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Clinical Trial to Assess the Effects of Dairy on Insulin Sensitivity and β-Cell Function

Primary Purpose

Diabetes

Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Low-fat dairy
Sugar-sweetened beverages
Sponsored by
Provident Clinical Research
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Diabetes focused on measuring Insulin sensitivity

Eligibility Criteria

18 Years - 74 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • subject is male or female, 18-74 yrs of age, inclusive
  • subject reports habitual consumption of ≥2 servings/d of high-sugar beverages (e.g., non-diet soda, fruit juice cocktails)
  • subject has waist circumference ≥33.0 inches for women and ≥36.0 inches for men
  • subject is at risk for development of type 2 diabetes mellitus (T2DM), based on 1 or more of the following: fasting glucose 100-125 mg/dL; glycosylated hemoglobin 5.7-6.4%, or ≥20% risk of developing diabetes in the next 7.5 yrs based on the San Antonio Heart Study prediction equation
  • subject has a score of 7-10 on the Vein Access Scale at screening
  • subject is normally active and judged to be in good health on the basis of medical history, physical examination and routine lab tests
  • if female, subject is willing to schedule treatment visits during the follicular phase of the menstrual cycle, defined as days 1-14, where day 1 is 1st day of menses
  • subject has a menstrual cycle duration ranging in length form 24-36 d (if premenopausal)
  • subject is willing to maintain a stable body weight and follow his/her habitual diet and exercise pattern, except for inclusion of study product, throughout the trial
  • subject is willing to maintain his or her habitual intake of coffee, tea, and alcoholic beverages throughout the trial
  • subject agrees to limit intake of non-study related dairy products to ≤1 serving per day during each treatment period
  • subject is ambulatory and willing to refrain from vigorous physical activity and consumption of alcoholic beverages 24 h prior to each test day
  • subject has no plans to change smoking habits during the study period
  • subject is willing to abstain from tobacco use 1 h prior to and during visits on LMTT test days
  • subject has no health conditions that would prevent him/her from fulfilling the study requirements as judged by the Investigator on the basis of medical history and routine lab test results

Exclusion Criteria:

  • subject has abnormal lab test results of clinical importance, including, but not limited to, TG ≥400 mg/dL, fasting creatinine ≥1.5 mg/dL, alanine aminotransferase or aspartate aminotransferase ≥1.5 times the upper limit of normal at screening
  • subject has a body mass index ≥45.0 kg/m2
  • subject has fasting blood glucose ≥126 mg/dL at screening or known diabetes mellitus (type 1 or T2DM)
  • subject has a habitual intake of ≥4 servings/d of dairy food and beverages
  • subject has known allergy or sensitivity to study product or any ingredients of study product. Subjects with lactose intolerance will be allowed to use products such as Lactaid dietary supplements
  • subject has a history of coronary heart disease, congestive heart failure, or serious ventricular dysrhythmias (ventricular tachycardia or fibrillation)
  • subject has a change in body weight of >4.5 kg within 4 weeks of screening
  • subject uses medications known to influence carbohydrate metabolism
  • subject has recent use of antibiotics
  • subject has an active infection
  • subject has unstable use of anti-hypertensive medications, thyroid hormone replacement, or lipid-altering drugs within 4 weeks of screening
  • subject has unstable use of lipid-altering foods or dietary supplements within 4 weeks of screening
  • subject uses niacin at doses >200 mg/d within 4 weeks of screening
  • subject has history of extreme dietary habits, e.g., Atkins, high protein
  • subject has a history or presence of clinically important endocrine, cardiac, renal, hepatic, pulmonary, biliary, pancreatic, gastrointestinal, or neurologic disorders that could interfere with interpretation of study results
  • subject has history of dysphagia, swallowing disorders, or intestinal motility disorders
  • subject has history of cancer
  • subject has uncontrolled hypertension at screening (systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg)

Sites / Locations

  • Provident Clinical Research (now Biofortis)

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Low-fat dairy

Sugar-sweetened beverages

Arm Description

3 servings/d of low-fat dairy

3 servings/d of sugar-sweetened foods

Outcomes

Primary Outcome Measures

Matsuda Insulin Sensitivity Index (MISI)
MISI calculated from glucose and insulin data obtained during a liquid meal tolerance test (LMTT). MISI = 10,000 divided by the square root of the quantity of fasting glucose x fasting insulin x mean post-load glucose from samples collected at 30, 60, 90 and 120 min after the start of the liquid meal x mean post-load insulin from samples collected at 30, 60, 90 and 120 min after the start of the liquid meal

