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日本2型糖尿病患者教学厨房项目的疗效:开放标签随机对照试验方案(TKD-J试验)

Efficacy of a teaching kitchen program for patients with type 2 diabetes in Japan: protocol for an open-label randomised controlled trial (TKD-J trial).

作者信息

Baden Megu Y, Kawamoto Saki, Kagisaki Takuya, Kato Sarasa, Mitsushio Kento, Hara Tomoyuki, Ozawa Harutoshi, Horii Tomomi, Ishibashi Chisaki, Hosokawa Yoshiya, Fujishima Yuya, Kozawa Junji, Nishizawa Hitoshi, Muraki Isao, Furuya Yusuke, Yonekura Akio, Yamashita Takatoshi, Kawabe Taro, Massa Jennifer, McClure Auden C, Eisenberg David M, Hu Frank B, Shimomura Iichiro

机构信息

Department of Metabolic Medicine, Graduate School of Medicine, The University of Osaka, Suita, Osaka, Japan

Department of Lifestyle Medicine, Graduate School of Medicine, The University of Osaka, Suita, Osaka, Japan.

出版信息

BMJ Open. 2025 Aug 25;15(8):e105580. doi: 10.1136/bmjopen-2025-105580.

Abstract

INTRODUCTION

This open-label randomised controlled trial (Teaching Kitchen for Diabetes in Japan [TKD-J] trial) evaluates the effectiveness of a modified Teaching Kitchen program for Japanese patients with type 2 diabetes. Based on the US Teaching Kitchen Multisite Trial, this program integrates hands-on culinary instruction with evidence-based lectures on nutrition, physical activity, sleep and mindfulness, combined with a personalised approach. This is the first prospective study to assess its impact on glycaemic control and clinical, behavioural, quality-of-life outcomes among Japanese patients with type 2 diabetes.

METHODS AND ANALYSIS

Two hundred adults aged 20-79 years with type 2 diabetes (HbA1c 6.5-8.9%) and either body mass index ≥23 kg/m² or abdominal obesity (waist ≥85 cm for men or ≥90 cm for women) will be recruited from Osaka University Hospital and 16 affiliated medical institutions in Japan. Participants will be randomly assigned in a 1:1 ratio to either an initial-start or a delayed intervention group (starting after a 4-month delay). The 12-month intervention includes a 4-month main program (weekly) and 8-month maintenance program (monthly), followed by a 4-month post-intervention follow-up. Data will be collected at baseline, and at months 0, 4, 8, 12 and 16. In the initial start group, the baseline and month 0 assessments coincide. In the delayed intervention group, month 0 occurs 4 months after baseline, following a control period. The primary outcome is the change in HbA1c levels during the first 4-month period, which corresponds to the randomised controlled trial phase. Secondary outcomes are changes in fasting plasma glucose, glycaemic variability assessed by blinded continuous glucose monitoring, diabetes treatment, anthropometric and metabolic measures, dietary behaviour, physical activity, sleep, quality of life, mindfulness, cooking skills and self-efficacy. In addition, program satisfaction and records collected through web application will also be assessed. Between-group and within-group changes over time will be analysed using mixed-effects linear regression models.

ETHICS AND DISSEMINATION

The study has been approved by the Ethics Committee of Osaka University Hospital (approval number: 23179 [T2]). Written informed consent will be obtained from all participants. Findings will be disseminated through peer-reviewed journals, conference presentations and community outreach.

TRIAL REGISTRATION NUMBER

UMIN-CTR (UMIN000052514).

摘要

引言

这项开放标签随机对照试验(日本糖尿病教学厨房 [TKD-J] 试验)评估了改良后的教学厨房项目对日本 2 型糖尿病患者的有效性。基于美国教学厨房多中心试验,该项目将实践烹饪指导与关于营养、体育活动、睡眠和正念的循证讲座相结合,并采用个性化方法。这是第一项评估其对日本 2 型糖尿病患者血糖控制以及临床、行为和生活质量结局影响的前瞻性研究。

方法与分析

将从大阪大学医院和日本 16 家附属医疗机构招募 200 名年龄在 20 - 79 岁之间的 2 型糖尿病成年人(糖化血红蛋白 [HbA1c] 为 6.5 - 8.9%),且其体重指数≥23 kg/m² 或存在腹型肥胖(男性腰围≥85 cm,女性腰围≥90 cm)。参与者将按 1:1 的比例随机分配至初始启动组或延迟干预组(延迟 4 个月后开始)。为期 12 个月的干预包括一个为期 4 个月的主要项目(每周一次)和一个为期 8 个月的维持项目(每月一次),随后是为期 4 个月的干预后随访。数据将在基线时以及第 0、4、8、12 和 16 个月收集。在初始启动组中,基线评估和第 0 个月评估重合。在延迟干预组中,第 0 个月在基线后 4 个月出现,经过一个对照期。主要结局是前 4 个月期间 HbA1c 水平的变化,这对应于随机对照试验阶段。次要结局包括空腹血糖的变化、通过盲法持续葡萄糖监测评估的血糖变异性、糖尿病治疗、人体测量和代谢指标、饮食行为、体育活动、睡眠、生活质量、正念、烹饪技能和自我效能感。此外,还将评估项目满意度以及通过网络应用程序收集的记录。将使用混合效应线性回归模型分析组间和组内随时间的变化。

伦理与传播

该研究已获得大阪大学医院伦理委员会的批准(批准号:23179 [T2])。将从所有参与者处获得书面知情同意书。研究结果将通过同行评审期刊、会议报告和社区宣传进行传播。

试验注册号

UMIN - CTR(UMIN000052514)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03e1/12382587/63e44e1badbb/bmjopen-15-8-g001.jpg

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