CClinicalTrials.gg
CompletedNCT03299790Updated Dec 10, 2020

Effect of High-intensity Interval Training on Cardiac Function and Regulation of Glycemic Control in Diabetic Cardiomyopathy

An interventional study of high-intensity interval exercise training (HIIT) and moderate-intensity exercise training (MIT) in Diabetic Cardiomyopathies and Type2 Diabetes, sponsored by Hasselt University. Completed at 1 site in Belgium. Open to participants aged 18 Years to 81 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-12-10.

Sponsored by Hasselt University · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
53
Allocation
Randomized
Ages
18 Years to 81 Years
Sex
All
01

Study summary

According to data of the International Diabetes Federation (IDF), diabetes in general affects approximately 415 million people worldwide and this number is still increasing. Cardiovascular diseases, one of the major complications of diabetes, are the leading cause of mortality and morbidity in the diabetic population. One of the cardiovascular complications is diabetic cardiomyopathy, in which structural and functional changes occur in the heart impairing cardiac function.

Exercise training has already proven the benefits on glycemic control in diabetes. This is also the case for the effects on cardiac function. However, as results are conflicting, it remains unclear which elements of exercise training should be focused on. For instance, high-intensity interval training (HIIT) is gaining interest as positive effects are already shown on glycemic control. Therefore, the potential of HIIT to improve cardiac function in diabetes should be investigated. Further on, the effects of exercise training on cardiac function are mainly investigated during rest by the use of transthoracic echocardiography. Therefore, as data are lacking, it remains unclear how the diabetic heart functions during exercise.

The aim of the present study is to investigate the effects of different training modalities (e.g. HIIT) on heart function in diabetes both during rest and during exercise itself. Therefore, cardiac function will be evaluated by the use transthoracic (exercise) echocardiography. This will be combined by the evaluation of several biochemical parameters.

The results will provide more insight in the pathology of diabetic cardiomyopathy as well as the potential of exercise training for this cardiovascular complication. Eventually, this research will contribute to the optimization of exercise programs for patients with diabetes.

02

Conditions studied

  • Diabetic Cardiomyopathies
  • Type2 Diabetes

Keywords

  • Type 2 diabetes
  • Diabetic cardiomyopathy
  • Cardiac function
  • Exercise echocardiography
  • Exercise training
03

Who can participate

Ages eligible
18 Years to 81 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • type 2 diabetes patients:

    • BMI > 20kg/m²
    • diagnosis of T2DM as stated in guidelines of ADA (American Diabetes Association)
    • stable medication for at least 3 months
  • Healthy controls:

    • BMI > 20kg/m²
    • no diabetes

Exclusion criteria

Exclusion Criteria:

  • iron deficiency anemia
  • participation in another clinical trial
  • heart diseases: CAD (coronary artery disease), ischemia, valvular diseases, congenital heart diseases
  • neurological, pneumological, oncological, orthopedic disorders
  • diabetes complications: renal diseases, retinopathy
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
53 participants (actual)

Study arms

  • Active comparator
    training group 1: HIIT

    high-intensity interval exercise training group (T2DM patients)

    Other: high-intensity interval exercise training (HIIT)

  • Active comparator
    training group 2: MIT

    moderate-intensity exercise training group (T2DM patients)

    Other: moderate-intensity exercise training (MIT)

  • No intervention
    Detraining period

    Follow-up: detraining of group 1 and 2 (T2DM patients)

  • No intervention
    Healthy controls

Interventions

  • Otherhigh-intensity interval exercise training (HIIT)

    This program includes 24 weeks of exercise training and is divided in different phases (phase 1: week 1-2, equal to the MIT group, phase 2: week 3-6, 6 bouts of high-intensity exercise, phase 3: week 7-12, 7 bouts of high-intensity exercise, phase 4: week 13-24, 8 bouts of high-intensity exercise). The exercise training program consists of 3 exercise sessions per week (for 6 months).

  • Othermoderate-intensity exercise training (MIT)

    This program includes 24 weeks of exercise training and is not devided in phases. The exercise training program consists of 3 endurance exercise sessions per week (for 6 months). The total exercise volume equals the exercise volume of the HIIT group.

