Patients with Type 1 diabetes and adequate glycemic control: HbA1c <7% at the entrance in the study.
Intervention:
Incremental maximal exercise Near-Infra Red-Spectroscopy at vastus lateralis and pre-frontal cortex (during exercise) Gas exchanges (VO2, VCO2) during exercise Combined DLCO/DLNO (at rest) Venous and arterialised blood sampling (rest and exercise) Muscle biopsy at the vastus lateralis (rest) Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires Accelerometry over one week Dual energy X-ray Absorptiometry

Patients with Type 1 diabetes and inadequate glycemic control: HbA1c >8% at the entrance in the study.
Intervention:
Incremental maximal exercise Near-Infra Red-Spectroscopy at vastus lateralis and pre-frontal cortex (during exercise) Gas exchanges (VO2, VCO2) during exercise Combined DLCO/DLNO (at rest) Venous and arterialised blood sampling (rest and exercise) Muscle biopsy at the vastus lateralis (rest) Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires Accelerometry over one week Dual energy X-ray Absorptiometry

Healthy controls for patients with Type 1 diabetes and adequate glycemic control matched on age, sex, body composition and physical activity level.
Intervention:
Oral Glucose Tolerance Test Incremental maximal exercise Near-Infra Red-Spectroscopy at vastus lateralis and pre-frontal cortex (during exercise) Gas exchanges (VO2, VCO2) during exercise Combined DLCO/DLNO (at rest) Venous and arterialised blood sampling (rest and exercise) Muscle biopsy at the vastus lateralis (rest) Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires Accelerometry over one week Dual energy X-ray Absorptiometry

Healthy controls for patients with Type 1 diabetes and inadequate glycemic control matched on age, sex, body composition and physical activity level.
Intervention:
Oral Glucose Tolerance Test Incremental maximal exercise Near-Infra Red-Spectroscopy at vastus lateralis and pre-frontal cortex (during exercise) Gas exchanges (VO2, VCO2) during exercise Combined DLCO/DLNO (at rest) Venous and arterialised blood sampling (rest and exercise) Muscle biopsy at the vastus lateralis (rest) Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires Accelerometry over one week Dual energy X-ray Absorptiometry

Whole blood, plasma, serum, and skeletal muscle (vastus lateralis) samples

Type 1 Diabetes

The exercise test starts 2-4h after a standardised breakfast. After a 2-min resting period sitting on the cycle ergometer (Excalibur Sport, Lode B.V, Medical Technology, Groningen, Netherlands), the test starts at 30 watts with a 20 watts increment every 2min until exhaustion.

Incremental maximal exercise

The subjects arrive after an overnight fast and have a 75g Glucose Oral Charge.

Oral Glucose Tolerance Test

A sample of vastus lateralis (less than 150mg) is taken with a specific needle under local anesthesia.

Muscle biopsy

Lung carbon monoxide and nitric oxide diffusion capacities are assessed at rest in a sitting position.

Combined DLCO-DLNO

Body composition is measured using dual energy X-ray absorptiometry at rest.

Dual energy X-ray absorptiometry

The subjects wear an uniaxial accelerometer over one week to assess their usual physical activity level

Accelerometry over one week

Diet questionnaire, quality-of-life questionnaires, physical activity questionnaires

Questionnaires

CHRU Lille

Muscle Oxygenation, Type 1 Diabetes, and Glycated Hemoglobin

Impact of Type 1 Diabetes and Glycated Haemoglobin Levels on Oxygen Delivery and Release to Active Muscle During Exercise and on Muscle Oxidation Capacity - Possible Impact on Aerobic Fitness

Incremental maximal exercise with gas exchange measure

measured in ear-lobe arterialised capillary samples

Deoxyhemoglobin and total hemoglobin assessed at vastus lateralis by Near Infrared Spectroscopy

Vastus lateralis muscle sample is obtained by the percutaneous technique after local anesthesia. The mitochondrial respiration is then studied in situ in saponin-skinned fibers.

Total hemoglobin and oxyhemoglobin are assessed at the left prefrontal cortex using Near-Infrared Spectroscopy.

