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Overgaard KS, Mohamed RA, Andersen TR, Lambrechtsen J, Egstrup K, Auscher S. ProtecT-2-D trial protocol: cardiovascular protection in patients with type 2 diabetes and established heart and/or vascular disease at a cardio-metabolic clinic-a randomized controlled trial. Cardiovasc Diabetol 2024; 23:241. [PMID: 38978117 PMCID: PMC11232310 DOI: 10.1186/s12933-024-02340-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 06/26/2024] [Indexed: 07/10/2024] Open
Abstract
BACKGROUND Cardiovascular disease remains the primary cause of morbidity and mortality despite advancements in the treatment of patients with type 2 diabetes. Effective diabetes management extends beyond blood glucose control and includes cardiovascular prevention and treatment. However, the conventional healthcare model often emphasizes single-disease-specific management, leading to fragmented care. We aim to establish an affordable Cardio-Metabolic Clinic (CMC) that can provide comprehensive assessment and specialized care with a focus on cardiovascular protection. METHODS The ProtecT-2-D study is a prospective, randomized control trial at the Cardiovascular Research Unit, Odense University Hospital Svendborg, Denmark. In this study, 1500 participants with type 2 diabetes and cardiovascular disease will be randomly assigned in a 2:1 ratio to receive either the intervention: treatment in the CMC, or the control: standard of care. The Cardio-Metabolic Clinic applies a decision-making algorithm coded with the latest guidelines to evaluate lifestyle factors and manage medical treatment. Health examinations are conducted at baseline and after three years, and clinical events will be assessed through registry and journal audits after five and ten years. The primary outcome is the time to the first occurrence of a composite of cardiovascular deaths, non-fatal acute myocardial infarctions, non-fatal stroke, or hospitalization due to heart failure at a time frame of five years. DISCUSSION The Cardio-Metabolic Clinic represents a pioneering approach to diabetes management that aims to improve patient outcomes by reducing the cardiovascular disease burden. This study could transform diabetes care and offer a multidisciplinary, cost-effective, and specialized treatment. We need to establish the efficacy and feasibility of a CMC to integrate comparable clinics into broader healthcare systems, and potentially enhance cardiovascular health in patients with type 2 diabetes. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT06203860.
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Affiliation(s)
- Katrine Schultz Overgaard
- Cardiovascular Research Unit, Odense University Hospital Svendborg, Baagøes Allé 15, 5700, Svendborg, Denmark.
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Roda Abdulkadir Mohamed
- Cardiovascular Research Unit, Odense University Hospital Svendborg, Baagøes Allé 15, 5700, Svendborg, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Thomas Rueskov Andersen
- Cardiovascular Research Unit, Odense University Hospital Svendborg, Baagøes Allé 15, 5700, Svendborg, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Jess Lambrechtsen
- Cardiovascular Research Unit, Odense University Hospital Svendborg, Baagøes Allé 15, 5700, Svendborg, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Kenneth Egstrup
- Cardiovascular Research Unit, Odense University Hospital Svendborg, Baagøes Allé 15, 5700, Svendborg, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Søren Auscher
- Cardiovascular Research Unit, Odense University Hospital Svendborg, Baagøes Allé 15, 5700, Svendborg, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Ramírez Gallegos I, Marina Arroyo M, López-González ÁA, Vicente-Herrero MT, Vallejos D, Sastre-Alzamora T, Ramírez-Manent JI. The Effect of a Program to Improve Adherence to the Mediterranean Diet on Cardiometabolic Parameters in 7034 Spanish Workers. Nutrients 2024; 16:1082. [PMID: 38613115 PMCID: PMC11013770 DOI: 10.3390/nu16071082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/29/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Cardiovascular and metabolic diseases include a large group of pathologies and constitute one of the most serious chronic health problems facing the 21st century, with high rates of morbidity and mortality worldwide. Unhealthy diets influence the development of these pathologies. The Mediterranean diet can be an important part in the treatment of these diseases. The objective of this study was to assess the effect of a program that aims to increase adherence to the Mediterranean diet on the improvement of different cardiometabolic risk parameters. METHODS A prospective intervention study was carried out on 7034 Spanish workers. Prior to the intervention, 22 cardiometabolic risk scales were evaluated. Participants in this study were informed both orally and in writing of the characteristics and benefits of the Mediterranean diet and were given the website of the Ministry of Health, Consumption and Social Welfare of Spain, which provides advice on nutrition. Adherence to the Mediterranean diet was reinforced by sending a monthly SMS to their mobile phones. After six months of follow-up, the 22 risk scales were re-evaluated to assess changes. Means and standard deviations were calculated using Student's t test to analyse quantitative variables. Prevalence was calculated using the Chi-square test when the variables were qualitative. RESULTS All the cardiometabolic risk scales studied decreased after implementing a program to improve and enhance adherence to the Mediterranean diet. The number of losses in the sample was very low, standing at 4.31%. CONCLUSIONS The Mediterranean diet is effective in reducing all cardiovascular risk scales evaluated. The mean values and prevalence of high values of the different cardiometabolic risk scales analysed led to lower values after the implementation of the program to increase adherence to the Mediterranean diet. We observed a significant positive difference in metabolic age in both sexes. We have obtained a significant improvement in the insulin resistance index, especially in the SPISE-IR index, data that we have not found in previous publications. Easy access to the Internet and new information and communication technologies facilitate adherence to a diet and can reduce the number of losses.
