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Pilot Study of OMEGA-3 and Vitamin D in High-Dose in Type I Diabetic Patients (POSEIDON)

Primary Purpose

Diabetes Mellitus, Type 1, Hypoglycemia, Diabetes Mellitus

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Cholecalciferol
Omega 3 fatty acid
Sponsored by
Rodolfo Alejandro
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Mellitus, Type 1

Eligibility Criteria

6 Years - 65 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

Patients must meet all of the following criteria to be eligible to participate in this study:

  1. Subjects or their parents if under 18 years old must be able to understand and provide informed consent.
  2. Males and females, 6-65 years of age.
  3. For new onset T1D subjects, ≤180 days from T1D diagnosis at the time of randomization with a MMTT stimulated C-peptide peak level ≥0.2 ng/ml prior to randomization.
  4. For established T1D subjects, >180 days and ≤10 years of T1D duration at the time of randomization and MMTT stimulated C-peptide peak level ≥0.2 ng/ml prior to randomization.
  5. Affected by T1D, according to ADA standard criteria, and confirmed by positivity of at least one T1D-associated autoantibody, to GAD65, IA-2, ZnT8, or insulin autoantibodies (if patient has been treated with insulin for less than 2 weeks).
  6. Female subjects of childbearing potential must have a negative pregnancy test upon study entry.
  7. Adequate venous access to support study required blood draws.

Exclusion Criteria

Potential participants must not meet any of the following exclusion criteria:

  1. Inability or unwillingness of a participant or their parents to give written informed consent or comply with study protocol.
  2. BMI>30 Kg/m2.
  3. Contra-indications to Omega-3 Fatty Acids and/or Vitamin-D (e.g., knowledge of hypersensitivity to drugs or its excipients, allergies with fish or shellfish etc.).
  4. Uncompensated heart failure, fluid overload, myocardial infarction or liver disease or severe impairment of a vital organ within the last 6 weeks before enrollment.
  5. Any sign or diagnosis of significant chronic active infection (e.g., hepatitis, tuberculosis, EBV, or CMV), or screening laboratory evidence consistent with a significant chronic active infection (such as positive for HIV, IGRA test for TB, or hepatitis B-C).
  6. Ongoing acute infections, e.g., acute respiratory tract urinary tract, or gastrointestinal tract infections.
  7. Subjects on weight altering medications, such as Orlistat.
  8. Subjects with eating disorders
  9. Ongoing or anticipated use of diabetes medications other than insulin.
  10. Current or ongoing use of non-insulin pharmaceuticals that affect glycemic control within prior 7 days of screening.
  11. People who chronically take drugs that affect bleeding time, such as anticoagulants ("blood thinners") or nonsteroidal anti-inflammatory drugs (NSAIDs), will not qualify to enroll in the study.
  12. Recent recipient of any licensed or investigational live attenuated vaccine(s) within 6 weeks of randomization.
  13. Use of investigational drugs within 4 months of participation.
  14. Concomitant therapy with immunosuppressive drugs, immunomodulators, or cytotoxic agents, or previous therapy less than 3 months from randomization.
  15. History or diagnosis of malignancy.
  16. History of gastroparesis or other severe gastrointestinal disease.
  17. History or diagnosis of malignancy with the exception of a history of localized basal or squamous cell carcinoma. There is conflicting evidence about whether omega-3 fatty acids found in seafood and fish oil might increase the risk of prostate cancer. Until additional research on the association of omega-3 consumption and prostate cancer risk is conducted, subjects with family history of prostate cancer in a first-degree relative will be excluded from the study.
  18. Presence of an allograft.
  19. AST, ALT or Alkaline Phosphatase >2 times upper limit of normal or total bilirubin >1.5 times upper limit of normal.
  20. History of a mental illness deemed to be clinically unstable or any situation that, in the opinion of the investigator, would interfere with the participant's ability to comply with study requirements.
  21. History of illicit drug or alcohol abuse.
  22. Pregnancy or ongoing breastfeeding for women; unwillingness or inability of both females and males of childbearing age to use a reliable and effective form of contraception, for the entire duration of the study.
  23. Past or current medical problems, or findings from physical examination, or laboratory testing, that are not listed above which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained.
  24. All patients who have coagulation, bleeding, or blood disorders will be excluded due to the effect of high dose of Omega 3 Fatty Acids on coagulation and bleeding process.

Sites / Locations

  • Diabetes Research Institute, University of Miami Miller School of MedicineRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Omega-3 and Vitamin D Combination

Vitamin D Only

Arm Description

The treatment arm A includes Omega-3 Fatty Acids and Cholecalciferol (Vitamin D) supplement.

The treatment arm B (control group) will receive only Cholecalciferol (Vitamin D) supplement.

