Clinical trial NCT01060540: Genetic Testing for Type 2 Diabetes
Official title: The Impact of Genetic Testing for Type 2 Diabetes on Health Behaviors
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Diabetes Mellitus
Keywords: genetic screening
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
Collaborators: name: Duke University
First posted: 2010-02-02
Enrollment: 601
Sex: ALL
Minimum age (years): 21
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: In this 6-month randomized, controlled trial, we examined whether providing participants with genetic test results and counseling regarding their risk for type 2 diabetes would motivate them to improve their health behaviors and lose weight to reduce their diabetes risk. We hypothesized that participants who received conventional diabetes counseling plus genetic test results and counseling would have at least 6 lb greater weight loss at 3 months than participants who received conventional diabetes counseling without genetic test results.

Detailed description: In this 6-month randomized, controlled trial, we evaluated the impact of genetic testing for type 2 diabetes on psychological, health behavior, and clinical outcomes. Eligibility criteria included age 21 to 65 years, overweight or obese (body mass index \[BMI\] \>27 kg/m2), and no prior diagnosis of type 2 diabetes. At baseline, participants (N=601) had conventional risk factors assessed, including demographics, fasting plasma glucose (FPG), and family history. They also provided blood samples for genetic testing of TCF7L2, PPARG, and KCNJ11, three genes that confer elevated risk for development of type 2 diabetes. Participants were then randomized to receive conventional counseling plus control eye disease counseling (CR+EYE) or conventional counseling plus genetic test results (CR+G). Two to four weeks following the baseline visit, when the genetic test results were available, participants returned for a visit with a genetic counselor. All participants received conventional risk counseling based on their lifetime population risk, FPG results, and family history. Next, participants were informed of their randomization assignments; CR+EYE participants received counseling on eye diseases, whereas CR+G participants received genetic counseling. Then perceived risk, affect, self-efficacy, and readiness to change were assessed. All other outcomes were also assessed at 3 and 6 months.

Eligibility criteria: Inclusion Criteria:

* body mass index \>27 kg/m2
* baseline fasting plasma glucose \<=125 mg/dL

Exclusion Criteria:

* prior diagnosis of type 2 diabetes
* fasting plasma glucose \>125 mg/dL on more than one occasion
* HbA1c \> 7%
* taking diabetes medication
* actively losing weight
* enrolled in research study focusing on lifestyle changes
* unable to provide informed consent or answer survey questions unassisted
* residing in nursing home or receiving home health care
* active diagnosis of psychosis or dementia
* at least one error on 6-item cognitive screener

Primary outcomes:
measure: Weight
timeFrame: 3 months
Secondary outcomes:
measure: Insulin Resistance (HOMA2-IR)
timeFrame: 3 months
measure: Perceived Lifetime Risk of Type 2 Diabetes
timeFrame: 3 months
measure: Daily Caloric Intake
timeFrame: 3 months
measure: Moderate Intensity Physical Activity
timeFrame: 3 months
Other outcomes:
Locations:
city: Durham
country: United States
facility: Durham VA Medical Center, Durham, NC
state: North Carolina
Study officials:
affiliation: Durham VA Medical Center, Durham, NC
name: Corrine I. Voils, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Vorderstrasse AA, Cho A, Voils CI, Orlando LA, Ginsburg GS. Clinical utility of genetic risk testing in primary care: the example of Type 2 diabetes. Per Med. 2013 Aug;10(6):549-563. doi: 10.2217/pme.13.47.
citation: Voils CI, Coffman CJ, Edelman D, Maciejewski ML, Grubber JM, Sadeghpour A, Cho A, McKenzie J, Blanpain F, Scheuner M, Sandelowski M, Gallagher MP, Ginsburg GS, Yancy WS Jr. Examining the impact of genetic testing for type 2 diabetes on health behaviors: study protocol for a randomized controlled trial. Trials. 2012 Aug 1;13:121. doi: 10.1186/1745-6215-13-121.
citation: Voils CI, Coffman CJ, Grubber JM, Edelman D, Sadeghpour A, Maciejewski ML, Bolton J, Cho A, Ginsburg GS, Yancy WS Jr. Does Type 2 Diabetes Genetic Testing and Counseling Reduce Modifiable Risk Factors? A Randomized Controlled Trial of Veterans. J Gen Intern Med. 2015 Nov;30(11):1591-8. doi: 10.1007/s11606-015-3315-5. Epub 2015 Apr 16.
citation: Waxler JL, O'Brien KE, Delahanty LM, Meigs JB, Florez JC, Park ER, Pober BR, Grant RW. Genetic counseling as a tool for type 2 diabetes prevention: a genetic counseling framework for common polygenetic disorders. J Genet Couns. 2012 Oct;21(5):684-91. doi: 10.1007/s10897-012-9486-x.