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Type 2 Diabetes MellitusNCT04763525

Efficacy of Pythagorean Self-Awareness for Aging Biomarkers Improvement, in T2D Patients and Healthy Individuals.

A study testing Pythagorean Self-Awareness Intervention(PSAI) in people with Type 2 Diabetes Mellitus and Telomere Shortening, run by National and Kapodistrian University of Athens at 1 site in Greece.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The present study explored the effects of the implementation of the Pythagorean Self Awareness Intervention (PSAI) on the dynamics of stress-related aging factors of immune cells in healthy volunteers and a cohort patients with type 2 diabetes mellitus . Read more about this study

Who is it for?
Ages 19 years and olderHealthy volunteers can take part
Conditions the study is for
Type 2 Diabetes Mellitus, Telomere Shortening
What is being tested?
Pythagorean Self-Awareness Intervention(PSAI)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
48 participants
Where
1 siteGreece
Study dates
4 Oct 2018to 26 Nov 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 19 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • adequate knowledge of the Greek language
  • For participants with T2DM, a minimum of 3-month stable antidiabetic, hypolipidemic and antihypertensive treatment
  • habitants of Athens, Greece

Who cannot join

  • participation in other stress management program
  • corticosteroid intake
  • diagnosis of psychiatric co-morbidity or autoimmune disease
  • change in antidiabetic, hypolipidemic, and antihypertensive treatment within the previous 3 months
  • patients with type 2 diabetes treated with insulin

Trial locations and contacts

1 site in 1 country.

Greece1 site
  • General University Laiko Hospital

    Athens, 11527

Other trials in Greece

About this study

Official title: Stress and Biomarkers of Aging: a Novel Stress Management Program With the Cognitive Restructuring Method "Pythagorean Self-Awareness Intervention" in Healthy Individuals and in Subjects With Type 2 Diabetes Mellitus.

The present study explored the effects of the implementation of the Pythagorean Self Awareness Intervention (PSAI) on the dynamics of stress-related aging factors of immune cells in healthy volunteers and a cohort patients with type 2 diabetes mellitus . The primary aim was to evaluate the effectiveness of PSAI on two key biomarkers of biological age, telomere length and proteasome levels, indicative of the crosstalk between cellular oxidative status and replicative potential, with respect to metabolic, hormonal and mental status changes. Secondary aims of this study included reduction of depression, perceived stress, anxiety and the establishment of lifestyle changes to enhance the quality of everyday life, including better quality of sleep, eating behaviours and an overall healthier status.

Read the detailed description

Study design This non randomized non blinded parallel trial was conducted at the Laiko Hospital of Athens, Diabetes Centre, First Department of Propaedeutic Internal Medicine of Attica, Greece, from 4.10.2018 to 26.11.2019. The study protocol was approved by the Ethics Committee of the Laiko Hospital (protocol number 5134/5-4-19) and was in accordance with the declaration of Helsinki. All participants were enlisted in the study only after being fully informed by the researcher about the aims and procedures of the research and submitting written consent.

Procedures Patients eligible for the above mentioned criteria were randomized in two groups: the group of healthy adult volunteers, and adults with type 2 diabetes who attended the outpatient diabetes clinic. This study was non-blinded, as patients and researchers were aware of the group assignment.

Being tested
Pythagorean Self-Awareness Intervention(PSAI)
Keywords
Stress physiology, behavioural intervention, stress management, type 2 diabetes, Pythagorean Self-Awareness
Medical subject headings
Diabetes Mellitus, Type 2

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Pythagorean Self-Awareness Intervention(PSAI)Behavioural

    The PSAI is a mental, stress-management technique that promotes self-awareness, cognitive reconstruction and self-improvement based on the Golden Verses moral framework of the ancient Greek philosopher Pythagoras. The individual must practice the technique twice daily( at bed-time and in the morning, every day, at home) and through a 3-stage internal dialogue (recall of daily events, inspection of related thoughts and emotions and self-appraisal)is encouraged to detect wrong choices and unhealthy behaviours and initiate self-correction towards a healthier lifestyle.

Study groups in NCT04763525
Study groupRoleWhat they receive
Intervention group Pythagorean Self-Awareness in patients with type 2 diabetesExperimentalN=21 patients with type 2 diabetes
Receives: Behavioral: Pythagorean Self-Awareness Intervention(PSAI)
Intervention group Pythagorean Self-Awareness for healthy individualsExperimentalN=27 healthy individuals
Receives: Behavioral: Pythagorean Self-Awareness Intervention(PSAI)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Determination of telomeres' length

    Extracted DNA from Peripheral blood mononuclear cells isolated from total blood

    Measured: 2 months

  2. Determination of telomeres' length

    Extracted DNA from Peripheral blood mononuclear cells isolated from total blood

    Measured: 6 months

  3. Determination of 20S proteasome concentration

    Protein extracts from Peripheral blood mononuclear cells isolated from total blood

    Measured: 6 months

  4. Healthy Lifestyle and Personal Control Questionnaire

    Self-report questionnaire for the evaluation of a healthy lifestyle with the instrument Healthy Lifestyle and Personal Control Questionnaire that explores five dimensions of lifestyle (Organized Physical Exercise, Social Support and Mental Control, Daily Routine, Dietary Harm Avoidance, Dietary Healthy Habits).Scores range from 26 to 104 with higher scores indicating a healthier lifestyle.

