ClinicalTrials.gg
Status unknownNCT03032354Updated Jul 11, 2017

Probiotics in Newly Recognized Type 1 Diabetes

A Phase 4 interventional study of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 and Placebo, (Placebo group) in Diabetes Mellitus, Type 1, sponsored by Medical University of Warsaw. Status unknown. Open to participants aged 8 Years to 17 Years. Per ClinicalTrials.gov, last updated 2017-07-11.

Sponsored by Medical University of Warsaw · Phase 4, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Jan 2017), so the status shown — last known as Not yet recruiting — may be out of date.
Phase
Phase 4
Study type
Interventional
Enrollment
96
Allocation
Randomized
Ages
8 Years to 17 Years
Sex
All
01

Study summary

They are major genera of bacteria that make up the colon flora in human, constitute intestinal microbial homeostasis, inhibit growth of pathogens, improve the gut mucosal barrier and modulate local and systemic immune responses. Changes in gut microbiota can influence the immune system by increasing gut permeability, intestinal inflammation, and impaired oral tolerance in type 1 diabetes.Taken together, the data imply that bacteriotherapy may potentially be used as a tool to modulate the immune system for preventing islet destruction. Supplementation of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 improved blood glucose control in normoglycaemic pregnant women and reduced the frequency of gestational diabetes mellitus

Aim of the study:

The effect of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 on beta-cell function in children with newly diagnosed type 1 diabetes: a randomized, double blind, placebo-controlled trial.

Primary end point:

Area under the curve (AUC) of c-peptide level during during fasting and at 30,60,90,120 min following the start of the meal

Intervention:

Included patients will be randomly assigned to receive a combination of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 (Probiotics Group ) or placebo (Placebo Group ) during six months.

The expected results:

Beneficial effect of Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 on beta-cell function shown in the properly performed, methodologically accurate study would create a rationale for its routine use in patients with newly diagnosed type 1 diabetes.

Read the detailed description

Intervention:

At the 6-month follow-up visit will be evaluated adherence and occurrence of side effects of the study procedure. The outcome measures will be assessed at the beginning of the study, and at the 6 and 12-month follow-up visit.

02

Conditions studied

  • Diabetes Mellitus, Type 1

Keywords

  • probiotics
  • children
  • remission
03

In context

Diabetes Mellitus, Type 1

3,614 studies on the registry are indexed under Diabetes Mellitus, Type 1; 586 are open to participants now.

This study's planned enrollment of 96 is above the median of 40 across 2,718 interventional studies indexed under Diabetes Mellitus, Type 1.

Browse Diabetes Mellitus, Type 1 studies →

Lead sponsor

Medical University of Warsaw is the lead sponsor of 325 studies on the registry; 87 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
8 Years to 17 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Type 1 diabetes confirmed by clinical history and the presence of at least one positive autoantibody: anti-glutamic acid decarboxylase (anti-GAD), islet antigen 2 (IA2), islet cell antibody ( ICA)
  • Fasting c-peptide level >/= 0.4 ng/ml
  • The diagnosis of diabetes during the last 60 days
  • Consent to participate in the study

Exclusion criteria

Exclusion Criteria:

  • Antibiotic-therapy during last 4 weeks
  • Taking of probiotics during last 2 weeks
  • Intestinal infection during last 2 weeks
  • Intestinal chronic diseases
05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
96 participants (estimated)

Study arms

  • Experimental
    Probiotics arm: Probiotics group

    combination of probiotics: Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12 in the same capsule

    Drug: Lactobacillus rhamnosus GG and Bifidobacterium lactis BB12

  • Placebo comparator
    Placebo arm: Placebo group

    Placebo - maltodextrin

    Other: Placebo, (Placebo group)

Interventions

  • DrugLactobacillus rhamnosus GG and Bifidobacterium lactis BB12

    Combination therapy of probiotics during 6 months

    Also known as: Probiotics

  • OtherPlacebo, (Placebo group)

    Placebo during 6 months

    Also known as: Maltodextrin

06

What researchers measure

Primary outcomes

  1. Area under the curve (AUC) during fasting and at 30,60,90,120 min following the start of the meal

    Time frame: 120 min responses to a mixed meal

Secondary outcomes

  1. Insulin requirement (U / kg body mass )

    Time frame: up 60 days from diabetes recognition, at 3th, 6th, 12th month

  2. HbA1c

    Time frame: up to 60 days from diabetes recognition, at 3th, 6th, 12th month

  3. Weight in kilograms

    Time frame: up to 60 days from diabetes recognition, and at 3th, 6th, 12th month

  4. Number of participants with abnormal laboratory values and/or adverse events that are related to treatment ( eg.abdominal pain, diarrhea , constipation , vomiting,flatulence)