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Affiliation(s)
- Ignacio Ramírez Gallegos
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain; (I.R.G.); (M.M.A.); (M.T.V.-H.); (D.V.); (T.S.-A.); (J.I.R.-M.)
| | - Marta Marina Arroyo
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain; (I.R.G.); (M.M.A.); (M.T.V.-H.); (D.V.); (T.S.-A.); (J.I.R.-M.)
| | - Ángel Arturo López-González
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain; (I.R.G.); (M.M.A.); (M.T.V.-H.); (D.V.); (T.S.-A.); (J.I.R.-M.)
- Faculty of Dentistry, University School ADEMA, 07010 Palma, Balearic Islands, Spain
- Institut d’Investigació Sanitària de les Illes Balears (IDISBA), Balearic Islands Health Research Institute Foundation, 07010 Palma, Balearic Islands, Spain
- Balearic Islands Health Service, 07010 Palma, Balearic Islands, Spain
| | - Maria Teófila Vicente-Herrero
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain; (I.R.G.); (M.M.A.); (M.T.V.-H.); (D.V.); (T.S.-A.); (J.I.R.-M.)
| | - Daniela Vallejos
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain; (I.R.G.); (M.M.A.); (M.T.V.-H.); (D.V.); (T.S.-A.); (J.I.R.-M.)
| | - Tomás Sastre-Alzamora
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain; (I.R.G.); (M.M.A.); (M.T.V.-H.); (D.V.); (T.S.-A.); (J.I.R.-M.)
| | - José Ignacio Ramírez-Manent
- Investigation Group ADEMA SALUD, University Institute for Research in Health Sciences (IUNICS), 07010 Palma, Balearic Islands, Spain; (I.R.G.); (M.M.A.); (M.T.V.-H.); (D.V.); (T.S.-A.); (J.I.R.-M.)
- Institut d’Investigació Sanitària de les Illes Balears (IDISBA), Balearic Islands Health Research Institute Foundation, 07010 Palma, Balearic Islands, Spain
- Balearic Islands Health Service, 07010 Palma, Balearic Islands, Spain
- Faculty of Medicine, University of the Balearic Islands, 07010 Palma, Balearic Islands, Spain
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Seto H, Toki H, Kitora S, Oyama A, Yamamoto R. Seasonal variations of the prevalence of metabolic syndrome and its markers using big-data of health check-ups. Environ Health Prev Med 2024; 29:2. [PMID: 38246652 PMCID: PMC10808004 DOI: 10.1265/ehpm.23-00216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 12/07/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND It is crucial to understand the seasonal variation of Metabolic Syndrome (MetS) for the detection and management of MetS. Previous studies have demonstrated the seasonal variations in MetS prevalence and its markers, but their methods are not robust. To clarify the concrete seasonal variations in the MetS prevalence and its markers, we utilized a powerful method called Seasonal Trend Decomposition Procedure based on LOESS (STL) and a big dataset of health checkups. METHODS A total of 1,819,214 records of health checkups (759,839 records for men and 1,059,375 records for women) between April 2012 and December 2017 were included in this study. We examined the seasonal variations in the MetS prevalence and its markers using 5 years and 9 months health checkup data and STL analysis. MetS markers consisted of waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), fasting plasma glucose (FPG). RESULTS We found that the MetS prevalence was high in winter and somewhat high in August. Among men, MetS prevalence was 2.64 ± 0.42 (mean ± SD) % higher in the highest month (January) than in the lowest month (June). Among women, MetS prevalence was 0.53 ± 0.24% higher in the highest month (January) than in the lowest month (June). Additionally, SBP, DBP, and HDL-C exhibited simple variations, being higher in winter and lower in summer, while WC, TG, and FPG displayed more complex variations. CONCLUSIONS This finding, complex seasonal variations of MetS prevalence, WC, TG, and FPG, could not be derived from previous studies using just the mean values in spring, summer, autumn and winter or the cosinor analysis. More attention should be paid to factors affecting seasonal variations of central obesity, dyslipidemia and insulin resistance.
