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Trial registered on ANZCTR
Registration number
ACTRN12617001111369
Ethics application status
Approved
Date submitted
21/07/2017
Date registered
28/07/2017
Date last updated
28/07/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
An investigation into heterozygosity for glycogen storage disease as a possible cause of glycogenic hepatopathy in type 1 diabetes
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Scientific title
An investigation into heterozygosity for glycogen storage disease as a possible cause of glycogenic hepatopathy in type 1 diabetes
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Secondary ID [1]
292490
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None
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Universal Trial Number (UTN)
U1111-1199-6662
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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 1 diabetes
304123
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Glycogenic hepatopathy
304124
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Glycogen storage disease
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Condition category
Condition code
Metabolic and Endocrine
303453
303453
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0
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Diabetes
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Metabolic and Endocrine
303454
303454
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0
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Metabolic disorders
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Oral and Gastrointestinal
303455
303455
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Blood sample taken at enrolment for gene panel for glycogen storage diseases, to determine whether there is an association between glycogen storage disease and glycogenic hepatopathy in a population with type 1 diabetes. Trial follow up will only be to inform patients the result of gene testing. Patients will receive ongoing clinical follow up for their glycogenic hepatopathy and type 1 diabetes irrespective of results of gene studies.
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Intervention code [1]
298670
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Diagnosis / Prognosis
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Intervention code [2]
298700
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Early detection / Screening
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Presence of heterozygosity for glycogen storage disease per gene panel testing on a blood sample.
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Assessment method [1]
302826
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Timepoint [1]
302826
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At enrolment
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Secondary outcome [1]
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HbA1c
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Assessment method [1]
337171
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Timepoint [1]
337171
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At enrolment into study
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Secondary outcome [2]
337172
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Serum lactate
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Assessment method [2]
337172
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Timepoint [2]
337172
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At enrolment into study
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Eligibility
Key inclusion criteria
Inclusion criteria:
• Type 1 diabetes
• Glycogenic hepatopathy either:
• Identified on liver biopsy (pathologic overloading of hepatocytes with glycogen) or
• Suspected clinically based on hepatomegaly on hepatic imaging, plus transaminases elevated greater than two times the upper limit of normal, plus elevated serum lactate persistent for more than 1 week
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Minimum age
8
Years
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Maximum age
70
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
• Another known cause of chronic liver disease
• Elevated transaminases attributable to another cause
• Do not consent to participate, or parent does not consent to participate in the case of a legal minor.
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
This is a pilot study recruiting approximately 10 patients from the Mater and LCCH. Pathogenic variants for GSDs are well defined. If all the forms of GSD are combined, GSD frequency is estimated to occur in the general population at a frequency of less than 1:10000. This corresponds to a carrier frequency of less than 1:50. A likely pathogenic mutation predicts 95-99.9% chance that the mutation is causative. Thus there is a 20% chance that a pathogenic mutation would occur by chance in one of our ten patients. Thus far the literature on type 1 diabetes and carrier status for GSD presenting with glycogenic hepatopathy consists of a single case. 10 cases will add substantially to current knowledge, and will aid in guiding further research.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
14/08/2017
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
10
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment postcode(s) [1]
16684
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4101 - South Brisbane
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Funding & Sponsors
Funding source category [1]
297058
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Charities/Societies/Foundations
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Name [1]
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Mater Foundation
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Address [1]
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Mater Hospital, Raymond Terrace, South Brisbane, Qld, Australia 4101
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Country [1]
297058
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Australia
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Primary sponsor type
Individual
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Name
Dr Stephanie Teasdale
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Address
Queensland Diabetes and Endocrine Centre, Level 2 Annerley Road Campus, Annerley Road, Mater Hospital, South Brisbane, Qld 4101
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Country
Australia
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Secondary sponsor category [1]
296063
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Hospital
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Name [1]
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Mater Hospital
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Address [1]
296063
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Mater Hospital, Raymond Terrace, South Brisbane, Qld, Australia 4101
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Country [1]
296063
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
298242
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Mater Misericordiae Ltd Human Research Ethics Committee (EC00332)
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Ethics committee address [1]
298242
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Human Research Ethics Committee, Mater Research Level 2 Aubigny Place, Raymond Terrace, South Brisbane 4101
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Ethics committee country [1]
298242
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Australia
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Date submitted for ethics approval [1]
298242
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06/02/2017
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Approval date [1]
298242
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13/07/2017
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Ethics approval number [1]
298242
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Summary
Brief summary
Glycogenic hepatopathy is an uncommon condition causing painful liver enlargement, impaired liver function and in the long term, may cause irreversible liver fibrosis in young individuals with type 1 diabetes. We wish to study whether there may be an underlying genetic cause which increases the risk for people to develop this condition. Glycogenic hepatopathy is thought to occur when there are concomitant high blood glucose levels and elevated insulin levels, and may be associated with elevated serum lactate levels. This triad contributes to increased liver glycogen storage ultimately culminating in liver damage. Excess hepatic glycogen storage is also characterstic of glycogen storage diseases, which are a group of heritable conditions where storage of glucose or release of glucose from storage does not occur normally, and can cause enlargement of the liver similar to glycogenic hepatopathy. People who have glycogen storage diseases typically have a mutation (change) in both copies of the causative gene. However, we are addressing the question of whether having type 1 diabetes with only one copy of the mutation for glycogen storage diseases (heterozygosity) is sufficient to precipitate abnormal glucose storage or release, resulting in the development of glycogenic hepatopathy. In support of our hypothesis, strict blood glucose control reverses glycogenic hepatopathy. This pilot study will help clarify whether genetic sequencing for mutations which cause glycogen storage disorders can identify young people with type 1 diabetes at risk of glycogenic hepatopathy. This will enable us to alter clinical practice by facilitating genetic counselling of these patients on the particular importance of tight blood glucose control in their case and make diagnosis of this disorder less invasive. Indeed, currently, a definitive diagnosis of glycogenic hepatopathy can only be made by liver biopsy. This may be hazardous particularly in young children, a common time when the disorder first presents. Determining whether there is a genetic mutation associated with glycogenic hepatopathy may enable diagnosis to be made without having to perform a liver biopsy.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Stephanie Teasdale
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Address
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Queensland Diabetes and Endocrine Centre, Level 2 Annerley Road Campus, Mater Hospital, Annerley Road, South Brisbane, Qld 4101
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Country
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Australia
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Phone
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+61 7 31638111
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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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Stephanie Teasdale
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Address
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Queensland Diabetes and Endocrine Centre, Annerley Road Campus, Mater Hospital, Annerley Road, South Brisbane, Qld 4101
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Country
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Australia
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Phone
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+61 7 31638111
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Fax
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Email
76451
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[email protected]
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Contact person for scientific queries
Name
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Stephanie Teasdale
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Address
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Queensland Diabetes and Endocrine Centre, Level 2 Annerley Road Campus, Mater Hospital, Annerley Road, South Brisbane, Qld 4101
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Country
76452
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Australia
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Phone
76452
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+61 7 31638111
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Fax
76452
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Email
76452
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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
No additional documents have been identified.
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