    Measured: 6 months

  5. Glycosylated haemoglobin

    total blood

    Measured: 6 months

Secondary outcomes (22)
  1. Hair cortisol concentration

    Hair specimens from the posterior vertex of the scalp, three cm proximal to scalp

    Measured: 6 months

  2. Total Body Water

    Total Body Water will be reported in percent and it will be measured by the device TANITA BC418 (Tanita Cooperation, Tokyo, Japan),

    Measured: 6 months

  3. Fat Free Mass

    Fat Free Mass will be reported in kilograms,and it will be measured by the device TANITA BC418 (Tanita Cooperation, Tokyo, Japan),

    Measured: 6 months

  4. Fat Mass

    Fat Mass will be reported in percentage and it will be measured by the device TANITA BC418 (Tanita Cooperation, Tokyo, Japan),

    Measured: 6 months

  5. Visceral fat

    Visceral fat will be reported in cm ^2 and it will be measured by the device TANITA BC418 (Tanita Cooperation, Tokyo, Japan)

    Measured: 6 months

  6. Trunk fat

    Trunk fat will be reported in percentage and it will be measured by the device TANITA BC418 (Tanita Cooperation, Tokyo, Japan)

    Measured: 6 months

  7. Body Mass Index

    Weight and height will be combined to report BMI in kg/m^2

    Measured: 6 months

  8. Depression Anxiety Stress Scale

    Self-referential symptoms of depression, anxiety and stress with the instrument Depression-Anxiety-Stress Scale-21 Three scores(Depression, Anxiety, Stress). Depression score ranging from 0 to 42, Anxiety score ranging from 0-42, Stress score ranging from 0-42. We expect reduction.

    Measured: 6 months

  9. Perceived Stress Scale

    Evaluation with the self-referential instrument the Perceived Stress Scale. Score ranging from 0 to 56 with higher score indicating higher perceived stress. We expect reduction.

    Measured: 6 months

  10. Self-referential quality of sleep

    Evaluation of sleep quality with the instrument Greek version Pittburgh Sleep Quality Index. Score ranging from 0 to 21. Score higher than 5 indicates poor sleep quality. We expect reduction.

    Measured: 6 months

  11. Self-referential Internal Health Locus of Control

    Evaluation of internal health locus with the instrument Health Locus of Control. Score ranging from 6 to 36 with higher scores indicating higher self-control over the individual's health. We expect increase.

    Measured: 6 months

  12. Self-referential External and chance Health Locus of Control

    Evaluation of External health locus of control and chance, with the instrument Health Locus of Control. Score ranging from 6 to 36 for each dimension. Higher score means that the individual perceives that his/her health is controlled by external factors and chance.We expect reduction.

    Measured: 6 months

  13. Self-referential health locus of control Powerful others

    Evaluation of health locus of control for Powerful others with the instrument Health Locus of Control. Score ranging from 6 to 36.Higher score means that the individual perceives that his/her health is controlled by powerful others such as health personnel.We expect reduction.

    Measured: 6 months

  14. Evaluation of verbal memory

    Assessment of verbal memory with the cognitive test California Verbal Learning test. Score ranging from 0 to 90 with higher score indicating better verbal memory. We expect increase.

    Measured: 6 months

  15. Evaluation of visuospatial memory

    Assessment of visuospatial memory with the cognitive test Brief Visuospatial Memory test-Revised. Score ranging from 0 to 36 with higher score indicating better visuospatial memory.We expect increase.

    Measured: 6 months

  16. Evaluation of speed processing information

    Assessment of speed processing of information with the cognitive test Symbol Digits Modality test. Score ranging from 0 to 95 with higher score indicating higher speed processing of information.We expect increase.

    Measured: 6 months

  17. Fatigue

    Assessment of physical, mental and brain fatigue with a visual analogue scale with minimum as 0 indicating no fatigue at all and maximum 10 indicating high degree of fatigue. We expect reduction.

