This study will investigate the potential benefit of scheduled natural daylight exposure to improve glucose control in type 2 diabetes (T2D) patients and to unravel molecular mechanisms underlying the effects of natural daylight on circadian clocks and (glucose) metabolism in human skeletal muscle from T2D patients. Participants will stay at our research facilities and will be exposed to natural daylight or artificial light during the daytime over 4.5 days in a randomized cross-over design. For both conditions, the evening and night will be spent under standardized dim and dark conditions.
Obesity and type 2 diabetes (T2D) are both strongly associated with a westernized lifestyle of low physical activity levels and high caloric intake. However, recently it has been recognized that also our 24-hour culture, characterized by working and eating late, reduced sleep (quantity and quality), and excessive light exposure in the evening and at night, should be considered as lifestyle factors that may negatively impact metabolic health. In this context, a factor that is often overlooked and underestimated is the lack of natural daylight since most people spend almost their entire work time in indoor office environments with limited access to natural daylight through windows. Therefore, this study investigates the potential benefit of scheduled natural daylight exposure to improve glucose control in T2D individuals and to unravel molecular mechanisms underlying effects of natural daylight on circadian clocks and (glucose) metabolism in human skeletal muscle from T2D patients. For this purpose, overweight to obese T2D patients (male and female) will undergo a randomized cross-over trial in which each subject serves as its own control. Participants will stay at our research facilities and will be exposed to natural daylight or artificial light during the daytime over 4.5 days. For both conditions, the evening and night will be spent under standardized dim and dark conditions, respectively. Over these two 4.5 days intervention periods, extensive 24h metabolic profiling will be conducted, including 24h continuous glucose monitoring, 24h blood and saliva sampling, 24h blood pressure and heart rate assessments, 24h core and skin temperature assessments, 24h energy expenditure and whole-body substrate metabolism, and a skeletal muscle biopsy and a mixed meal tolerance test with indirect calorimetry will be performed on the respectively last test day.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
13
Over 4.5 days, participants will stay at our research facilities under different light conditions. Over these days different measurements will take place, including 24h continuous glucose monitoring, 24h blood and saliva sampling, 24h blood pressure and heart rate assessments, 24h core and skin temperature assessments, 24h energy expenditure and whole-body substrate metabolism, and a skeletal muscle biopsy and a mixed meal tolerance test with indirect calorimetry will be performed on the respectively last test day.
Maastricht University
Maastricht, Netherlands
average 24h blood glucose levels
Interstistial glucose levels determined by continuous glucose monitoring
Time frame: continously over 4.5 days
Postprandial metabolism upon a mixed-meal tolerance test (energy expenditure)
Energy expenditure (kJ/min) measured by indirect calorimetry
Time frame: measured at 9:00, 9:30, 10:00, 11:00, 12:00 and 13:00 on Day 5
Postprandial metabolism upon a mixed-meal tolerance test (carbohydrate oxidation)
Carbohydrate oxidation (μmol/kg x min) measured by indirect calorimetry
Time frame: measured at 9:00, 9:30, 10:00, 11:00, 12:00 and 13:00 on Day 5
Postprandial metabolism upon a mixed-meal tolerance test (fatty acid oxidation)
Fatty acid oxidation (μmol/kg x min) measured by indirect calorimetry
Time frame: measured at 9:00, 9:30, 10:00, 11:00, 12:00 and 13:00 on Day 5
Postprandial plasma metabolites upon a mixed-meal tolerance test (glucose)
Plasma glucose levels determined from venous blood draws
Time frame: measured at 9:00, 9:15, 9:30, 9:45, 10:00, 10:30, 11:00, 11:30, 12:00, 13:00 on Day 5
Postprandial plasma metabolites upon a mixed-meal tolerance test (insulin)
Plasma insulin levels determined from venous blood draws
Time frame: measured at 9:00, 9:15, 9:30, 9:45, 10:00, 10:30, 11:00, 11:30, 12:00, 13:00 on Day 5
Postprandial plasma metabolites upon a mixed-meal tolerance test (free fatty acids)
Plasma FFA levels determined from venous blood draws
Time frame: measured at 9:00, 9:15, 9:30, 9:45, 10:00, 10:30, 11:00, 11:30, 12:00, 13:00 on Day 5
Postprandial plasma metabolites upon a mixed-meal tolerance test (triglycerides)
Plasma triglyceride levels determined from venous blood draws
Time frame: measured at 9:00, 9:15, 9:30, 9:45, 10:00, 10:30, 11:00, 11:30, 12:00, 13:00 on Day 5
Skeletal muscle biopsy outcomes (Circadian transciptome)
Quantify DNA by micro-array
Time frame: muscle tissue taken at 7:30h on Day 5
Culturing human primary myotubes to assess circadian reporter characteristics
in vivo culturing of primary myotubes
Time frame: muscle tissue taken at 7:30h on Day 5
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