05

What researchers measure

Primary outcomes

  1. Transthoracic echocardiography (TTE) during excercise

    heart function during exercise by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,...) and cardiac structure (left ventricle mass, intraventricular wall mass,...)

    Time frame: day 1

  2. Transthoracic echocardiography (TTE) during excercise

    heart function during exercise by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,...) and cardiac structure (left ventricle mass, intraventricular wall mass,...)

    Time frame: month 3

  3. Transthoracic echocardiography (TTE) during excercise

    heart function during exercise by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,...) and cardiac structure (left ventricle mass, intraventricular wall mass,...)

    Time frame: month 6

  4. Transthoracic echocardiography (TTE) during excercise

    heart function during exercise by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,...) and cardiac structure (left ventricle mass, intraventricular wall mass,...)

    Time frame: month 12

  5. Transthoracic echocardiography (TTE)

    heart function in rest by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,...) and cardiac structure (left ventricle mass, intraventricular wall mass,...)

    Time frame: day 1

  6. Transthoracic echocardiography (TTE)

    heart function in rest by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,...) and cardiac structure (left ventricle mass, intraventricular wall mass,...)

    Time frame: month 3

  7. Transthoracic echocardiography (TTE)

    heart function in rest by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,...) and cardiac structure (left ventricle mass, intraventricular wall mass,...)

    Time frame: month 6

  8. Transthoracic echocardiography (TTE)

    heart function in rest by means of standard echocardiography: evaluation of diastolic and systolic function (mitral inflow pattern, ejection fraction, tissue doppler imaging, strain rate analyses,...) and cardiac structure (left ventricle mass, intraventricular wall mass,...)

    Time frame: month 12

  9. ECG (Electrocardiogram) during excercise

    ECG during excercise (an incremental exercise test on a cycle)

    Time frame: month 3

  10. ECG (Electrocardiogram) during excercise

    ECG during excercise (an incremental exercise test on a cycle)

    Time frame: month 12

  11. ECG (Electrocardiogram)

    ECG in rest

    Time frame: month 3

  12. ECG (Electrocardiogram)

    ECG in rest

    Time frame: month 12

Secondary outcomes

  1. Glycemic control

    glycemic concentrations, HbA1c levels, insulin sensitivity, inflammation, cardiac biomarkers

    Time frame: day 1

  2. Glycemic control

    glycemic control, insulin sensitivity, inflammation, cardiac biomarkers

    Time frame: month 3

  3. Glycemic control

    glycemic concentrations, HbA1c levels, insulin sensitivity, inflammation, cardiac biomarkers

    Time frame: month 6

  4. Glycemic control

    glycemic concentrations, HbA1c levels, insulin sensitivity, inflammation, cardiac biomarkers

    Time frame: month 12

  5. Insulin metabolism

    Fasting serum insulin, homeostasis model assessment insulin resistance and measures of central insulin sensitivity derived from an oral glucose tolerance test (75g)

    Time frame: day 1

  6. Insulin metabolism

    Fasting serum insulin, homeostasis model assessment insulin resistance and measures of central insulin sensitivity derived from an oral glucose tolerance test (75g)

    Time frame: month 3

  7. Insulin metabolism

    Fasting serum insulin, homeostasis model assessment insulin resistance and measures of central insulin sensitivity derived from an oral glucose tolerance test (75g)

    Time frame: month 6

  8. Insulin metabolism

    Fasting serum insulin, homeostasis model assessment insulin resistance and measures of central insulin sensitivity derived from an oral glucose tolerance test (75g)

    Time frame: month 12

  9. Cardiac function

    Cardiac biomarkers (brain-derived natriuretic peptide (BNP) levels, cardiac troponin levels)

    Time frame: day 1

  10. Cardiac function

    Cardiac biomarkers (BNP levels, cardiac troponin levels)

    Time frame: month 3

  11. Cardiac function

    Cardiac biomarkers (BNP levels, cardiac troponin levels)