Outcomes

Primary Outcome Measures

MMTT (Mixed Meal Tolerance Test)
Stimulated (90 minute sample of a MMTT) C-peptide greater or equal to baseline level.

Secondary Outcome Measures

Hemoglobin A1c Level Reduction
Reduction in HbA1c at the one year visit compared to baseline
Reduction in Insulin Requirements
Reduction in insulin requirement at the 1 year visit compared to baseline
Incidence of Adverse Events (AE)
Incidence of adverse events (AE) comparable to general diabetes population

Full Information

First Posted
January 10, 2018
Last Updated
July 25, 2023
Sponsor
Rodolfo Alejandro
Collaborators
Diabetes Research Institute Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT03406897
Brief Title
Pilot Study of OMEGA-3 and Vitamin D in High-Dose in Type I Diabetic Patients
Acronym
POSEIDON
Official Title
A Pilot, Safety and Feasibility Trial of High-Dose Omega-3 Fatty Acids and High-Dose Cholecalciferol (Vitamin D) Supplementation in Type 1 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 23, 2018 (Actual)
Primary Completion Date
September 2025 (Anticipated)
Study Completion Date
December 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Rodolfo Alejandro
Collaborators
Diabetes Research Institute Foundation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
The investigator propose to test the safety and efficacy of a regimen that combines Omega-3 Fatty Acids and Vitamin D in a design that considers timing and duration of administration in relation to their effects and predicted synergies.
Detailed Description
These agents may afford promote sustained immune regulation, reduce inflammation, and provide support for the residual beta cell mass. This integrated therapeutic regimen addresses major pathogenic mechanisms in T1D (Type 1 Diabetes) and thus represents a rational and well supported approach to preserve insulin secretion in T1D (Type 1 Diabetes). This approach could halt the disease progress, preserve β-cell function and hopefully reduce dose of insulin required to manage T1D (Type 1 Diabetes). The investigator hypothesizes that Omega-3 Fatty Acids and Vitamin D, administered to patients with newly or established T1D (Type 1 Diabetes) and residual stimulated C-peptide secretion will be safe and may preserve insulin secretion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus, Type 1, Hypoglycemia, Diabetes Mellitus, Diabetes, Autoimmune

