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Trial registered on ANZCTR
Registration number
ACTRN12613000592741
Ethics application status
Approved
Date submitted
16/05/2013
Date registered
27/05/2013
Date last updated
23/03/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Does a High Protein Enriched Drink and Vitamin D Enhance the Health Benefits of Progressive Resistance Training Program in Older Adults with Type 2 Diabetes?
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Scientific title
Does a High Protein Enriched Drink and Vitamin D Enhance the Health Benefits of the Lift for Life (Registered Trademark) Resistance Training Program on Glycaemic Control, Body Composition and Cardiometabolic Risk Factors in Older Adults with Type 2 Diabetes?
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Secondary ID [1]
282345
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 2 Diabetes
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Condition category
Condition code
Metabolic and Endocrine
289241
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0
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Diabetes
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Diet and Nutrition
289242
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0
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Other diet and nutrition disorders
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Public Health
289243
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0
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Other public health
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A 6-month, randomised controlled trial in which participants with type 2 diabetes will participate in a progressive resistance training program (termed Lift for Life) and receive a daily protein enriched drink and vitamin D supplements for 6 months. The Lift for Life program is an individually tailored and supervised group-based community-based program in which participants undertake progressive resistance training twice a week for the first 8 weeks and then three times each week thereafter. Each session will last 45-60 minutes and target all major muscle groups. Participants will perform 3 sets of 8-10 repetitions at a weight that cannot be lifted for more than 8-10 repetitions. Training will be made progressively more challenging by incorporating the principle of progressive overload (increments of 2-10% weekly). All training is supervised by accredited Lift for Life exercise trainers. To increase protein intake and vitamin D status, participants will be asked to consume a protein enriched drink each day that will contain approximately 20 g of protein and take two 1000 IU vitamin D3 capsules daily for the duration of the study. On the training days, participants will also be asked to consume a second protein enriched drink after training. Exercise logs and completed exercise cards regularly checked by the trainers will be used to monitor exercise adherence. Adherence to the drinks will be monitored using a daily calendar and counting any remaining drinks at 3 and 6 months. Compliance to the supplements will be monitored by a capsule count from bottles returned at 3 and 6 months.
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Intervention code [1]
286965
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Lifestyle
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Intervention code [2]
286966
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Treatment: Other
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Comparator / control treatment
Participants allocated to the active control group will also undertake the same progressive resistance training program (Lift for Life) as those in the intervention group, but will not receive an energy matched placebo drink or placebo tablets.
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Control group
Active
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Outcomes
Primary outcome [1]
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Glycemic control (HbA1c)
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Assessment method [1]
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Timepoint [1]
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Baseline, 3 and 6 months
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Primary outcome [2]
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Insulin sensitivity (estimated from the HOMA-2 program)
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Assessment method [2]
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Timepoint [2]
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Baseline, 3 and 6 months
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Secondary outcome [1]
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Lean tissue mass (measured by DXA) and muscle cross-sectional area (measured by pQCT)
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Assessment method [1]
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Timepoint [1]
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Baseline and 6 months
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Secondary outcome [2]
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Systolic and diastolic blood pressure
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Assessment method [2]
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Timepoint [2]
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Baseline and 6 months
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Secondary outcome [3]
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Blood lipids (total cholesterol, HDL- and LDL- cholesterol and triglycerides)
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Assessment method [3]
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Timepoint [3]
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Baseline, 3 and 6 months
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Secondary outcome [4]
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Adipokines and inflammatory biomarkers
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Assessment method [4]
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Timepoint [4]
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Baseline, 3 and 6 months
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Secondary outcome [5]
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Three repetition maximum leg and back muscle strength will be assessed on an isotonic leg press and seated row machine.
