NCT04054934

Brief Summary

Type 1 diabetes mellitus (T1DM), makes its appearance during childhood and youth, but management implications last till late adulthood. Its treatment includes the combination of multiple daily glucose measurements, insulin administration and balanced nutrition. The goals of therapy are to achieve glycemic control (HbA1c \< 7.5%), and minimal glycemic excursions. Furthermore, recent studies imply that keeping HbA1c within target range is not sufficient to prevent complications, attributed mainly to blood glucose level fluctuating from high to low, associated with food intake and adolescents behavior. The current implication of glycemic control on the central nervous system (CNS) includes abnormal electrical brain activity, structural changes in brain's white and grey matter, and cognitive impairment. Still, little is known on the effect of sleep pattern, including circadian rhythm reversal ("biological clock) on asymptomatic glycemic excursions, and on CNS functions. There is no data regarding the association of the biologic clock on CNS functionality among adolescents, nonetheless among T1DM adolescents, for whom behavior and circadian rhythm alterations may have harmful effect. The investigators propose a cross-over designed study by examining adolescents with and without T1DM during 2 weeks of regular sleeping pattern (night sleep), and during 2 weeks of sleeping during the day as happens during summer vacation. The main objective of the proposed study is to offer proof of the clinical and metabolic relevance and cognitive effects of the reversal of the circadian clock in adolescents with and T1DM during summer vacations and weekends. Study is designed to demonstrate a difference among healthy and diabetics during reversed night/day circadian clocks in the time spent within target range of glucose, performance on neuro cognitive tasks, electrical brain activity, and hormonal profile.

Trial Health

65
Monitor

Trial Health Score

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

Enrollment
100

participants targeted

Target at P50-P75 for all trials

Timeline
7mo left

Started Jan 2022

Longer than P75 for all trials

Status
not yet recruiting

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 Progress88%
Jan 2022Dec 2026

First Submitted

Initial submission to the registry

May 26, 2019

Completed
3 months until next milestone

First Posted

Study publicly available on registry

August 13, 2019

Completed
2.4 years until next milestone

Study Start

First participant enrolled

January 1, 2022

Completed
4.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2026

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2026

Last Updated

May 26, 2020

Status Verified

May 1, 2020

Enrollment Period

4.9 years

First QC Date

May 26, 2019

Last Update Submit

May 22, 2020

Conditions

Keywords

T1DMHypothalamusCORTICAL BRAINGlucose variabilityBiological clockPediatrics

Outcome Measures

Primary Outcomes (3)

  • Affects of reversal circadian clock on neuro cognitive tasks performance among healthy and T1D patients, according to glucose

    Score of neurocognitive tests for executive function according to day/night sleeping pattern session

    2 years

  • Affects of reversal circadian clock on Glucose Variability parameters among both healthy and T1DM adolescents .

    Time spent in range of glucose of 70-180 mg/dl according to day/night sleeping pattern

    2 years

  • Affects of reversal circadian clock on sleep quality among both healthy and T1DM adolescents (mainly T1DM), controlled for BMI-SDS, and mean HbA1c in T1D patients.

    Quality of sleep according to PSQI, according to day/night sleeping pattern

    2 years

Secondary Outcomes (6)

  • Melatonin profile according to night/day sleep cycle among healthy and among T1D patients

    2 years

  • Temperature according to night/day sleep cycle among healthy and among T1D patients

    2 years

  • EEG registration in accordance with the circadian curve and neurocognitive achievements

    2 years

  • MRI structural changes

    2 years

  • Hormonal profile according to night/day sleep cycle among healthy and among T1D patients

    2 years

  • +1 more secondary outcomes

Study Arms (2)

Normal Circardian rhythm

Regular night sleep, with at least 7 hours length of sleep.

Behavioral: Normal Circadian Rhythm

Reversed circadian rhythm

Night/day circadian clock is opposite, with at least 7 hours length of sleep

Behavioral: Reversed Circadian Rhythm

Interventions

Revered day/ night sleep cycle

Reversed circadian rhythm

Normal day/ night sleep cycle

Normal Circardian rhythm

Eligibility Criteria

Age12 Years - 18 Years
Sexall
Healthy VolunteersYes
Age GroupsChild (0-17), Adult (18-64)
Sampling MethodProbability Sample
Study Population

Patiets ages 12-18 years with type 1 diabetes mellitus and healthy controls same age and gender distribution

You may qualify if:

  • Families living in areas with high access to medical care.
  • Age: 12-18 years old
  • T1D diagnosis for longer than 1 year
  • speaking fluent Hebrew

You may not qualify if:

  • significant renal or liver function abnormalities
  • head injuries,
  • epileptic episodes
  • psychiatric medications
  • lack of Hebrew abilities
  • disagreement to comply with all the study requests
  • history of more than one episode of a severe hypoglycemic event in the past, including loss of consciousness or more than one episode of diabetic ketoacidosis.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

Sleep Disorders, Circadian RhythmAttention Deficit Disorder with HyperactivityMemory Disorders

Condition Hierarchy (Ancestors)

Chronobiology DisordersNervous System DiseasesDyssomniasSleep Wake DisordersOccupational DiseasesMental DisordersAttention Deficit and Disruptive Behavior DisordersNeurodevelopmental DisordersNeurobehavioral ManifestationsNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Central Study Contacts

Study Design

Study Type
observational
Observational Model
CASE CROSSOVER
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER GOV
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Head of Pediatric Endocrinology Unit

Study Record Dates

First Submitted

May 26, 2019

First Posted

August 13, 2019

Study Start

January 1, 2022

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2026

Last Updated

May 26, 2020

Record last verified: 2020-05