Secondary Outcome Measures

Waist circumference
Measured using a non-stretch anthropometric tape
Blood pressure
Standardized vital signs measurements will include resting blood pressure and pulse measured using an automated blood pressure measurement device.
Fasting and 2-hr LMTT insulin and glucose concentrations
During the LMTT subjects consume a liquid meal load (two-8 oz servings of Ensure®, Ross Products Division, Abbott Laboratories, Columbus, Ohio), and blood samples will be obtained at t = -10, 30, 60, 90, and 120 min ± 5 min where t = 0 min is the start of meal consumption. Serum insulin and plasma glucose concentrations will be measured in fasting (-10 min) and 2 hr (120 min) samples.
Homeostasis model assessment of insulin resistance (HOMA-IR)
HOMA-IR = the quantity of fasting glucose in mg/dL x fasting insulin in microunits/mL divided by 405
Homeostasis model assessment of beta-cell function (HOMA%B)
HOMA%B = 360 x fasting insulin in microunits/mL divided by fasting glucose in mg/dL minus 63
Glucose total area under the curve (AUC) from 0-120 min
Glucose total AUC 0-120 min will be calculated using the trapezoidal rule on glucose concentrations in blood samples collected at -10, 30, 60, 90, and 120 min where 0 min is the start of the liquid meal consumption in the LMTT.
Insulin total AUC 0-120 min
Insulin total AUC 0-120 min will be calculated using the trapezoidal rule on insulin concentrations in blood samples collected at -10, 30, 60, 90, and 120 min where 0 min is the start of the liquid meal consumption in the LMTT.
30 min Δ insulin/Δ glucose
Change in insulin from baseline to 30 min of the LMTT will be divided by the change in glucose from baseline to 30 min of the LMTT
AUC insulin/AUC glucose
AUC for insulin divided by the AUC for glucose
Disposition Index
Disposition index = MISI x the quantity of AUC for insulin divided by the AUC for glucose
Fasting plasma total cholesterol (total-C)
Fasting plasma low-density lipoprotein cholesterol (LDL-C)
Calculated as LDL-C = total-C minus HDL-C minus the quantity of triglycerides (TG) divided by 5
Fasting plasma high-density lipoprotein cholesterol (HDL-C)
Fasting plasma total-C/HDL-C
Calculated as total-C concentration divided by HDL-C concentration
Fasting plasma non-HDL-C
Calculated as non-HDL-C = total-C minus HDL-C
Fasting plasma TG
Serum 25-hydroxy vitamin D [25(OH)D]
Plasma high-sensitivity C-reactive protein (hs-CRP)

Full Information

First Posted
September 3, 2013
Last Updated
September 3, 2013
Sponsor
Provident Clinical Research
Collaborators
BioFortis, Dairy Research Institute
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1. Study Identification

Unique Protocol Identification Number
NCT01936935
Brief Title
Clinical Trial to Assess the Effects of Dairy on Insulin Sensitivity and β-Cell Function
Official Title
A Randomized, Controlled, Crossover Trial to Assess the Effects of Dairy Intake on Insulin Sensitivity and β-Cell Function in Men and Women at Risk for Diabetes Who Are Habitual Consumers of High Sugar Beverages
Study Type
Interventional

2. Study Status

Record Verification Date
September 2013
Overall Recruitment Status
Unknown status
Study Start Date
September 2012 (undefined)
Primary Completion Date
September 2013 (Anticipated)
Study Completion Date
September 2013 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Provident Clinical Research
Collaborators
BioFortis, Dairy Research Institute

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The aim of this trial is to evaluate the effects of dairy product consumption on insulin sensitivity and pancreatic β-cell function in men and women at risk for the development of type 2 diabetes mellitus (T2DM) who habitually consume beverages high in sugar (non-diet sodas and fruit juice cocktails).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes
Keywords
Insulin sensitivity