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Model Description
The study is a two-arm, open label, randomized trial. All four groups will receive standard intensive diabetes treatment with insulin and dietary management. Group I: Fourteen (14) adults (18-65 years) of established T1D > 6 months (>180 days) and up to 10 years of T1D duration Group II: Fourteen (14) adults (18-65 years) of new-onset T1D diagnosed within last 6 months (≤ 180 days) Group III: Fourteen (14) children (6-17 years) of established T1D > 6 months (>180 days) and up to 10 years of T1D duration Group IV: Fourteen (14) children (6-17 years) of new-onset T1D diagnosed within last 6 months (≤ 180 days) Participants in each group will be randomly assigned in a 1:1 ratio to receive either one year of high dose Omega-3 fatty acids and Vitamin D combination (Arm A) or Vitamin D alone (Arm B). Both arms will receive Vitamin D supplementation.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
56 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Omega-3 and Vitamin D Combination
Arm Type
Active Comparator
Arm Description
The treatment arm A includes Omega-3 Fatty Acids and Cholecalciferol (Vitamin D) supplement.
Arm Title
Vitamin D Only
Arm Type
Active Comparator
Arm Description
The treatment arm B (control group) will receive only Cholecalciferol (Vitamin D) supplement.
Intervention Type
Drug
Intervention Name(s)
Cholecalciferol
Other Intervention Name(s)
Vitamin D
Intervention Description
Oral Administration
Intervention Type
Drug
Intervention Name(s)
Omega 3 fatty acid
Other Intervention Name(s)
Omega 3
Intervention Description
Oral Administration
Primary Outcome Measure Information:
Title
MMTT (Mixed Meal Tolerance Test)
Description
Stimulated (90 minute sample of a MMTT) C-peptide greater or equal to baseline level.
Time Frame
Through study completion, and average of one year
Secondary Outcome Measure Information:
Title
Hemoglobin A1c Level Reduction
Description
Reduction in HbA1c at the one year visit compared to baseline
Time Frame
Through study completion, and average of one year
Title
Reduction in Insulin Requirements
Description
Reduction in insulin requirement at the 1 year visit compared to baseline
Time Frame
Through study completion, and average of one year
Title
Incidence of Adverse Events (AE)
Description
Incidence of adverse events (AE) comparable to general diabetes population
Time Frame
Through study completion, and average of one year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Patients must meet all of the following criteria to be eligible to participate in this study: Subjects or their parents if under 18 years old must be able to understand and provide informed consent. Males and females, 6-65 years of age. For new onset T1D subjects, ≤180 days from T1D diagnosis at the time of randomization with a MMTT stimulated C-peptide peak level ≥0.2 ng/ml prior to randomization. For established T1D subjects, >180 days and ≤10 years of T1D duration at the time of randomization and MMTT stimulated C-peptide peak level ≥0.2 ng/ml prior to randomization. Affected by T1D, according to ADA standard criteria, and confirmed by positivity of at least one T1D-associated autoantibody, to GAD65, IA-2, ZnT8, or insulin autoantibodies (if patient has been treated with insulin for less than 2 weeks). Female subjects of childbearing potential must have a negative pregnancy test upon study entry. Adequate venous access to support study required blood draws. Exclusion Criteria Potential participants must not meet any of the following exclusion criteria: Inability or unwillingness of a participant or their parents to give written informed consent or comply with study protocol. BMI>30 Kg/m2. Contra-indications to Omega-3 Fatty Acids and/or Vitamin-D (e.g., knowledge of hypersensitivity to drugs or its excipients, allergies with fish or shellfish etc.). Uncompensated heart failure, fluid overload, myocardial infarction or liver disease or severe impairment of a vital organ within the last 6 weeks before enrollment. Any sign or diagnosis of significant chronic active infection (e.g., hepatitis, tuberculosis, EBV, or CMV), or screening laboratory evidence consistent with a significant chronic active infection (such as positive for HIV, IGRA test for TB, or hepatitis B-C). Ongoing acute infections, e.g., acute respiratory tract urinary tract, or gastrointestinal tract infections. Subjects on weight altering medications, such as Orlistat. Subjects with eating disorders Ongoing or anticipated use of diabetes medications other than insulin. Current or ongoing use of non-insulin pharmaceuticals that affect glycemic control within prior 7 days of screening. People who chronically take drugs that affect bleeding time, such as anticoagulants ("blood thinners") or nonsteroidal anti-inflammatory drugs (NSAIDs), will not qualify to enroll in the study. Recent recipient of any licensed or investigational live attenuated vaccine(s) within 6 weeks of randomization. Use of investigational drugs within 4 months of participation. Concomitant therapy with immunosuppressive drugs, immunomodulators, or cytotoxic agents, or previous therapy less than 3 months from randomization. History or diagnosis of malignancy. History of gastroparesis or other severe gastrointestinal disease. History or diagnosis of malignancy with the exception of a history of localized basal or squamous cell carcinoma. There is conflicting evidence about whether omega-3 fatty acids found in seafood and fish oil might increase the risk of prostate cancer. Until additional research on the association of omega-3 consumption and prostate cancer risk is conducted, subjects with family history of prostate cancer in a first-degree relative will be excluded from the study. Presence of an allograft. AST, ALT or Alkaline Phosphatase >2 times upper limit of normal or total bilirubin >1.5 times upper limit of normal. History of a mental illness deemed to be clinically unstable or any situation that, in the opinion of the investigator, would interfere with the participant's ability to comply with study requirements. History of illicit drug or alcohol abuse. Pregnancy or ongoing breastfeeding for women; unwillingness or inability of both females and males of childbearing age to use a reliable and effective form of contraception, for the entire duration of the study. Past or current medical problems, or findings from physical examination, or laboratory testing, that are not listed above which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained. All patients who have coagulation, bleeding, or blood disorders will be excluded due to the effect of high dose of Omega 3 Fatty Acids on coagulation and bleeding process.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
David A Baidal, M.D.
Phone
(305) 243-7740
Ext
6-7740
Email
dbaidal@med.miami.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Rodolfo Alejandro, M.D.
Phone
(305) 243-5324
Email
RAlejand@med.miami.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Camillo Ricordi, M.D.
Organizational Affiliation
Professor and Center Director of Diabetes Research Institute
Official's Role
Study Director
Facility Information:
Facility Name
Diabetes Research Institute, University of Miami Miller School of Medicine
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rodolfo Alejandro, M.D.
Phone
305-243-5324
Email
ralejand@med.miami.edu
First Name & Middle Initial & Last Name & Degree
David A Baidal, M.D.
Phone
(305) 243-7740
Email
dbaidal@med.miami.edu
First Name & Middle Initial & Last Name & Degree
Rodolfo Alejandro, M.D.
First Name & Middle Initial & Last Name & Degree
David A Baidal, M.D.

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
27467009
Citation
Baidal DA, Ricordi C, Garcia-Contreras M, Sonnino A, Fabbri A. Combination high-dose omega-3 fatty acids and high-dose cholecalciferol in new onset type 1 diabetes: a potential role in preservation of beta-cell mass. Eur Rev Med Pharmacol Sci. 2016 Jul;20(15):3313-8.
Results Reference
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Pilot Study of OMEGA-3 and Vitamin D in High-Dose in Type I Diabetic Patients

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