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Affiliation(s)
- Hiroe Seto
- Graduate School of Human Sciences, Osaka University, Osaka 565-0871, Japan
- Health Care Division, Health and Counseling Center, Osaka University, Osaka 560-0043, Japan
| | - Hiroshi Toki
- Health Care Division, Health and Counseling Center, Osaka University, Osaka 560-0043, Japan
- Research Center for Nuclear Physics, Osaka University, Osaka 567-0047, Japan
| | - Shuji Kitora
- Health Care Division, Health and Counseling Center, Osaka University, Osaka 560-0043, Japan
| | - Asuka Oyama
- Health Care Division, Health and Counseling Center, Osaka University, Osaka 560-0043, Japan
| | - Ryohei Yamamoto
- Health Care Division, Health and Counseling Center, Osaka University, Osaka 560-0043, Japan
- Laboratory of Behavioral Health Promotion, Department of Health Promotion, Graduate School of Medicine, Osaka University, Osaka 565-0043, Japan
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Haș IM, Teleky BE, Vodnar DC, Ștefănescu BE, Tit DM, Nițescu M. Polyphenols and Cardiometabolic Health: Knowledge and Concern among Romanian People. Nutrients 2023; 15:nu15102281. [PMID: 37242164 DOI: 10.3390/nu15102281] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
The cardiometabolic health of the population is a crucial indicator of public health, considering the significant impact of cardiovascular disease (CVD) and diabetes on global mortality. Determining the population's knowledge and the predictors of these pathologies is essential in developing effective educational and clinical strategies for the prevention and management of cardiometabolic risk (CMR). Polyphenols are natural compounds with a multitude of beneficial effects on cardiometabolic health. This study explored the current knowledge, understanding, and awareness of CMR, the benefits of polyphenols among Romanians, and how sociodemographic and clinical characteristics influence this aspect. Five hundred forty-six subjects responded anonymously to an online questionnaire designed to assess their knowledge. The data were collected and analyzed based on gender, age, education level, and BMI status. Most respondents expressed concern to a great or very great extent about their health (78%) and food (60%), with significant differences (p < 0.05) depending on age, educational level, and BMI status. Of the respondents, 64.8% declared that they were familiar with the CMR term. Still, the results showed a weak correlation between the stated risk factors and the self-assessment of increased risk (r = 0.027) for CVD or diabetes. Only 35% of the respondents reported a good or very good knowledge of the term "polyphenols", 86% recognized the antioxidant effect, and significantly fewer (26%) recognized the prebiotic effect. Developing and implementing targeted educational strategies to enhance learning and individual behaviors related to CMR factors and the benefits of polyphenols is necessary.
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Affiliation(s)
- Ioana Mariana Haș
- Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania
| | - Bernadette-Emőke Teleky
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania
- Department of Food Science and Technology, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania
| | - Dan-Cristian Vodnar
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania
- Department of Food Science and Technology, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania
| | - Bianca Eugenia Ștefănescu
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania
| | - Delia Mirela Tit
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 29 N. Jiga St., 410028 Oradea, Romania
| | - Maria Nițescu
- Department of Preclinical-Complementary Sciences, University of Medicine and Pharmacy "Carol Davila", 050474 Bucharest, Romania
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Manla Y, Almahmeed W. Cardiometabolic Clinics: Is There a Need for a Multidisciplinary Clinic? FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:880468. [PMID: 36992726 PMCID: PMC10012126 DOI: 10.3389/fcdhc.2022.880468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022]
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Patient-Centered Care for Patients with Cardiometabolic Diseases: An Integrative Review. J Pers Med 2021; 11:jpm11121289. [PMID: 34945763 PMCID: PMC8703261 DOI: 10.3390/jpm11121289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/28/2021] [Accepted: 11/19/2021] [Indexed: 12/31/2022] Open
Abstract
Patient-centered care is essential in high-quality health care, as it leads to beneficial outcomes for patients. The objective of this review is to systematize indicators for the care of patients with cardiometabolic diseases based on patient-centered care, extending from the stages of diagnostic evaluation and care planning to intervention. An integrative literature review was conducted by searching seven scientific databases, and a narrative analysis was performed. A total of 15 articles were included, and indicators related to diagnosis and care planning/intervention were extracted. In the planning of care centered on the person with cardiometabolic diseases, the individuality, dynamics of the processes, flexibility and the participation of all stakeholders should be taken into account. The needs of the person must be addressed through the identification of problems; establishment of individual goals; shared decision making; information and education; systematic feedback; case management; meeting the patient’s preferences and satisfaction with care; engagement of the family; and therapeutic management. The indicators for intervention planning extracted were behavioral interventions, therapeutic management programs, lifestyle promotion, shared decision making, education patient and information, interventions with the use of technology, promotion of self-management, program using technology, therapeutic relationship, therapeutic adherence programs and specialized intervention.
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