Study protocol for a multicentre, randomised, parallel group, sham-controlled clinical trial investigating the effect of transcutaneous vagal nerve stimulation on gastrointestinal symptoms in people with diabetes complicated with diabetic autonomic neuropathy: the DAN-VNS Study

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DOI

  • Tina Okdahl, Aalborg Universitet
  • ,
  • Davide Bertoli, Aalborg Universitet
  • ,
  • Birgitte Brock, Steno Diabet Ctr Copenhagen, Steno Diabetes Center
  • ,
  • Klaus Krogh
  • Filip Krag Knop, Steno Diabet Ctr Copenhagen, Steno Diabetes Center
  • ,
  • Christina Brock
  • Asbjørn M Drewes

INTRODUCTION: A high proportion of people with diabetes experience gastrointestinal (GI) symptoms, which may be manifestations of diabetic autonomic neuropathy (DAN). The current treatment regime is ineffective and associated with major side effects. Transcutaneous vagal nerve stimulation (tVNS) is a new therapeutic option, which has been shown to increase GI motility and reduce inflammatory responses. As vagus is the main neuronal pathway for extrinsic coordination of GI secretion and motility, we hypothesise that tVNS will improve DAN-induced GI symptoms in subjects with diabetes.

METHODS AND ANALYSIS: The DAN-VNS study is a randomised multicentre clinical trial investigating the effect of short-term, high intensity as well as long-term, medium-intensity tVNS on GI symptom alleviation in 120 subjects with diabetes. The primary outcome consists of changes from baseline in subjective ratings of symptom severity. Secondary outcomes include changes in gastric motility and GI transit time measured by MRI and wireless motility capsule. Moreover, cardiovascular and sudomotor function, glycaemic control, brain sensory processing and presence of low-grade inflammation will be investigated as secondary outcome measures. Lastly, 15 responders of tVNS treatment will be included in an explorative, randomised, cross-over study, in which the acute endocrine and metabolic response to short-term tVNS will be investigated.

ETHICS AND DISSEMINATION: The study has been approved by the North Denmark Region Committee on Health Research Ethics (N-20190020). Results will be published in relevant international peer-reviewed journals.

TRIAL REGISTRATION NUMBER: NCT04143269.

OriginalsprogEngelsk
Artikelnummere038677
TidsskriftBMJ Open
Vol/bind11
Nummer1
Antal sider13
ISSN2044-6055
DOI
StatusUdgivet - jan. 2021

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