    Time frame: month 6

  12. Cardiac function

    Cardiac biomarkers (BNP levels, cardiac troponin levels)

    Time frame: month 12

  13. Inflammation and oxidative stress

    C reactive protein (CRP) levels, tumor necrosis factor-(TNF)alpha levels, interleukin (IL)-10 (interleukin) levels, oxidative stress markers (superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GPX))

    Time frame: day 1

  14. Inflammation and oxidative stress

    CRP levels, TNF-alpha levels, IL-10 levels, oxidative stress markers (SOD, MDA, GPX)

    Time frame: month 3

  15. Inflammation and oxidative stress

    CRP levels, TNF-alpha levels, IL-10 levels, oxidative stress markers (SOD, MDA , GPX)

    Time frame: month 6

  16. Inflammation and oxidative stress

    CRP levels, TNF-alpha levels, IL-10 levels, oxidative stress markers (SOD, MDA, GPX)

    Time frame: month 12

  17. body composition

    body composition, measured using dual x-ray absorptiometry

    Time frame: day 1

  18. body composition

    body composition, measured using dual x-ray absorptiometry

    Time frame: month 6

  19. Maximal oxygen uptake (ml/O2/kg/min)

    exercise capacity measured using indirect calorimetry and an incremental bicycle exercise protocol

    Time frame: day 1

  20. Maximal oxygen uptake (ml/O2/kg/min)

    exercise capacity measured using indirect calorimetry and an incremental bicycle exercise protocol

    Time frame: month 3

  21. Maximal oxygen uptake (ml/O2/kg/min)

    exercise capacity measured using indirect calorimetry and an incremental bicycle exercise protocol

    Time frame: month 6

  22. Maximal oxygen uptake (ml/O2/kg/min)

    exercise capacity measured using indirect calorimetry and an incremental bicycle exercise protocol

    Time frame: month 12

06

Study locations

1 site
  • Jessa Ziekenhuis
    Hasselt, 3500, Belgium
07

References and documents

Publications

  • Van Ryckeghem L, Keytsman C, De Brandt J, Verboven K, Verbaanderd E, Marinus N, Franssen WMA, Frederix I, Bakelants E, Petit T, Jogani S, Stroobants S, Dendale P, Bito V, Verwerft J, Hansen D. Impact of continuous vs. interval training on oxygen extraction and cardiac function during exercise in type 2 diabetes mellitus. Eur J Appl Physiol. 2022 Apr;122(4):875-887. doi: 10.1007/s00421-022-04884-9. Epub 2022 Jan 17. PubMed 35038022 ↗
  • Van Ryckeghem L, Keytsman C, Verboven K, Verbaanderd E, Frederix I, Bakelants E, Petit T, Jogani S, Stroobants S, Dendale P, Bito V, Verwerft J, Hansen D. Exercise capacity is related to attenuated responses in oxygen extraction and left ventricular longitudinal strain in asymptomatic type 2 diabetes patients. Eur J Prev Cardiol. 2022 Jan 11;28(16):1756-1766. doi: 10.1093/eurjpc/zwaa007. PubMed 33623980 ↗
  • Van Ryckeghem L, Keytsman C, Verbaanderd E, Frederix I, Bakelants E, Petit T, Jogani S, Stroobants S, Dendale P, Bito V, Verwerft J, Hansen D. Asymptomatic type 2 diabetes mellitus display a reduced myocardial deformation but adequate response during exercise. Eur J Appl Physiol. 2021 Mar;121(3):929-940. doi: 10.1007/s00421-020-04557-5. Epub 2021 Jan 8. PubMed 33417036 ↗
08

Registry details

Key details

Study ID
NCT03299790
Lead sponsor
Hasselt University
Collaborators
Jessa Hospital
Responsible party
Dominique Hansen (prof. dr., Hasselt University) — Principal investigator
First posted
Oct 3, 2017
Start date
Oct 6, 2017
Primary completion
Dec 31, 2019
Completion
Sep 30, 2020
Last update
Dec 10, 2020

Oversight

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

Not currently enrolling

This study is completed, as verified in Dec 2020. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion