Blood Sugar Regulation for Cardiovascular Health Promotion and Disease Prevention

Schwarz, Peter E. H.; Timpel, Patrick; Harst, Lorenz; Greaves, Colin; Ali, Mohammed K.; Lambert, Jeffrey; Weber, Mary Beth; Almedawar, Mohamad M.; Morawietz, Henning

doi:10.1016/j.jacc.2018.07.081

Cited by 36 publications

(25 citation statements)

References 146 publications

(168 reference statements)

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“…Despite considerable heterogeneity between the primary studies included in the analysis [66], the potential of pharmacistled interventions is supported by findings by de Barra and colleagues [102]. Therefore, governments should support the implementation of interdisciplinary care teams, with special regard to the involvement of pharmacists [39].…”

Section: Policy Implicationsmentioning

confidence: 96%

“…Such interventions should be initiated early in pregnancy and continue throughout the pregnancy, as major short-and long-term health consequences for both the mother and the child are likely. • Develop and implement national diabetes plans as well as regional strategies promoting local partnerships with communities and stakeholders [38] • Governments should support the implementation of interdisciplinary care teams, with special regard to the involvement of pharmacists [39] • Improve the transparency of product ingredients using mandatory simple and intuitive nutrition or menu labelling [40] • Set up government food benefit programmes to incentivise the purchase of fruit and vegetables [41] • Support the certification of digital devices and apps to improve access to evidencebased health information [42] • Use narrative and visual messages to improve diabetes awareness [43] • Support interpretative nutrition labelling, like traffic lights, to decrease SSB sales [41] • Strengthen the framing of diabetes as a problem to be tackled on the societal level [44] • Raise taxes on unhealthy products (and consider the liability for adverse health effects of food and beverage products) and reinvest the money in local infrastructure (outdoor gyms and playgrounds) [45] Pregnant women and young families • Screen high-risk groups (elevated risk due to family history, increased BMI) for early detection of GDM [46] as a precondition for lifestyle change • Give advice regarding healthy eating and set activity targets during pregnancy [47,48] • Give advice regarding the benefits of breastfeeding [49] • Employ multimedia communication strategies to increase the widespread knowledge of diabetes risk during pregnancy [50,51] Children and adolescents…”

Section: Pregnant Women and Young Familiesmentioning

confidence: 99%

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What should governments be doing to prevent diabetes throughout the life course?

et al. 2019

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Health systems and governments are increasingly required to implement measures that target at-risk populations to prevent noncommunicable diseases. In this review we lay out what governments should be doing to prevent diabetes throughout the life course. The following four target groups were used to structure the specific recommendations: (1) pregnant women and young families, (2) children and adolescents, (3) working age population, and (4) the elderly. The evidence to date supports the effectiveness of some known government policy measures, such as sugar taxes and regulatory measures in the (pre-)school setting for children and adolescents. Many of these appear to be more effective if they are part of a bundle of strategies and if they are supplemented by communication strategies. Although there is a current focus on strategies that target the individual, governments can make use of evidence-based population-level prevention strategies. More research and continuous evaluation of the overall and subgroup-specific effectiveness of policy strategies using high-quality longitudinal studies are needed.

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Section: Policy Implicationsmentioning

confidence: 96%

Section: Pregnant Women and Young Familiesmentioning

confidence: 99%

What should governments be doing to prevent diabetes throughout the life course?

et al. 2019

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“…The holistic understanding of health and social care characterises the MCM and includes aspects of participation, prevention, health promotion and public health [24,38,39]. This includes both individual level and populationbased lifestyle interventions [40,41]. The systematic review by Bongaerts et al reported a higher potential for newly diagnosed patients [18].…”

Section: Support Active Participation Prevention and Health Promotionmentioning

confidence: 99%

“…Using resources derived from the living environment and the community of patients when implementing the CCM have shown positive results in terms of clinical and behavioural outcomes [26,60]. Similarly, recent evidence suggests that task shifting from physicians to community-based health workers, nurses [61,62] and pharmacists may be of benefit, especially in rural areas [41,63].…”

Section: Living Environment/community Engagementmentioning

confidence: 99%

The Manage Care Model – Developing an Evidence-Based and Expert-Driven Chronic Care Management Model for Patients with Diabetes