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
44 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Low-fat dairy
Arm Type
Experimental
Arm Description
3 servings/d of low-fat dairy
Arm Title
Sugar-sweetened beverages
Arm Type
Placebo Comparator
Arm Description
3 servings/d of sugar-sweetened foods
Intervention Type
Other
Intervention Name(s)
Low-fat dairy
Intervention Description
2 servings/d of 2% non-flavored, unsweetened milk + 1 serving/d sweetened low-fat yogurt
Intervention Type
Other
Intervention Name(s)
Sugar-sweetened beverages
Intervention Description
2 servings/d of non-diet soda + 1 serving/d of non-dairy pudding
Primary Outcome Measure Information:
Title
Matsuda Insulin Sensitivity Index (MISI)
Description
MISI calculated from glucose and insulin data obtained during a liquid meal tolerance test (LMTT). MISI = 10,000 divided by the square root of the quantity of fasting glucose x fasting insulin x mean post-load glucose from samples collected at 30, 60, 90 and 120 min after the start of the liquid meal x mean post-load insulin from samples collected at 30, 60, 90 and 120 min after the start of the liquid meal
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
Waist circumference
Description
Measured using a non-stretch anthropometric tape
Time Frame
6 weeks
Title
Blood pressure
Description
Standardized vital signs measurements will include resting blood pressure and pulse measured using an automated blood pressure measurement device.
Time Frame
6 weeks
Title
Fasting and 2-hr LMTT insulin and glucose concentrations
Description
During the LMTT subjects consume a liquid meal load (two-8 oz servings of Ensure®, Ross Products Division, Abbott Laboratories, Columbus, Ohio), and blood samples will be obtained at t = -10, 30, 60, 90, and 120 min ± 5 min where t = 0 min is the start of meal consumption. Serum insulin and plasma glucose concentrations will be measured in fasting (-10 min) and 2 hr (120 min) samples.
Time Frame
6 weeks
Title
Homeostasis model assessment of insulin resistance (HOMA-IR)
Description
HOMA-IR = the quantity of fasting glucose in mg/dL x fasting insulin in microunits/mL divided by 405
Time Frame
6 weeks
Title
Homeostasis model assessment of beta-cell function (HOMA%B)
Description
HOMA%B = 360 x fasting insulin in microunits/mL divided by fasting glucose in mg/dL minus 63
Time Frame
6 weeks
Title
Glucose total area under the curve (AUC) from 0-120 min
Description
Glucose total AUC 0-120 min will be calculated using the trapezoidal rule on glucose concentrations in blood samples collected at -10, 30, 60, 90, and 120 min where 0 min is the start of the liquid meal consumption in the LMTT.
Time Frame
6 weeks
Title
Insulin total AUC 0-120 min
Description
Insulin total AUC 0-120 min will be calculated using the trapezoidal rule on insulin concentrations in blood samples collected at -10, 30, 60, 90, and 120 min where 0 min is the start of the liquid meal consumption in the LMTT.
Time Frame
6 weeks
Title
30 min Δ insulin/Δ glucose
Description
Change in insulin from baseline to 30 min of the LMTT will be divided by the change in glucose from baseline to 30 min of the LMTT
Time Frame
6 weeks
Title
AUC insulin/AUC glucose
Description
AUC for insulin divided by the AUC for glucose
Time Frame
6 weeks
Title
Disposition Index
Description
Disposition index = MISI x the quantity of AUC for insulin divided by the AUC for glucose
Time Frame
6 weeks
Title
Fasting plasma total cholesterol (total-C)
Time Frame
6 weeks
Title
Fasting plasma low-density lipoprotein cholesterol (LDL-C)
Description
Calculated as LDL-C = total-C minus HDL-C minus the quantity of triglycerides (TG) divided by 5
Time Frame
6 weeks
Title
Fasting plasma high-density lipoprotein cholesterol (HDL-C)
Time Frame
6 weeks
Title
Fasting plasma total-C/HDL-C
Description
Calculated as total-C concentration divided by HDL-C concentration
Time Frame
6 weeks
Title
Fasting plasma non-HDL-C
Description
Calculated as non-HDL-C = total-C minus HDL-C
Time Frame
6 weeks
Title
Fasting plasma TG
Time Frame
6 weeks
Title
Serum 25-hydroxy vitamin D [25(OH)D]
Time Frame
6 weeks
Title
Plasma high-sensitivity C-reactive protein (hs-CRP)
Time Frame
6 weeks
Other Pre-specified Outcome Measures:
Title
Mean circulating glucose level
Description
Mean circulating glucose level will be measured over 24 h in the continuous glucose monitoring (CGM) subset of subjects
Time Frame
6 weeks
Title
Mean daytime glucose values
Description
Mean daytime glucose values (6 am to 8 pm) measured in the CGM subset of subjects
Time Frame
6 weeks
Title
Mean evening/nighttime glucose values
Description
Mean evening/nighttime glucose values (8 pm to 6 am) measured in the CGM subset of subjects
Time Frame
6 weeks
Title
Mean peak postprandial glucose
Description
Mean peak postprandial glucose values during CGM after the lunch and dinner meals
