Counterregulatory Hormone Production in Adrenal Insufficiency and Diabetes Type I (CANDI)
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Purpose
Patients with adrenal insufficiency also exhibit an adrenomedullary dysfunction. Furthermore, patients who suffer from both, adrenal insufficiency and type I diabetes more frequently report hypoglycemia, particularly after strenuous activities. The study investigates the counter regulatory hormonal response to physical stress and the impact on cognitive function in subjects with and without Addison's disease, type I diabetes and healthy subjects.
| Condition | Intervention |
|---|---|
|
Addison's Disease Adrenal Insufficiency Diabetes Mellitus Type I |
Procedure: Spiroergometry |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Counterregulatory Hormone Production and Cognitive Function in Patients With Adrenal Insufficiency and Diabetes Mellitus Type I |
- difference in cognitive function before and after physical stress [ Time Frame: testing is performed at first visit (baseline, duration 5 min) and second visit (at least 48 hours after visit1). The second test is performed 5 min after strenous activity of 23 min duration, test duration again 5 min) ] [ Designated as safety issue: No ]study participants are tested with three standardized tests: stroop-task, symptom rating scale and a short term memory test. First testing is performed at visit 1 at rest, the second test at visit 2 after strenous activity at a bicycle ergometer.
- differences in counterregulatory hormonal response to physical stress [ Time Frame: at visit 2, blood sampling over 180 min starting 10 min before spiroergometry ] [ Designated as safety issue: No ]blood samples for determination of blood glucose, catecholamines and other counterregulatory hormones (cortisol, growth hormone) are collected before, during and after physical activity.
Biospecimen Retention: Samples Without DNA
blood samples for hormonal analysis
| Estimated Enrollment: | 40 |
| Study Start Date: | March 2011 |
| Estimated Study Completion Date: | August 2012 |
| Estimated Primary Completion Date: | March 2012 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
Type I diabetes
Adult patients with diabetes mellitus type I but normal adrenal function
|
Procedure: Spiroergometry
At visit 1 determination of the individual VO2max by spiroergometry after first testing of cognitive function. At visit 2: Spiroergometry with 3 min warm up followed by 5 min 50% VO2max and 15 min at the individual respiratory compensation point (RCP). Other Name: not available
|
|
Addison's disease
Adult patients with Addison's disease
|
Procedure: Spiroergometry
At visit 1 determination of the individual VO2max by spiroergometry after first testing of cognitive function. At visit 2: Spiroergometry with 3 min warm up followed by 5 min 50% VO2max and 15 min at the individual respiratory compensation point (RCP). Other Name: not available
|
|
Type I diabetes and Addison's disease
Patients suffering from both, diabetes mellitus type I and Addison's disease
|
Procedure: Spiroergometry
At visit 1 determination of the individual VO2max by spiroergometry after first testing of cognitive function. At visit 2: Spiroergometry with 3 min warm up followed by 5 min 50% VO2max and 15 min at the individual respiratory compensation point (RCP). Other Name: not available
|
|
healthy controls
healthy controls with normal adrenal function and normal glucose regulation
|
Procedure: Spiroergometry
At visit 1 determination of the individual VO2max by spiroergometry after first testing of cognitive function. At visit 2: Spiroergometry with 3 min warm up followed by 5 min 50% VO2max and 15 min at the individual respiratory compensation point (RCP). Other Name: not available
|
Detailed Description:
As patients with adrenal insufficiency also exhibit an adrenomedullary dysfunction and patients who suffer from both, adrenal insufficiency and type I diabetes more frequently report hypoglycemia, particularly after strenuous activities this study investigates the counter-regulatory hormonal response to physical stress and the impact on cognitive function in subjects with and without Addison's disease, type I diabetes and healthy subjects. Patients will perform ergometer training with an individualized intensity and fulfill cognitive function testing (stroop test and fatigue inventories) before and after strenuous activity.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Non-Probability Sample |
Four groups:
Patients with Addison's disease alone patients with diabetes mellitus type I alone patients with both, Addison's disease and Diabetes mellitus type I healthy controls
Inclusion Criteria:
- Diagnosis of Addison's disease and/or diabetes mellitus type I or healthy control with normal adrenal function and normal glucosse regulation
- Age ≥ 18 years
- Ability to comply with the study protocol
- Capability to perform spiroergometry
Exclusion Criteria:
Any contraindication for performing spiroergometry according to the guidelines of the German Cardiac Society:
- akute myokardial infarction
- instable angina pectoris
- symptomatic arrhythmia
- severe and symptomatic stenosis of the aortic valve
- decompensated heart failure
- acute pulmonary embolism
- Acute myocarditis
- Acute pericarditis
- Acute aortic dissection
- main coronary artery disease
- valvulopathies
- electrolyte disturbance
- arterial hypertension (systolic blood pressure > 200 mm Hg, diastolic BP > 110 mm Hg)
- Tachyarrhythmia or Bradyarrhythmia
- Hypertrophic cardiomyopathy and other forms of obstructive heart disease
- second or third degree atrioventricular block
- Fever
- Diabetes mellitus Type 2
- Diseases or medication influencing the endogenous levels of plasma catecholamines(e. g. pheochromocytoma, paraganglioma, antidepressants, levodopa)
- Glucocorticoid-pharmacotherapy
Contacts and Locations| Contact: Stefanie Hahner, MD | +49 931 201 1 | hahner_s@medizin.uni-wuerzburg.de |
| Contact: Bruno Allolio, MD | +49 931 201 1 | allolio_b@medizin.uni-wuerzburg.de |
| Germany | |
| Dept. of Endocrinology and Diabetology, Dept. of Medicine I, University Hospital Wuerzburg | Recruiting |
| Wuerzburg, Germany, 97080 | |
| Contact: Stefanie Hahner, MD +49 931 201 1 hahner_s@medizin.uni-wuerzburg.de | |
| Study Chair: | Bruno Allolio, MD | University of Wuerzburg |
| Principal Investigator: | Stefanie Hahner, MD | University of Wuerzburg |
More Information
No publications provided
| Responsible Party: | Bruno Allolio, professor of medicine, head of the department of endocrinology and diabetology, University of Wuerzburg |
| ClinicalTrials.gov Identifier: | NCT01452893 History of Changes |
| Other Study ID Numbers: | CANDI-1 |
| Study First Received: | September 29, 2011 |
| Last Updated: | October 12, 2011 |
| Health Authority: | Germany: Ethics Commission |
Additional relevant MeSH terms:
|
Addison Disease Adrenal Insufficiency Diabetes Mellitus Diabetes Mellitus, Type 1 Adrenal Gland Diseases Endocrine System Diseases Autoimmune Diseases |
Immune System Diseases Glucose Metabolism Disorders Metabolic Diseases Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013