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Assessment method [5]
302655
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Timepoint [5]
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Baseline and 6 months
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Secondary outcome [6]
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Fat mass (percent body fat) measured by DXA
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Assessment method [6]
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Timepoint [6]
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Baseline and 6 months
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Secondary outcome [7]
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Balance and gait via the 30-sec sit-to-stand, timed-up-and-go (TUG) and four-square step test
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Assessment method [7]
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Timepoint [7]
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Baseline and 6 months
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Secondary outcome [8]
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Health related quality of life (SF36v2)
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Assessment method [8]
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Timepoint [8]
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Baseline, 3 and 6 months
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Eligibility
Key inclusion criteria
Males and females aged 50 to 75 years with established type 2 diabetes, treated with diet alone or oral hypoglycaemic agents (not insulin). All participants enrolled in the study must also have received approval from their local physician to participate in the community-based Lift for Life resistance training program.
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Minimum age
50
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Participants will be excluded based on the following: 1) glycemic control (HbA1c) >10%; 2) current or prior participation in progressive resistance training (>1 week) or moderate-intensity physical activity >=150 min/week for >3 months; 3) vitamin D and/or calcium supplement use (>500 IU/d and >600 mg/d) in the past 3 months; 4) severe orthopaedic, cardiovascular or respiratory conditions that would preclude participation in an exercise program, or those with absolute contraindications to exercise according to American College of Sports Medicine (ACSM) guidelines; 5) renal impairment (eGFR <45 mL/min/1.73m2) or disease; 6) use of protein supplements; 7) conditions that may affect vitamin D or calcium metabolism; 8) current smoker, or 9) BMI >40 kg/m2.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants who are eligible and registered to commence participation in the Lift for Life resistance training program will be invited to participate in this study. Participants may be referred to the program from their doctor or may respond to local advertisements about the program. Eligible participants will then be screened further to ensure they fulfill the inclusion criteria for this study. All participants must receive approval from their local physician prior to participating in the program. Randomisation will be at the level of the individual participant (ID), stratified by gender and diabetes treatment (diet or oral hypoglycaemic agents), using a computer-generated random number sequence by an independent researcher not involved in the study. The assignment will be blinded to the investigators involved in all testing so that they will be unaware of the group assignment.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be computer-generated (random number sequence) by an independent researcher.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
Randomised controlled trial
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
All statistical analyses will be conducted on an intention-to-treat basis using Stata (version 11). Wherever possible, we will obtain endpoint measures from all withdrawals and include all randomised subjects in our final ITT analysis. Time, group and group-by-time interactions will be examined using linear mixed regression models. Potential covariates to be included in the model will include: age, sex, race/ethnicity, changes in medication and change in habitual physical activity or diet.
Based on our previous data from progressive resistance training studies in people with type 2 diabetes and work of others that have assessed the independent or combined effects of protein, vitamin D and resistance training on the main outcome measures, we estimate that 168 participants would provide 90% power (P<0.05 two-tailed) to detect a 0.5% absolute difference for the change in HbA1c levels between the groups, assuming a conservative SD of 1.1%. For insulin sensitivity, a sample size of 140 would be required to detect a 0.7 difference for the change in HOMA-2 IR between the groups at a power of 90%, assuming a conservative SD of 1.2. To compensate for a projected 20% drop-out, a total of 202 participants will be recruited into the study and randomised 1:1 to the two groups (101 per group).