    Time frame: at 3th, 6th, 12th month

  5. Occurrence of other autoimmune diseases

    Time frame: at 12th month

  6. Height in meters

    Time frame: up to 60 days from diabetes recognition, and at 3th, 6th, 12th month

  7. BMI in kg/m2

    Time frame: up to 60 days from diabetes recognition, and at 3th, 6th, 12th month

  8. BMI score

    Time frame: up to 60 days from diabetes recognition, and at 3th, 6th, 12th month

  9. severe hypoglycemia

    Time frame: up to 60 days from diabetes recognition, at 3th, 6th, 12th month

  10. ketoacidosis

    Time frame: up to 60 days from diabetes recognition, at 3th, 6th, 12th month

  11. Fasting c- peptide concentrations in ng/ml

    Time frame: up to 60 days from diabetes recognition, and in: 6th, 12th month

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Kriegel MA, Sefik E, Hill JA, Wu HJ, Benoist C, Mathis D. Naturally transmitted segmented filamentous bacteria segregate with diabetes protection in nonobese diabetic mice. Proc Natl Acad Sci U S A. 2011 Jul 12;108(28):11548-53. doi: 10.1073/pnas.1108924108. Epub 2011 Jun 27. PubMed 21709219 ↗
  • Greenbaum CJ, Beam CA, Boulware D, Gitelman SE, Gottlieb PA, Herold KC, Lachin JM, McGee P, Palmer JP, Pescovitz MD, Krause-Steinrauf H, Skyler JS, Sosenko JM; Type 1 Diabetes TrialNet Study Group. Fall in C-peptide during first 2 years from diagnosis: evidence of at least two distinct phases from composite Type 1 Diabetes TrialNet data. Diabetes. 2012 Aug;61(8):2066-73. doi: 10.2337/db11-1538. Epub 2012 Jun 11. PubMed 22688329 ↗
  • Effect of intensive therapy on residual beta-cell function in patients with type 1 diabetes in the diabetes control and complications trial. A randomized, controlled trial. The Diabetes Control and Complications Trial Research Group. Ann Intern Med. 1998 Apr 1;128(7):517-23. doi: 10.7326/0003-4819-128-7-199804010-00001. PubMed 9518395 ↗
  • Shapiro AM, Ricordi C, Hering BJ, Auchincloss H, Lindblad R, Robertson RP, Secchi A, Brendel MD, Berney T, Brennan DC, Cagliero E, Alejandro R, Ryan EA, DiMercurio B, Morel P, Polonsky KS, Reems JA, Bretzel RG, Bertuzzi F, Froud T, Kandaswamy R, Sutherland DE, Eisenbarth G, Segal M, Preiksaitis J, Korbutt GS, Barton FB, Viviano L, Seyfert-Margolis V, Bluestone J, Lakey JR. International trial of the Edmonton protocol for islet transplantation. N Engl J Med. 2006 Sep 28;355(13):1318-30. doi: 10.1056/NEJMoa061267. PubMed 17005949 ↗
  • Laitinen K, Poussa T, Isolauri E; Nutrition, Allergy, Mucosal Immunology and Intestinal Microbiota Group. Probiotics and dietary counselling contribute to glucose regulation during and after pregnancy: a randomised controlled trial. Br J Nutr. 2009 Jun;101(11):1679-87. doi: 10.1017/S0007114508111461. Epub 2008 Nov 19. PubMed 19017418 ↗
  • Luoto R, Laitinen K, Nermes M, Isolauri E. Impact of maternal probiotic-supplemented dietary counselling on pregnancy outcome and prenatal and postnatal growth: a double-blind, placebo-controlled study. Br J Nutr. 2010 Jun;103(12):1792-9. doi: 10.1017/S0007114509993898. Epub 2010 Feb 4. PubMed 20128938 ↗
  • Badami E, Sorini C, Coccia M, Usuelli V, Molteni L, Bolla AM, Scavini M, Mariani A, King C, Bosi E, Falcone M. Defective differentiation of regulatory FoxP3+ T cells by small-intestinal dendritic cells in patients with type 1 diabetes. Diabetes. 2011 Aug;60(8):2120-4. doi: 10.2337/db10-1201. Epub 2011 Jun 6. PubMed 21646390 ↗
  • Hara N, Alkanani AK, Ir D, Robertson CE, Wagner BD, Frank DN, Zipris D. The role of the intestinal microbiota in type 1 diabetes. Clin Immunol. 2013 Feb;146(2):112-9. doi: 10.1016/j.clim.2012.12.001. Epub 2012 Dec 11. PubMed 23314185 ↗