Time Frame
6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
74 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: subject is male or female, 18-74 yrs of age, inclusive subject reports habitual consumption of ≥2 servings/d of high-sugar beverages (e.g., non-diet soda, fruit juice cocktails) subject has waist circumference ≥33.0 inches for women and ≥36.0 inches for men subject is at risk for development of type 2 diabetes mellitus (T2DM), based on 1 or more of the following: fasting glucose 100-125 mg/dL; glycosylated hemoglobin 5.7-6.4%, or ≥20% risk of developing diabetes in the next 7.5 yrs based on the San Antonio Heart Study prediction equation subject has a score of 7-10 on the Vein Access Scale at screening subject is normally active and judged to be in good health on the basis of medical history, physical examination and routine lab tests if female, subject is willing to schedule treatment visits during the follicular phase of the menstrual cycle, defined as days 1-14, where day 1 is 1st day of menses subject has a menstrual cycle duration ranging in length form 24-36 d (if premenopausal) subject is willing to maintain a stable body weight and follow his/her habitual diet and exercise pattern, except for inclusion of study product, throughout the trial subject is willing to maintain his or her habitual intake of coffee, tea, and alcoholic beverages throughout the trial subject agrees to limit intake of non-study related dairy products to ≤1 serving per day during each treatment period subject is ambulatory and willing to refrain from vigorous physical activity and consumption of alcoholic beverages 24 h prior to each test day subject has no plans to change smoking habits during the study period subject is willing to abstain from tobacco use 1 h prior to and during visits on LMTT test days subject has no health conditions that would prevent him/her from fulfilling the study requirements as judged by the Investigator on the basis of medical history and routine lab test results Exclusion Criteria: subject has abnormal lab test results of clinical importance, including, but not limited to, TG ≥400 mg/dL, fasting creatinine ≥1.5 mg/dL, alanine aminotransferase or aspartate aminotransferase ≥1.5 times the upper limit of normal at screening subject has a body mass index ≥45.0 kg/m2 subject has fasting blood glucose ≥126 mg/dL at screening or known diabetes mellitus (type 1 or T2DM) subject has a habitual intake of ≥4 servings/d of dairy food and beverages subject has known allergy or sensitivity to study product or any ingredients of study product. Subjects with lactose intolerance will be allowed to use products such as Lactaid dietary supplements subject has a history of coronary heart disease, congestive heart failure, or serious ventricular dysrhythmias (ventricular tachycardia or fibrillation) subject has a change in body weight of >4.5 kg within 4 weeks of screening subject uses medications known to influence carbohydrate metabolism subject has recent use of antibiotics subject has an active infection subject has unstable use of anti-hypertensive medications, thyroid hormone replacement, or lipid-altering drugs within 4 weeks of screening subject has unstable use of lipid-altering foods or dietary supplements within 4 weeks of screening subject uses niacin at doses >200 mg/d within 4 weeks of screening subject has history of extreme dietary habits, e.g., Atkins, high protein subject has a history or presence of clinically important endocrine, cardiac, renal, hepatic, pulmonary, biliary, pancreatic, gastrointestinal, or neurologic disorders that could interfere with interpretation of study results subject has history of dysphagia, swallowing disorders, or intestinal motility disorders subject has history of cancer subject has uncontrolled hypertension at screening (systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥100 mm Hg)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kevin C Maki, PhD
Organizational Affiliation
Biofortis Clinical Research, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Provident Clinical Research (now Biofortis)
City
Addison
State/Province
Illinois
ZIP/Postal Code
60101
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
25733460
Citation
Maki KC, Nieman KM, Schild AL, Kaden VN, Lawless AL, Kelley KM, Rains TM. Sugar-sweetened product consumption alters glucose homeostasis compared with dairy product consumption in men and women at risk of type 2 diabetes mellitus. J Nutr. 2015 Mar;145(3):459-66. doi: 10.3945/jn.114.204503. Epub 2015 Jan 7.
Results Reference
derived

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Clinical Trial to Assess the Effects of Dairy on Insulin Sensitivity and β-Cell Function

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