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
20/10/2013
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Actual
7/02/2014
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Date of last participant enrolment
Anticipated
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Actual
22/03/2016
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Date of last data collection
Anticipated
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Actual
22/09/2016
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Sample size
Target
202
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Accrual to date
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Final
198
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council (NHMRC)
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Address [1]
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Deakin University
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Address
Centre for Physical Activity and Nutrition Research
221 Burwood Highway,
Burwood, Melbourne, Victoria 3125
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Country
Australia
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Secondary sponsor category [1]
285982
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Charities/Societies/Foundations
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Name [1]
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Baker IDI Heart and Diabetes Institute
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Address [1]
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Level 4
99 Commerical Rd, Melbourne, Victoria, 3004
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Country [1]
285982
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Australia
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Secondary sponsor category [2]
285983
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University
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Name [2]
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Curtin University
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Address [2]
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School of Public Health
GPO Box U 1987
Perth WA 6845
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Country [2]
285983
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Australia
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Secondary sponsor category [3]
285984
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Commercial sector/Industry
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Name [3]
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Fitness Australia
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Address [3]
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Level 3, 180 Albert Rd
South Melbourne VIC 3205
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Country [3]
285984
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
289214
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Deakin University Human Research Ethics Committee
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Ethics committee address [1]
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Human Research Ethics Deakin Research Integrity Deakin University 221 Burwood Highway Burwood Victoria 3125
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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09/04/2013
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Ethics approval number [1]
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2013-050
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Summary
Brief summary
Lifestyle factors such as exercise and diet remains the cornerstone in the management of type 2 diabetes. Progressive resistance training is one mode of exercise that can improve glycaemic control and other metabolic risk factors that contribute to the development of diabetes complications. Whether diet and exercise combined can have added benefits remains unknown. In non-diabetic adults, high protein diets can enhance the benefits of resistance training on muscle mass and strength. There is also evidence that vitamin D deficiency is associated with glucose intolerance and insulin resistance, which can be improved with treatment. This study builds upon our current community-based resistance training program, titled ‘Lift for Life (L4L)’, to examine whether post-exercise ingestion of a protein enriched drink and vitamin D can enhance the benefits of resistance training on glycaemic control, body composition and cardiometabolic health in adults with type 2 diabetes. This study is important as the findings will underpin more precise exercise and nutrition guidelines for the management of glycaemic control and cardiometabolic risk factors in people with type 2 diabetes, along with the ongoing refinement of community-based initiatives for the management of this condition.
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Trial website
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Trial related presentations / publications
Miller EG, Nowson CA, Dunstan DW, Kerr DA, Solah V, Menzies D, Daly RM. Recruitment of older adults with type 2 diabetes into a community-based exercise and nutrition randomised controlled trial. Trials Sep 26;17(1):467, 2016. Daly RM, Miller E, Dunstan DW, Nowson C, Kerr D, Solah V, Menzies D. The effects of progressive resistance training combined with a whey-protein drink and vitamin D supplementation on glycaemic control, body composition and cardiometabolic risk factors in older adults with Type 2 diabetes: Study protocol for a randomised controlled trial. Trials 15:431, 2014 DOI: 10.1186/1745-6215-15-431
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Public notes
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Contacts
Principal investigator
Name
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Prof Robin Daly
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Address
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Deakin University
Centre for Physical Activity and Nutrition Research
221 Burwood Highway
Burwood, Melbourne, Victoria 3125
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Country
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Australia
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Phone
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+61 3 9244 6040
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Eliza Miller
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Address
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Deakin University
School of Exercise and Nutrition Sciences
221 Burwood Highway
Burwood, Melbourne, Victoria 3125
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Country
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Australia
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Phone
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+61 3 52271100
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Robin Daly
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Address
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Deakin University
Centre for Physical Activity and Nutrition Research
221 Burwood Highway
Burwood, Melbourne, Victoria 3125
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Country
39284
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Australia
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Phone
39284
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+61 3 9244 6040
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Fax
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Email
39284
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
The effects of progressive resistance training combined with a whey-protein drink and vitamin D supplementation on glycaemic control, body composition and cardiometabolic risk factors in older adults with type 2 diabetes: Study protocol for a randomized controlled trial.
2014
https://dx.doi.org/10.1186/1745-6215-15-431
Embase
Recruitment of older adults with type 2 diabetes into a community-based exercise and nutrition randomised controlled trial.
2016
https://dx.doi.org/10.1186/s13063-016-1589-5
Embase
Effects of whey protein plus vitamin D supplementation combined with progressive resistance training on glycaemic control, body composition, muscle function and cardiometabolic risk factors in middle-aged and older overweight/obese adults with type 2 diabetes: A 24-week randomized controlled trial.
2021
https://dx.doi.org/10.1111/dom.14299
N.B. These documents automatically identified may not have been verified by the study sponsor.
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