  • Ludvigsson J, Faresjo M, Hjorth M, Axelsson S, Cheramy M, Pihl M, Vaarala O, Forsander G, Ivarsson S, Johansson C, Lindh A, Nilsson NO, Aman J, Ortqvist E, Zerhouni P, Casas R. GAD treatment and insulin secretion in recent-onset type 1 diabetes. N Engl J Med. 2008 Oct 30;359(18):1909-20. doi: 10.1056/NEJMoa0804328. Epub 2008 Oct 8. PubMed 18843118 ↗
  • American Diabetes Association. Standards of medical care in diabetes--2014. Diabetes Care. 2014 Jan;37 Suppl 1:S14-80. doi: 10.2337/dc14-S014. No abstract available. PubMed 24357209 ↗
  • Mejia-Leon ME, Petrosino JF, Ajami NJ, Dominguez-Bello MG, de la Barca AM. Fecal microbiota imbalance in Mexican children with type 1 diabetes. Sci Rep. 2014 Jan 22;4:3814. doi: 10.1038/srep03814. PubMed 24448554 ↗
  • Patelarou E, Girvalaki C, Brokalaki H, Patelarou A, Androulaki Z, Vardavas C. Current evidence on the associations of breastfeeding, infant formula, and cow's milk introduction with type 1 diabetes mellitus: a systematic review. Nutr Rev. 2012 Sep;70(9):509-19. doi: 10.1111/j.1753-4887.2012.00513.x. PubMed 22946851 ↗
  • Murri M, Leiva I, Gomez-Zumaquero JM, Tinahones FJ, Cardona F, Soriguer F, Queipo-Ortuno MI. Gut microbiota in children with type 1 diabetes differs from that in healthy children: a case-control study. BMC Med. 2013 Feb 21;11:46. doi: 10.1186/1741-7015-11-46. PubMed 23433344 ↗
  • Vaarala O. Human intestinal microbiota and type 1 diabetes. Curr Diab Rep. 2013 Oct;13(5):601-7. doi: 10.1007/s11892-013-0409-5. PubMed 23934614 ↗
  • Vaarala O, Atkinson MA, Neu J. The "perfect storm" for type 1 diabetes: the complex interplay between intestinal microbiota, gut permeability, and mucosal immunity. Diabetes. 2008 Oct;57(10):2555-62. doi: 10.2337/db08-0331. PubMed 18820210 ↗
  • de Goffau MC, Luopajarvi K, Knip M, Ilonen J, Ruohtula T, Harkonen T, Orivuori L, Hakala S, Welling GW, Harmsen HJ, Vaarala O. Fecal microbiota composition differs between children with beta-cell autoimmunity and those without. Diabetes. 2013 Apr;62(4):1238-44. doi: 10.2337/db12-0526. Epub 2012 Dec 28. PubMed 23274889 ↗
  • Hague A, Butt AJ, Paraskeva C. The role of butyrate in human colonic epithelial cells: an energy source or inducer of differentiation and apoptosis? Proc Nutr Soc. 1996 Nov;55(3):937-43. doi: 10.1079/pns19960090. No abstract available. PubMed 9004335 ↗
  • Peng L, Li ZR, Green RS, Holzman IR, Lin J. Butyrate enhances the intestinal barrier by facilitating tight junction assembly via activation of AMP-activated protein kinase in Caco-2 cell monolayers. J Nutr. 2009 Sep;139(9):1619-25. doi: 10.3945/jn.109.104638. Epub 2009 Jul 22. PubMed 19625695 ↗
  • Brown CT, Davis-Richardson AG, Giongo A, Gano KA, Crabb DB, Mukherjee N, Casella G, Drew JC, Ilonen J, Knip M, Hyoty H, Veijola R, Simell T, Simell O, Neu J, Wasserfall CH, Schatz D, Atkinson MA, Triplett EW. Gut microbiome metagenomics analysis suggests a functional model for the development of autoimmunity for type 1 diabetes. PLoS One. 2011;6(10):e25792. doi: 10.1371/journal.pone.0025792. Epub 2011 Oct 17. PubMed 22043294 ↗
  • Luopajarvi K, Savilahti E, Virtanen SM, Ilonen J, Knip M, Akerblom HK, Vaarala O. Enhanced levels of cow's milk antibodies in infancy in children who develop type 1 diabetes later in childhood. Pediatr Diabetes. 2008 Oct;9(5):434-41. doi: 10.1111/j.1399-5448.2008.00413.x. Epub 2008 May 21. PubMed 18503496 ↗
