In a multicenter, prospective, randomized, controlled clinical trial to compare influenza vaccination and placebo in sustaining β cell function in early type 1 diabetes mellitus.
Type 1 diabetes (T1D) is an autoimmune disease in which T cells attack and destroy the insulin-producing β cells in the pancreatic islets. In theory, immunotherapies aimed at re-programming the immune system to avoid β cell destruction is a promising strategy to prevent T1D or delay onset of overt disease. In this trial we test the hypothesis that influenza vaccination is superior to no influenza vaccination in sustaining β cell function in early T1D. Secondary outcome measures include change in autoantibodies directed against antigens present in the pancreatic islets, measures of severity of disease, change in inflammatory markers, and antibody titers against the four viruses included in the vaccine. Despite improvements in care, T1D is a leading cause of debilitating complications and early death globally. Children with residual β cell function are at lower risk for severe hypoglycemia, have better diabetes regulation, and have lower insulin requirements compared to children without residual β cell function. Thus, a simple, cheap treatment to mitigate T1D is highly warranted.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
100
We will use 0.5 mL standard dose quadrivalent influenza vaccine containing 15 μg of hemagglutinin per strain consistent with WHO recommendations according to season.
Aalborg University Hospital
Aalborg, Denmark
RECRUITINGAarhus University Hospital
Aarhus, Denmark
RECRUITINGSteno Diabetes Center Copenhagen
Copenhagen, Denmark
Change in fasting residual β cell (C-peptide) function.
Measured as the area under the concentration-time curve (AUC) for mixed-meal tolerance test-stimulated C-peptide concentration over 4 hours relative to baseline (AUC 0-4 h, C-peptide, 12 months/ AUC 0-4 h, C-peptide, baseline)
Time frame: 12 months
Change in fasting residual β cell (C-peptide) function.
Measured as the area under the concentration-time curve (AUC) for mixed-meal tolerance test-stimulated C-peptide concentration over 4 hours relative to baseline (AUC 0-4 h, C-peptide, 6 months/ AUC 0-4 h, C-peptide, baseline)
Time frame: 6 months.
Change in HbA1c
Measured as standard laboratory test in mmol/mol
Time frame: 12 months.
Change in insulin requirements.
Measured as total insulin dose per kg body weight per day as a mean for the last 14 days.
Time frame: 12 months.
Time-In-Range of blood glucose.
Defined as percentage time in range (3.9-10.0 mmol/L) of continuous glucose monitoring over 14 days.
Time frame: 12 months.
Variation of blood glucose.
Determined as percent coefficient of variation of blood glucose over 14 days.
Time frame: 12 months.
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Gødstrup Hospital
Herning, Denmark
RECRUITINGHolbaek Sygehus
Holbæk, Denmark
RECRUITINGNykoebing F Sygehus
Nykøbing Falster, Denmark
RECRUITINGRanders Regional Hospital
Randers, Denmark
RECRUITINGSjællands Universitetssygehus
Roskilde, Denmark
RECRUITINGSlagelse Hospital
Slagelse, Denmark
RECRUITINGViborg Regional Hospital
Viborg, Denmark
RECRUITING