Clinical Research
Advancing Diabetes Care
Our team is committed to providing the best patient care possible. As one of top research hospitals in the world, we have our own research team who work to advance our knowledge of how to prevent and manage chronic diseases.
The clinical research studies we run help us to understand patient needs and preferences and improve health outcomes. Our studies have shown that cardiac rehabilitation saves lives. We have tested and reported on treatments that can improve quality of life, fitness, strength, confidence to exercise, healthy eating patterns, and mental wellbeing.
Participating in Research Studies
Patients are a critical part of our research. You may have the opportunity to join a research study as a participant. Some studies are short and involve sharing your thoughts and ideas in a survey, interview, or focus group. Other studies may test the effectiveness of a device, procedure, or change in behaviour over time.
Joining a research study is always voluntary. If you choose not to participate in a study, you will receive the same excellent care.
Ongoing Studies
Read about current studies that our research team is involved in.
Adapting and evaluating a new delivery model of patient education to increase knowledge and promote behaviour change for diabetes patients in the Philippines
Institutions
Chong Hua Heart Institute Cardiac Rehabilitation Unit, Philippines
University Health Network (UHN), Canada
Investigators
Principal Investigator in Canada: Dr Paul Oh
Principal Investigator in the Philippines: Dr Maria Rosan Trani
Research Coordinator: Dr Gabriela Melo Ghisi (UHN)
Research collaborators: Crystal Aultman (UHN), Dr Shazna Bersabal (Chong Hua), Dr Imelda Bilocura (Chong Hua), Dr Rhea Karla Panilagao (Chong Hua)
Summary
The prevalence of diabetes in the Philippines is increasing due to rapid urbanization and Westernization of the Filipino culture and the country is expected to have one of the highest number of newly diagnosed diabetes cases by 2025.
Considering that there is a positive association between knowledge about diabetes, treatment adherence and behaviour change, patient education is a fundamental aspect of diabetes care. The main objectives of educational interventions designed for diabetes patients are reducing the barriers for individuals with diabetes, their families and communities, and health professionals, and the promotion of efficient self-care. In addition, education interventions can improve clinical outcomes, prevent or delay diabetes and its acute and chronic complications, improve quality of life, and contribute to positive behavioural changes.
Despite the effectiveness achieved by diabetes educational interventions, most studies on this topic have been carried out in high-income countries, highlighting the need to study this theme in low- and middle-income countries such as the Philippines. Therefore, the purpose of this research project is to culturally adapt an education intervention for diabetes patients called Diabetes College and investigate its effects in the Philippines.
This project is divided into three phases:
- Preparation: a group of healthcare providers who are experts in diabetes and primary and secondary prevention along with a group of patients reviewed the English version of the Diabetes College curriculum (developed in Canada). Both groups completed a short online survey to assess the understandability, actionability, and cultural relevance of these materials to diabetes patients in the Philippines.
- Implementation: based on feedback received from patients and healthcare providers, previous national studies on diabetes education, and local guidelines, the Diabetes College materials were adapted to the needs of the target population in the Philippines. In this phase, the Canadian group hosted virtual meetings with the Filipino group to provide educational sessions on how to use the curriculum materials.
- Assessment: a prospective longitudinal study in Filipino diabetes patients (attending cardiac rehabilitation or outpatient clinic of primary prevention) receiving education through the English Diabetes College materials (structured educational classes with videos, slides and facilitation for 4 to 8 weeks). There will not be a comparison group. Disease-related knowledge, number of steps taken per day, adherence to a heart-healthy diet will be assessed.
Progress
All 218 patients were recruited. Data collection is underway.
Exercise and Lifestyle Education Program for Patients with Prediabetes and Diabetes: Multicenter Randomized Controlled Trial in Brazil
Institutions
Federal University of Juiz de Fora (UFJF), Brazil
Federal University of Minas Gerais (UFMG), Brazil
University Health Network (UHN), Canada
Investigators
Principal Investigator: Prof Lilian Pinto da Silva (UFJF)
Research Coordinator at UFJF: Ana Paula Batalha
Research Coordinator at UFMG: Patrícia Fernandes Trevizan
Trainees: Adriano L Pereira, Gabriela C Nascimento, Bruno Mariano, Larissa Barbosa de Carvalho
Research collaborators: Ana Paula Boroni (UFJF), Ann Kristine Jansen (UFMG), Daniele Sirineu Pereira (UFMG), Danielle Aparecida Gomes Pereira (UFMG), Danielle Guedes Andrade Ezequiel (UFJF), Gabriela Lima de Melo Ghisi (UHN), Paul Oh (UHN)
Summary
The number of people living with diabetes in Brazil continues to increase. Moreover, the incidence of prediabetes is rising around the world and consequently demanding strategies to prevent type 2 diabetes. Since diabetes management includes the use of medications and lifestyle changes, including dietary restrictions and physical exercise, patient education is a crucial aspect to promote the prevention and control of this disease. However, lifestyle education programs are still poorly implemented in countries such as Brazil.
The goal of this research project is to investigate the effects of an Exercise and Lifestyle Education (ExLE) program on functional capacity and other outcomes compared to an Exercise (Ex) program in patients living with prediabetes and diabetes in Brazil.
This is a multicenter double-blinded randomized controlled trial with two parallel arms: ExLE program (12 weeks of exercise and educational interventions) and Ex program (12 weeks of exercise intervention only). The study is taking place in two Brazilian cities located in the more densely populated Brazilian region, including a state capital. The programs can be delivered in two formats (face-to-face or remote) based on internet access and technology literacy and preference of the participants.
The primary outcome is functional capacity assessed by the Incremental Shuttle Walk Test, a test requiring patients to walk progressively faster each minute
Other outcomes include (1) disease-related knowledge, (2) health behaviors (physical activity level, exercise self-efficacy, health literacy, and medication adherence) and (3) cardiometabolic health parameters (glycemic control, anthropometric measures, and cardiac autonomic control). Quality of life, program adherence, satisfaction with interventions, and 6-month related diabetes morbidity will also be assessed. Assessments will occur at pre- and post-intervention, and a six-month follow-up.
Progress
This study is currently ongoing. Until now, 86 participants have been enrolled in the study, of which 43 were randomized to the ExLE program, and 43 were randomized to the Ex program.
Studies Looking for Participants
Check back regularly for updates
How to Join a Research Study
To join a research study, watch for the emails and flyers from the research team and contact the person listed. For general questions about joining a study, contact Priscilla Gonsalves at priscilla.gonsalves@uhn.ca
What Can I Expect?
All research at UHN that involves human subjects needs to be approved before the study begins. The Research Ethics Board (REB) is a group of people who help protect the safety of people joining a study. They work to ensure privacy, dignity and justice for all participants.
Before you join a study, there will be two keys steps — prescreening and informed consent.
Prescreening
Researchers have a set of questions that they may ask you to see if you are eligible (satisfy the conditions) for the study. They also use this process to explain the study and understand your interest in joining. Participants who meet the criteria to join the study move onto the informed consent process.
Informed Consent
Before you join a research study, you will be asked to provide your informed consent. Informed consent means that you have been given all information about the study that you need to make a choice about whether to join the study or not. Even if you provide consent, you can always leave a study without giving a reason.
Contact Information
Team Lead: Dr. Paul Oh, MD MSc FRCPC FACP FAACVPR
Medical Director and GoodLife Fitness Chair, Cardiovascular Prevention and Rehabilitation Program, Toronto Rehab and Peter Munk Cardiac Centre; Senior Scientist, The KITE Research Institute; Associate Professor of Medicine, University of Toronto
Contact (for research only): Priscilla Gonsalves