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The goal of this randomized, double-blind, placebo-controlled, 6-month supplementation study in individuals with type 2 diabetes is to investigate whether taking daily dietary supplements of vitamin D3 (1600 IU) or prebiotics (inulin, 10 gram) has beneficial effects on cardiovascular disease risk factors.
The goal of this randomized, double-blind, placebo-controlled trial, with a two-by-two factorial design in individuals with type 2 diabetes (T2D) is to investigate whether taking daily dietary supplements of vitamin D3 (1600 IU) or prebiotics (inulin, 10 gram) has beneficial effects on cardiovascular disease (CVD) risk factors.
About 200 subjects with T2D will be included in this study. All participants will provide written informed consent before randomization. Eligible participants must have no history of cancer, macrovascular or microvascular complications at trial entry, and they are required to agree to limited use of vitamin D, prebiotics, probiotics, or synbiotic supplementations, as well as to convenient access to study centers. Safety exclusions include renal failure or dialysis, cirrhosis, history of hypercalcemia, or other conditions that would preclude participation.
Eligible participants will be assigned by chance to one of four groups: (1) daily vitamin D3 (1600 IU) and prebiotics (10 grams); (2) daily vitamin D3 (1600 IU) and prebiotics placebo (10 grams); (3) daily vitamin D3 placebo and prebiotics (10 grams); or (4) daily vitamin D3 placebo (1600 IU) and prebiotics placebo (10 grams). Randomization will be computer-generated within sex and age groups.
During the run-in period, baseline questionnaires will be designed to collect data on sociodemographic factors, lifestyle habits, health status, and medical conditions, and participants will undergo physical measurements at baseline. Blood, urine, and faeces samples will also be obtained at study centers.
Participants in all groups will be required to take two capsules each day, containing either vitamin D3 or vitamin D3 placebo, as well as a strip of prebiotics powder (10 g per strip, brew with warm water) or prebiotics placebo. Participants will receive their capsules and powder at study centers each month.
Participants will complete follow-up questionnaires, including information on adherence to trial regimens, outside use of supplementations, development of major illnesses, and potential side effects of the trial agents, at 3 months and 6 months after randomization. Physical measurements and collection of biological samples will be conducted at study centers 6 months after randomization.
The primary outcomes, including glycated hemoglobin (HbA1c) and blood lipids (such as total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol), will be measured using blood samples. The data will be collected and analyzed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vitamin D3 + Prebiotics | Active Comparator |
| |
| Vitamin D3 + Prebiotics placebo | Active Comparator |
| |
| Prebiotics +Vitamin D3 placebo | Active Comparator |
| |
| Vitamin D3 placebo + Prebiotics placebo | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vitamin D3 | Drug | Vitamin D3 (cholecalciferol), 1600 IU per day. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Glycated hemoglobin (HbA1c) | Concentration of HbA1c, measured in the percentage of hemoglobin | 6 months |
| Concentration of blood lipids | Concentration of blood lipids (total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol), measured in mmol/L | 6 months |
| Metagenomic analysis of the gut microbiota | The diversity of the gut microbiota will be assessed by high-quality whole-metagenomic sequencing | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Concentration of fasting glucose | Concentration of fasting glucose, measured in mmol/L | 6 months |
| Concentration of fasting insulin | Concentration of fasting insulin, measured in milli-International unit/L |
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Inclusion Criteria:
Type 2 diabetes (meeting any of the following criteria):
Physician-diagnosed type 2 diabetes, use of oral hypoglycemic medication or insulin, fasting blood glucose ≥ 7.0 mmol/L, HbA1c ≥ 6.5% (48 nmol/L), 2-hour plasma glucose (2hPG) ≥ 11.1 mmol/L.
Men aged 35-70 years or women aged 35-70 years.
Convenient access to study centers.
Written informed consent obtained before any trial-related activities.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gang Liu, PHD | School of Public Health, Tongji Medical College, Huazhong University of Science and Technology | Principal Investigator |
| An Pan, PHD | School of Public Health, Tongji Medical College, Huazhong University of Science and Technology | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bao'an Center Hosipital of Shenzhen | Shenzhen | Guangdong | China | |||
| School of Public Health, Tongji Medical College, Huazhong University of Science and Technology |
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| Prebiotics | Dietary Supplement | Prebiotics (inulin), 10g per day. |
|
|
| Vitamin D3 placebo | Dietary Supplement | Vitamin D3 placebo |
|
| Prebiotics placebo | Dietary Supplement | Prebiotics placebo, 10g per day. |
|
| 6 months |
| Systolic and diastolic blood pressure | The level of systolic blood pressure and diastolic blood pressure, measured in mmHg | 6 months |
| Estimated glomerular filtration rate (eGFR) | Calculating the level of eGFR using Chronic Kidney Disease Epidemiology Collaboration equation | 6 months |
| Concentration of C-reactive protein (CRP) | Concentration of CRP, measured in mg/dL | 6 months |
| Concentration of procalcitonin | Concentration of procalcitonin, measured in pg/mL | 6 months |
| Concentration of interleukin-6 (IL-6) | Concentration of IL-6, measured in pg/mL | 6 months |
| Concentration of serum 25(OH)D | Concentration of serum 25(OH)D concentrations, measured in nmol/L | 6 months |
| Body weight | Weight in kilograms | 6 months |
| Waist circumference | Waist circumference in centimeters | 6 months |
| Hip circumference | Hip circumference in centimeters | 6 months |
| Wuhan |
| Hubei |
| China |
| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| D002318 | Cardiovascular Diseases |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| D002762 | Cholecalciferol |
| D056692 | Prebiotics |
| D007444 | Inulin |
| ID | Term |
|---|---|
| D002782 | Cholestenes |
| D002776 | Cholestanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D013261 | Sterols |
| D014807 | Vitamin D |
| D012632 | Secosteroids |
| D008563 | Membrane Lipids |
| D008055 | Lipids |
| D004043 | Dietary Fiber |
| D004040 | Dietary Carbohydrates |
| D002241 | Carbohydrates |
| D011135 | Polysaccharides, Bacterial |
| D011134 | Polysaccharides |
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019587 | Dietary Supplements |
| D019602 | Food and Beverages |
| D013213 | Starch |
| D005936 | Glucans |
| D001704 | Biopolymers |
| D011108 | Polymers |
| D046911 | Macromolecular Substances |
| D005630 | Fructans |
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