Diabetes Mellitus Clinical Trial
Official title:
Control of Diabetes and Periodontitis Through a New Anti-inflammatory Nordic Diet
There is a significant and growing interest in nutrition and health in the general population
and there is also, paradoxically, an increasing problem with obesity and general debilitating
conditions of affluence, such as type 2 diabetes mellitus. Igelösa Life Science AB has
developed a modified Okinawan-based Nordic Diet (OBND) diet based on evidence primarily from
the diet of the long-lived and healthy Okinawa population. The diet includes fish and whole
grains, with a high level of vegetables, but is low in fat. In 2016, a clinical nutrition
study was carried out at Kristianstad University with the intention to determine if the OBND
resulted in reductions/changes in clinical and medical markers of importance for treatment of
diabetes mellitus and gingivitis/periodontitis. The diet had a positive impact on the
clinical progress of otherwise debilitating conditions such as diabetes and the health
benefits on clinical parameters was extremely rapid, that is, within two weeks. Not only did
the patients with type 2 diabetes receive the OBND, their partners were also offered the same
option. This is a key innovation and the participants stated that it was a great support,
which facilitated adherence and promotes the long-term impact on health. Ingrained habits
such as poor diet, can only be defeated by a concerted team effort and our work to date
provides a glimpse of the potential benefits to Sweden and the rest of the developed world
through this shared approach.
Initial studies have shown promising effects of the OBND on both diabetes and periodontal
conditions. The objective of this study is to compare the OBND to the current recommended
standard diet. Assuming the study provides positive evidence of health impact due to improved
food quality, it will also be seen that the production and delivery of such 'healthy-living'
meals will be of commercial interest for industry. The mission is to offer an evidence-based
natural food alternative that both prevents disease and improves the health status of
individuals with diabetes. The long-term goal is to design efficient and effective products
that will protect against diabetes and other chronic diseases. The combination of scientific
credibility and commercial interests may be a key factor to transfer the new knowledge about
healthy dieting into actual improvements in public health.
The project has one main goal: to perform a clinical trial to compare the OBND with standard
of care diet. The outcome of the clinical trial will be analyzed in the areas:
medicine/odontology, sensory science, nursing, public health and health economics.
Study objectives:
- To assess if the consumption of the designated diet results in added medical/dental
health outcome for the OBND in comparison to standard of care diet. The study is a
randomized case control clinical trial.
- To perform cost-effectiveness analyses comparing costs and health benefits for the test
and control diets with focus on individuals with type 2 diabetes mellitus and otherwise
healthy individuals living in close relationship to those with diabetes.
- To assess consumer acceptance of the diet: (I) acceptance of the diets (questionnaire,
focus groups and food diary), (II) acceptability of the diet in relation to taste of the
diet, and the prospect of adopting the diet in everyday life, and (III) sensory analysis
of identical dishes prepared according to the OBND and the standard of care diet.
Study design The study design is a randomized double-blinded clinical trial with four
subgroups including 20 individuals per study group.
Test Group A: OBND, individuals diagnosed with type 2 diabetes (T2D) with a need for insulin
intake
Test Group B: OBND, relatives who do not have T2D
Control Group C: Standard of care diet, individuals diagnosed with T2D with a need for
insulin intake
Control Group D: Standard of care diet, relatives who do not have T2D
Based on the above reported studies and available data on blood sugar and lipid values, the
investigators have identified that 18 individuals in each group will provide adequate
statistical power (alpha=0.05, beta=0.85). While lost to follow up occurs, the investigators
will enroll 20 individuals in each group. Thus, a total of 80 study individuals (test and
control) will be enrolled. Data analyses will be performed according to per protocol as well
as per intent to treat. Clinical examination procedures in medicine and dentistry will follow
principles of good clinical practice. Study group assignment will be based on a randomization
using the SPSS statistics package. A pre-baseline examination will be performed to ensure
that all study individuals fulfill study requirements. The investigators will monitor that
study individuals are compliant to protocol.
Study time schedule The study design includes a pre-baseline study examination two weeks
before study start to ensure that study individuals meet the criteria for study participation
and to control for Hawthorne effects. Study individuals will be enrolled in groups of 8 to 10
individuals and re-examined at baseline. The primary study endpoint is the third examination
will be performed 4 weeks after baseline examination. A follow-up examination will occur
after 6 months (plus/minus 14 days). All study enrollments will be completed within one
month. Study individuals will receive phone calls during the study period to encourage
compliance and respond to specific questions.
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