    Measured: 6 months

  18. Perimeter of the waist

    Perimeter will be reported in centimeters

    Measured: 6 months

  19. Perimeter of the neck

    Perimeter will be reported in centimeters

    Measured: 6 months

  20. Perimeter of the hips

    Perimeter will be reported in centimeters

    Measured: 6 months

  21. Extracellular water

    Extracellular water will be reported in percentage and with be assessed by a device of bioelectrical impedance technology by BIOTEKNA©, Biomedical Technologies, Venice, Italy

    Measured: 6 months

  22. Intracellular water

    Intracellular water will be reported in percentage and it will be measured by a device of bioelectrical impedance technology by BIOTEKNA©, Biomedical Technologies, Venice, Italy

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Feb 2021
  2. Study start4 Oct 2018
  3. Primary completion26 Nov 2019
  4. Study completion26 Nov 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
48 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04763525
Sponsor's protocol ID
5134/5-4-19
Status last verified
Feb 2021
First submitted
9 Feb 2021
Last updated
21 Feb 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The data will be made available upon study publication.

Publications

  • Lopez-Otin C, Blasco MA, Partridge L, Serrano M, Kroemer G. The hallmarks of aging. Cell. 2013 Jun 6;153(6):1194-217. doi: 10.1016/j.cell.2013.05.039.

    PubMed 23746838
  • de Magalhaes JP, Passos JF. Stress, cell senescence and organismal ageing. Mech Ageing Dev. 2018 Mar;170:2-9. doi: 10.1016/j.mad.2017.07.001. Epub 2017 Jul 5.

    PubMed 28688962
  • Weber D, Stuetz W, Toussaint O, Debacq-Chainiaux F, Dolle MET, Jansen E, Gonos ES, Franceschi C, Sikora E, Hervonen A, Breusing N, Sindlinger T, Moreno-Villanueva M, Burkle A, Grune T. Associations between Specific Redox Biomarkers and Age in a Large European Cohort: The MARK-AGE Project. Oxid Med Cell Longev. 2017;2017:1401452. doi: 10.1155/2017/1401452. Epub 2017 Jul 19.

    PubMed 28804532
  • Chondrogianni N, Stratford FL, Trougakos IP, Friguet B, Rivett AJ, Gonos ES. Central role of the proteasome in senescence and survival of human fibroblasts: induction of a senescence-like phenotype upon its inhibition and resistance to stress upon its activation. J Biol Chem. 2003 Jul 25;278(30):28026-37. doi: 10.1074/jbc.M301048200. Epub 2003 May 7.

    PubMed 12736271
  • Puhlmann LMC, Valk SL, Engert V, Bernhardt BC, Lin J, Epel ES, Vrticka P, Singer T. Association of Short-term Change in Leukocyte Telomere Length With Cortical Thickness and Outcomes of Mental Training Among Healthy Adults: A Randomized Clinical Trial. JAMA Netw Open. 2019 Sep 4;2(9):e199687. doi: 10.1001/jamanetworkopen.2019.9687.

    PubMed 31553468
  • Diaz-Ruiz A, Guzman-Ruiz R, Moreno NR, Garcia-Rios A, Delgado-Casado N, Membrives A, Tunez I, El Bekay R, Fernandez-Real JM, Tovar S, Dieguez C, Tinahones FJ, Vazquez-Martinez R, Lopez-Miranda J, Malagon MM. Proteasome Dysfunction Associated to Oxidative Stress and Proteotoxicity in Adipocytes Compromises Insulin Sensitivity in Human Obesity. Antioxid Redox Signal. 2015 Sep 1;23(7):597-612. doi: 10.1089/ars.2014.5939. Epub 2015 Mar 31.

    PubMed 25714483
  • Tsoli S, Vasdekis S, Tigani X, Artemiadis A, Chrousos G, Darviri C. A novel cognitive behavioral treatment for patients with chronic insomnia: A pilot experimental study. Complement Ther Med. 2018 Apr;37:61-63. doi: 10.1016/j.ctim.2018.01.015. Epub 2018 Feb 1.

    PubMed 29609939
  • Charalampopoulou M, Bacopoulou F, Syrigos KN, Filopoulos E, Chrousos GP, Darviri C. The effects of Pythagorean Self-Awareness Intervention on breast cancer patients undergoing adjuvant therapy: A pilot randomized controlled trial. Breast. 2020 Feb;49:210-218. doi: 10.1016/j.breast.2019.12.012. Epub 2019 Dec 20.

    PubMed 31901782
  • Darviri C, Alexopoulos EC, Artemiadis AK, Tigani X, Kraniotou C, Darvyri P, Chrousos GP. The Healthy Lifestyle and Personal Control Questionnaire (HLPCQ): a novel tool for assessing self-empowerment through a constellation of daily activities. BMC Public Health. 2014 Sep 24;14:995. doi: 10.1186/1471-2458-14-995.

    PubMed 25253039

Questions about this trial

What is this clinical trial studying?

A study testing Pythagorean Self-Awareness Intervention(PSAI) in people with Type 2 Diabetes Mellitus and Telomere Shortening, run by National and Kapodistrian University of Athens at 1 site in Greece.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Feb 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Greece. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Determination of telomeres' length (time frame: 2 months). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04763525, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Feb 2021.

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