraj University, Vajira Hospital, Bangkok, Thailand. Through close collaboration, networking, in-person training and workshops, the proposed study will enhance research capacity and improve lives of those living with HIV.

Conditions

Abnormal Glucose Metabolism

Outcome Measures

Primary Outcomes (1)

• new diabetes

  occurrence of diabetes mellitus

  12 months after intervention

Study Arms (2)

intervention group

EXPERIMENTAL

Behavioral: Lifestyle Intervention

control group

NO INTERVENTION

Interventions

Lifestyle Intervention BEHAVIORAL

a 6-month intensive lifestyle intervention program led by a multidisciplinary team of diabetes nurses and dieticians, and a follow up at 12 months for these participants. This will be a group-based activity adapted from the Diabetes Prevention Program -Thailand project

intervention group

Eligibility Criteria

• Age: 35 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• HIV-infected patients, age 35-65 years old
• Receiving antiretroviral therapy
• Diagnosis of prediabetes (hemoglobin A1c, HbA1c levels ≥5.7-\<6.5% and fasting glucose levels \<126 mg/dl and 2-hour glucose levels \<200 mg/dl following 75-gram OGTT)

You may not qualify if:

• Serious medical problems (stroke with significant disability, estimated glomerular filtration rate \<45 ml/min/1.73 m2, uncontrolled congestive heart failure, symptoms suggestive of untreated cardiopulmonary disease such as chest pain or shortness of breath, significant anemia defined as hemoglobin \<9.0 g/dL, severe pulmonary disease including those requiring home oxygen therapy, end stage liver disease)
• A previous diagnosis of diabetes
• Currently diagnosed with contagious infectious disease
• Pregnancy

Sponsors & Collaborators

• Mahidol University: lead
• University of Illinois at Chicago: collaborator

Study Sites (1)

Faculty of Medicine Ramathibodi Hospital, Mahidol University

Bangkok, 10400, Thailand

RECRUITING

Related Publications (2)

• Nimitphong H, Sungkanuparph S, Areevut C, Saetung S, Jerawatana R, Hathaidechadusadee A, Somwang S, Tongchom W, Saibuathong N, Sakmanarit J, Pichitchaipitak O, Phuphuakrat A, Reutrakul S. Effects of an intensive lifestyle intervention and the role of sleep in people living with HIV and prediabetes: a pilot and feasibility study. BMC Res Notes. 2021 Apr 17;14(1):145. doi: 10.1186/s13104-021-05558-z.

  PMID: 33865450 DERIVED

• Phuphuakrat A, Nimitphong H, Reutrakul S, Sungkanuparph S. Prediabetes among HIV-infected individuals receiving antiretroviral therapy: prevalence, diagnostic tests, and associated factors. AIDS Res Ther. 2020 May 24;17(1):25. doi: 10.1186/s12981-020-00284-1.

  PMID: 32448349 DERIVED

Study Officials

• Somnuek Sungkanuparph, MD

  Mahidol University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Somnuek Sungkanuparph, MD

CONTACT

+6622011581; somnuek.sun@mahidol.ac.th

Sirimon R Pratuangtham, MD

CONTACT

sreutrak10800@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: May 22, 2018
• First Posted: June 4, 2018
• Study Start: July 21, 2017
• Primary Completion: July 1, 2019
• Study Completion: July 1, 2020
• Last Updated: June 4, 2018

Record last verified: 2018-05

Data Sharing

• IPD Sharing: Will not share

Locations

TH (1)