Timpel

Lang²,

Wens

et al. 2020

Int J Integr Care

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BackgroundA growing number of EU citizens suffers from diabetes, posing an emerging health, social and economic burden in the EU [1]. This burden is mostly driven by type 2 diabetes mellitus (T2DM), which is increasingly diagnosed at younger age and leads to a rising number of adults with T2DM aged 65 and older [1]. Due to these rising numbers in diabetes prevalence a growing number of patients faces accompanying comorbidities as well as complex needs [2][3][4][5]. However, many care systems are historically built on separate sectors (health vs. social care, in-vs. outpatient care). This traditional acute and episodic focus of care is inadequate to effectively meet the complex needs of patients as it increases the risk of care fragmentation and loss of information [6,7]. Although these circumstances are repetitively part of health policy initiatives [8,9], there is still an institutional and regulatory separation between health and social care services, as well as between ambulatory and inpatient care [10].Integrated care is said to improve outcomes of care by linking services of providers along the continuum of care and thus overcoming issues of fragmentation [11]. Back in 1996, Ed Wagner developed the Chronic Care Model (CCM), which became a cornerstone to improve care delivery for chronically ill patients. The CCM comprises the following six components: (1) community, (2) health system, (3) self-management support, (4) delivery system design, (5) decision support and (6) clinical information systems [12]. Ever since, different initiatives developed new models targeting specific weaknesses of the initial CCM.However, recent analysis uncovered that the understanding of established models' impact on chronic disease management is limited [13]. This is especially true for the effectiveness and applicability of chronic care models in different populations and settings [13]. Additionally, on behalf of the MANAGE CARE Study Group Background: Most current care models are disease-or symptom-focused and mostly do not account for the individual needs of patients with chronic diseases. The aim of this study was to develop an innovative, evidence-based and expert-based practice model for the management of patients with type 2 diabetes mellitus. Method: An iterative approach was used combining systematic literature search with qualitative methods, including a standardised survey of experts in chronic care (n = 92), an expert workshop of professionals (n = 22) and a multilingual online survey (n = 659). Using three consensus meetings involving researchers, policy makers and experts in chronic care, a limited number of core components and care recommendations was set up to develop a new chronic care model. Results: The developed 'MANAGE CARE MODEL' includes aspects of the health and social care system, resources derived from the living environment, aspects of health promotion and prevention, as well as an expanded understanding of improved outcomes as an integral part of chronic care. Conclusion: The MANAGE CARE MODEL provides...

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“…Cardiovascular disease (CVD) is the most prevalent cause of death worldwide and presents a significant burden, affecting approximately 7 million individuals in the United Kingdom (British Heart Foundation, ; Nichols, Townsend, Scarborough, & Rayner, ). There has been a decline in mortality rates of CVD in the last 30 years, coinciding with the development and implication of evidence‐based behaviour change lifestyle interventions (Artinian et al, ; Haskell, ; Rothman, ; Schwarz et al, ; Unal, Critchley, & Capewell, ). These interventions have targeted the modifiable risk factors, such as hyperglycaemia, smoking, obesity, poor dietary control and physical inactivity; contributing to greater health benefits for individuals and a reduction in the prevalence of CVD.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of behaviour change techniques on lifestyle interventions of patients with a high risk of developing cardiovascular disease. Using a qualitative approach

Kuriakose

Kuczyńska

Timpel

et al. 2020

Health Soc Care Community

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This study aimed to identify key active ingredients on the maintenance of behaviour change for lifestyle interventions of patients with a high risk of developing cardiovascular disease (CVD) who participated in a MOtiVational intErviewing InTervention (MOVE IT) randomised control trial (RCT). A process evaluation was carried out using focus groups. Twenty‐six participants of the MOVE IT RCT were purposively recruited and split into six focus groups. Four groups had attended six or more sessions of the intensive phase (completers) and two groups had withdrawn before the end of the intensive phase or had not attended any sessions (non‐completers). Focus groups were audio recorded, transcribed verbatim and analysed inductively using thematic analysis. Three overall themes were generated from the six focus groups: (a) long‐term benefits from diet and physical activity education, (b) group versus individual structure and adherence and (c) impact on health beliefs and risk of CVD. A fourth theme was generated from the two groups of non‐completers only: (d) need for professional rapport building and feedback. We found that the key active ingredients for effective behavioural change in lifestyle interventions are having well‐developed rapport between facilitators and patients; and providing alternative forms of feedback to encourage maintenance of behaviour change. Furthermore, such programmes also need to have established and strong relationships with associated health professionals (i.e. the General Practitioner) to increase participation and maintenance of engagement.

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Blood Sugar Regulation for Cardiovascular Health Promotion and Disease Prevention

Cited by 36 publications

References 146 publications

What should governments be doing to prevent diabetes throughout the life course?

What should governments be doing to prevent diabetes throughout the life course?

The Manage Care Model – Developing an Evidence-Based and Expert-Driven Chronic Care Management Model for Patients with Diabetes

Effectiveness of behaviour change techniques on lifestyle interventions of patients with a high risk of developing cardiovascular disease. Using a qualitative approach

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