Synchronized Diabetes and Heart Care Improves Every Aspect of Patients Health
January 21, 2025

David Tschantz lived an incredibly healthy life with not so much as an overnight hospital stay – until his late fifties. Over the course of a year, he found himself getting more and more out of breath, but he continued trying to go about his life and did not visit a doctor about his poor breathing. One day in 2019, after noticing a huge decline in his health, Tschantz’s family staged an intervention and told him then and there that he needed to go to the hospital.
Diagnosed with Several Medical Conditions
At University Hospitals Ahuja Medical Center, a variety of tests revealed Tschantz was suffering from a multitude of health problems. He had fluid on his heart and lungs. He was diagnosed with type 2 diabetes. Doctors also discovered congestive heart failure, a condition in which the heart can’t pump enough blood to circulate oxygen throughout the body.
Tschantz’s care team addressed his issues at the hospital, referred him for follow-up, and prescribed several medications.
Tschantz was doing relatively well until 2022 when he rapidly developed a serious foot infection. He noticed redness and swelling on a Monday and by Thursday he was admitted into the hospital. The infection, which was determined to have an unknown cause unrelated to diabetes, forced a below-the-knee amputation on his right side.
CINEMA Provides Coordinated Cardiometabolic Care
Things seemed bleak for Tschantz and his health, but it was around this time in the fall of 2022 that he was referred to University Hospitals Harrington Heart & Vascular Institute’s Center for Integrated and Novel Approaches in Vascular-Metabolic Disease (UH CINEMA). This unique cardiometabolic program with doctors, nurses, certified diabetes educators and pharmacists encompasses heart, kidney and diabetes care. The patient’s care team manages overlapping issues all in one place through one program.
“Patients with diabetes often must make separate appointments with a variety of specialists like cardiologists, endocrinologists, nephrologists, ophthalmologists, wound care specialists and more,” said Ian Neeland, MD, cardiologist and director of UH CINEMA. “With our program, we aim to coordinate care for multiple specialties, so patients have fewer appointments. We also offer other crucial support like group sessions and educational classes.”
“When I came to CINEMA, they did a panel and got a baseline for me. It was not good,” said Tschantz. “And I didn’t feel good either. I wasn’t healthy, wasn’t taking care of myself. I lived a pretty sedentary lifestyle with a relatively poor diet.”
Tschantz’s A1C, the blood test that measures your average blood sugar level and is used to monitor diabetes, was greater than 13 percent (6.5 percent or above indicates diabetes). He had high blood pressure and high cholesterol. His heart’s ejection fraction measured 30 percent. Ejection fraction in a healthy heart is 50 to 70 percent.
“From the time I started at CINEMA I felt supported and empowered to create a positive change in my health,” said Tschantz.
Tschantz receives care for his heart, diabetes and general health all through UH CINEMA. He also attends support groups and educational classes through the program.
Dr. Neeland led Tschantz’s care team. They prescribed a continuous glucose monitor so that Tschantz could keep better tabs on his sugar levels. Dr. Neeland also transitioned him off one medication and onto Mounjaro, an injectable GLP-1/GIP receptor agonist medication used to treat type 2 diabetes and aid in weight loss.
Notable Improvements in Overall Health
“Over the next two years we saw astounding changes in David’s health,” said Dr. Neeland. “A huge part of this is due to his dedication to and participation in the program, as well as his adherence to all of our guidance.”
Nearly every aspect of Tschantz’s health has improved. His A1C is normal and he has no detectable diabetes. He’s lost 50 pounds. His breathing has returned to normal. His ejection fraction has recovered and is now in a better range and his heart has healed itself with no evidence of heart failure.
“I truly thought that if you had heart failure that was it for you,” said Tschantz. “I thought you would die from it, or you would need some sort of serious surgery. Same for diabetes. I had no idea you could heal all these issues with a few medications and by living a healthier life.”
Empowered to Live a Healthier Life
“UH CINEMA is a patient-centered program,” said Dr. Neeland. “We want to make participation easy for the patient by combining doctor visits, and enjoyable by providing interesting and fun classes. I think that helped David stay engaged over the long haul and see improved results over time.”
Tschantz says he has improved his diet and is now more physically active, including his participation in UH CINEMA’s armchair workout classes. He has a prosthesis for his right foot and does some moderate walking.
“I’m back to doing things I enjoy like building through carpentry and I’m working with my brother,” said Tschantz. “Before CINEMA I didn’t have much hope of feeling good again, but now I feel as close as possible to my best, maybe even better!”
Tags: Diabetes, Heart Health, CINEMA, Ian Neeland, MD