  • Turley SJ, Lee JW, Dutton-Swain N, Mathis D, Benoist C. Endocrine self and gut non-self intersect in the pancreatic lymph nodes. Proc Natl Acad Sci U S A. 2005 Dec 6;102(49):17729-33. doi: 10.1073/pnas.0509006102. Epub 2005 Nov 29. PubMed 16317068 ↗
  • Oikarinen M, Tauriainen S, Oikarinen S, Honkanen T, Collin P, Rantala I, Maki M, Kaukinen K, Hyoty H. Type 1 diabetes is associated with enterovirus infection in gut mucosa. Diabetes. 2012 Mar;61(3):687-91. doi: 10.2337/db11-1157. Epub 2012 Feb 7. PubMed 22315304 ↗
  • King C, Sarvetnick N. The incidence of type-1 diabetes in NOD mice is modulated by restricted flora not germ-free conditions. PLoS One. 2011 Feb 25;6(2):e17049. doi: 10.1371/journal.pone.0017049. PubMed 21364875 ↗
  • Roesch LF, Lorca GL, Casella G, Giongo A, Naranjo A, Pionzio AM, Li N, Mai V, Wasserfall CH, Schatz D, Atkinson MA, Neu J, Triplett EW. Culture-independent identification of gut bacteria correlated with the onset of diabetes in a rat model. ISME J. 2009 May;3(5):536-48. doi: 10.1038/ismej.2009.5. Epub 2009 Feb 19. PubMed 19225551 ↗
  • Valladares R, Sankar D, Li N, Williams E, Lai KK, Abdelgeliel AS, Gonzalez CF, Wasserfall CH, Larkin J, Schatz D, Atkinson MA, Triplett EW, Neu J, Lorca GL. Lactobacillus johnsonii N6.2 mitigates the development of type 1 diabetes in BB-DP rats. PLoS One. 2010 May 6;5(5):e10507. doi: 10.1371/journal.pone.0010507. PubMed 20463897 ↗
  • Groele L, Szajewska H, Szalecki M, Swiderska J, Wysocka-Mincewicz M, Ochocinska A, Stelmaszczyk-Emmel A, Demkow U, Szypowska A. Lack of effect of Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12 on beta-cell function in children with newly diagnosed type 1 diabetes: a randomised controlled trial. BMJ Open Diabetes Res Care. 2021 Mar;9(1):e001523. doi: 10.1136/bmjdrc-2020-001523. PubMed 33771763 ↗
  • Groele L, Szajewska H, Szypowska A. Effects of Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12 on beta-cell function in children with newly diagnosed type 1 diabetes: protocol of a randomised controlled trial. BMJ Open. 2017 Oct 11;7(10):e017178. doi: 10.1136/bmjopen-2017-017178. PubMed 29025837 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Jul 2017; primary completion for Dec 2018, 17 months later.

Of 63 non-industry phase 4 interventional studies under Diabetes Mellitus, Type 1, half reached primary completion within 25 months of starting (the median), counting those still running; a quarter within 13 and three quarters within 43. This study's planned 17 months is below that.

Counting every sponsor, half of 74 studies reached it within 22 months; a quarter within 12 and three quarters within 38.

How these figures are worked out, and which studies are left out of them.

Registered
Jan 5, 2017
First posted
Jan 26, 2017
StartEst.
Jul 15, 2017
Primary completionEst.
Dec 2018
CompletionEst.
Dec 2018
Last update
Jul 11, 2017
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 11, 2017, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03032354
Responsible party
Hanna Szajewska (Prof., Medical University of Warsaw) — Principal investigator
First posted
Jan 26, 2017
Start date
Jul 15, 2017 (estimated)
Primary completion
Dec 2018 (estimated)
Completion
Dec 2018 (estimated)
Last update
Jul 11, 2017

Study contacts

Agnieszka Szypowska, Assoc. Prof.
Contact
agnieszka.szypowska@gmail.com
+48 509928617
Lidia Groele, PhD
Contact
lgroele@wp.pl
+48 608 671 083
Agnieszka Szypowska, Assoc. Prof.
principal investigator · Medical University of Warsaw

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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