Lung capillary carbon monoxide and nitric oxide diffusion capacities (DLCO, DLNO)

venous erythrocyte 2,3-diphosphoglycerate, arterialised capillary potential of hydrogen oxygen partial pressure, carbon dioxide partial pressure

oxidative stress (blood oxidative and antioxidant markers at rest and in response to maximal exercise), endocannabinoid system activity

Lipid profile (HDL-C, LDL-C, apolipoprotein A1, apolipoprotein B, lipoprotein a, ...) Insulin resistance markers (blood ghrelin, adiponectin, leptin...)

Free fatty acids, glycerol, glucose, insulin, catecholamines, glucagon, cortisol, insulin-like growth factor 1, brain-derived neurotrophic factor...

Dual energy X-ray Absorptiometry, skinfold thickness, waist and hip circumferences

University Hospital, Lille

Long-term program including initial self-management education program (1 to 7 sessions, based on individual assessment), and follow-up group sessions maintained for 2 years (4-monthly assessment, empowerment, and contextual action planning; facultative additional specific thematic sessions being delivered if needed).

Initial self-management group education: 1 to 7 sessions (< 3 months), based on individual assessment.

Type 2 Diabetes

After an initial intensive group education, four-monthly follow-up self-management group education sessions for 2 years. Each session is based on empowerment, socio-constructivism, social learning theory: personalized assessment (BG and risk factors, actions: realized, planned, achieved (or not), cognitive work, analysis of individual and social context and environment (facilitators, obstacles) then action planning. Specific additional sessions can be scheduled (food management, diabetes treatment and hypoglycemia, exercise, self monitoring of BG, insulin dosage, foot care). Sessions are framed, and structured, with patient booklet support. Sessions are delivered at the community level, by trained registered nurses, under the coordination of the health management network Reucare.

Structured self-management group education during 2 years

Groupe Hopitalier Est Réunion

Centre Hospitalier Gabriel Martin

Diabetolgy - UNiversity Hospital Sud Réunion

Department of endocrinology, University Hospital Reunion Island - Felix Guyon Site

Two Years Maintenance of Structured Group Self-management Education in Type 2 Diabetes : a Randomized Controlled Trial

Multicenter Randomized Trial of Structured Educational Intervention at the Community Level in Insufficiently Controlled Patients With Type 2 Diabetes in Reunion Island

Blood sugar Total, HDL and LDL cholesterol, triglycerides

retinopathy stages, micro-albuminuria or proteinuria, creatinine clearance, foot risk grade, ischemic heart or cerebral disease

physical activity and diet (Baecke and food frequency questionnaires)

medical follow-up and appointments, compliance (questionnaire)

self-efficacy, social support, HAD (anxiety and depression)

short DQOL adapted and validated for Reunion

Centre Hospitalier Universitaire de la Réunion

Ministry of Health, France

Diabetes Mellitus, Type 2

Insuline glargine

Insulin Glargine in Type 2 Diabetes Mellitus

Pilot Study on Glycaemic Variability in Type 2 Diabetes Mellitus Patients With Basal Insulin and Fixed Combo Oral Antidiabetic Treatment.

Medical Affairs Study Director

Sanofi

The 334 general practices in Denmark, United Kingdom and the Netherlands have been randomised to screening for diabetes followed by routine care (RC group) according to national guidelines, or screening followed by multifactorial treatment (IT group).

The intervention targeted individual patients and the Primary Care Team. Practitioners were trained in a target driven, intensive multifactorial approach including lifestyle advice (smoking cessation, physical activity 30 min./day and healthy diet) and pharmacological treatment with the aim of reducing the complications of diabetes as described in protocol.
The training included meetings, practice visiting, written feed back reports and reminders on controls.

diabetes complications/nikotinas

Muscle Oxygenation, Type 1 Diabetes, and Glycated Hemoglobin

Two Years Maintenance of Structured Group Self-management Education in Type 2 Diabetes : a Randomized Controlled Trial

Insulin Glargine in Type 2 Diabetes Mellitus

The ADDITION Study. Intensive Treatment in People With Screen Detected Diabetes in Primary Care.

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