Assigment .Apa seven . All instructions attached.
Review of Literature
Andresa Carvalho Florida National University
MSN Capstone Project-DBX-DL01 Dr. Carmen Lazo
July 17, 2024
10
The subsequent review of literature compiles original research papers and meta-analyses that examine the effectiveness of specific diet and exercise regimens in the management of adult Type 2 diabetes mellitus (T2DM) population. In this synthesis, the author reviews the literature regarding these technologies and analyzes the effectiveness of such interventions for increasing patient satisfaction and improving glycemic control and relates these findings.
Synthesis of Primary Research Studies
First Study: Very limited information on this article. It's not a complete paragraph.
Almutairi et al. (2019). performed a randomized clinical trial to assess outcome of a targeted life style modification for people diagnosed with T2DM They concluded that the patients who followed the pervaded diet and exercise schedules, had drop in HbA1c and better lipid profile scores.
Second Study:
Pandey et al. (2020) also analyzed the long-term result of a structured lifestyle therapy What is the structured therapy? on cardiovascular incidence in overweight/obese individuals with T2DM. The results showed that changes in the lifestyle favorably affected the rate of cardiovascular events, which extended the concept of the positive impact of such interventions on, besides glycemic control.
Third Study:
Another meta-analysis by Courcoulas et al (2020) compared the results of different primary lifestyle interventions in T2DM patients. From the analysis, it was identified clearly that the programs for diet and exercise, For example?especially in structured format, had significant impact, all the time, on glycemic control with the effect size always reported to be improving though in inconsistent manners. The study pointed the necessity individual approaches because the maximum value of the benefits.
Fourth Study:
In the study by Li et al (2023), the Diabetes Prevention Program (DPP) implemented a large comparative trial of lifestyle changes Which are the lifestyle changes? and metformin for the prevention of diabetes in the at–risk population. The outcomes revealed that the lifestyle changes stood out as being more efficient than metformin for the prevention of diabetes with lifestyle changes’ lowering the frequency of diabetes in participants by 58 % more efficiently than metformin with 31%.
Fifth Study:
An international systematic literature review This paragraph is limited for a systemic review.by Sánchez-Sánchez and his team was published in 2020 addressing lifestyle changes, including diet and exercise, with reference to T2DM. The review stated that the Mediterranean diet and aerobic exercise as powerful ways of improving the patients’ glycemic levels and minimization of medication use.
Sixth Study:
In a 2021 parallel-designed clinical trial by Milenkovic and colleagues, the Mediterranean diet's effects on glycemic control What's the Mediterranean diet consist of? Don't assume the reader knows.were measured in individuals with T2DM. It was reported that the patients receiving the dietary intervention benefited from reduced HbA1c concentration and increased sensitivity of insulin compared with low-fat dieters.
Seventh Study:
Shah et al., 2021 assess the impact of varying physical activities What kind of activities? for how long? How many times?on glycemic control amongst patients with T2DM. The results indicated that HbA1c levels were reduced via aerobic and resistance training, though combined training methods showed the most beneficial effect.
Eighth Study:
In this respect, Jiménez-Maldonado et al. (2020) examined the effects of HIIT Explain to the reader what HIIT stand for. in patients with T2DM considering its effect on glycemic control. In this direction, it was found that not
only is HIIT effective in improving insulin action, but also in reducing HbA1c—two important strategies for treating diabetes .
Ninth Study:
Goldberg et al. (2022) in a cross-sectional study, evaluated the relationship of adherence with Self-Care Activities for Diabetes to the maintenance of glycemic control and cardiovascular risk factors among patients with T2DM.They established that long-term educational Which was what?interventions to modify the lifestyles of the patients brought a diminution of the HbA1c levels, blood pressure, and cholesterol levels.
Tenth Study:
In a works randomized controlled trial design, Taheri et al., (2020) offered an intensive lifestyle intervention aimed at ascertaining weight loss and glycemic improvement in T2DM How?patients. It was also established that the subjects in the intervention group lost more weight and improved glycemic profile compared to the control group subjects, who received only standard conventional care.
Synthesis of Evidence
Similarities
The various selected primary research investigate weight loss & exercise again reveal that the two types of interventions in diet clearly enhance glycemic status for T2DM patients.
Therefore, the consumption of the Mediterranean diet, low glycemic index diet, aerobic exercise, resistance training and HIIT lead to decrease in the HbA1c levels and enhancement in insulin sensitivity among the participants. Furthermore, most of these changes reflected other aspects of patients’ general health, including, among others, weight reduction, improved lipid profiles, and lesser cardiovascular risks.
Differences
However, the degree to which subjects differed according to the studies included in the meta-analysis, meaning that the effect was not uniformly positive across all studies. Some of the reasons for this variation may be due to the type of diets, the intensity and duration of the physical activities as well as the characteristics of the study population. For instance, in some research, the Mediterranean diet and HIIT provided significant improvement but the low fat diets and conventional steady-state exercise regimes caused moderate to poorer outcomes.
Controversies
The issue of change maintenance and dietary and physical activity interventions are another area of concern. There are some prospective trials like, the Diabetes Prevention Program (Canno, et al., 2020). while majority of the authors observed high initial success in adopting EBPs, most of them observed that challenges were likely to arise in the long-term implementation of the same. Further, being physically active, there is controversy about which kind of exercise is the best to targeting metabolic regulation, where the benefits of HIIT as well as combined aerobic and resistance exercise have been discussed.
Knowledge for PICOT
The basic research question for analyzing structure and process factors within patient data set (P): Patient satisfaction (O) of T2DM patients with the proposed diet and exercise programme You did not demonstrate this on your articles description. (I) in comparison to the conventional management with oral hypoglycemic agents
(C) during the proposed time frame of 8 weeks (T). Systematic interventions prove that lifestyle changes result to improved glycemic control and cardiovascular health, and quality of life. For instance, Li et al; Diabetic Prevention Program (DPP) Research Group (2023) noted that lifestyle
modification was superior when it comes to the prevention of diabetes, risk of which was higher in the participants under study, compared to metformin them.
Body of Evidence for Practice Change
The evidence overwhelmingly supports structured diet and exercise programs It's not overwhelming, you presented very little evidence.as a quite viable route to improving patient satisfaction and health outcomes for those with T2DM. Several research studies have been carried out on this subject, including works by Almutairi et al., 2019, and research by Pandey et al. in 2020, citing that such lifestyle interventions are associated with significant improvements in the glycemic control and general good health of subjects. It is further supported by systematic reviews, such as Sánchez-Sánchez et al. (2020), which stated the benefits from dietary modification and physical activity.
Objectives for Practice Change
The overall objective, therefore, is to increase patients' satisfaction and treatment outcomes related to T2DM through effective interventions of diet and exercise. Some of the objectives include reduction in HbA1c, a number of people requiring oral hypoglycemic agents, enhancement of patient satisfaction, reduction in diabetes complication like cardiovascular disease and neuropathy.
Proposition for Change
The worse management of T2DM is due to the patient’s non-compliance to life style changes and total dependence on drugs. Challenges that include inadequate education of patients, scarce access to nutritional advice, and unfavorable encouragement for exercise negatively impact glycemic control and complicate the illness (Bekele et al., 2020). Thus, in order to solve these problems, the implementation of the diet and exercise plan that corresponds to the structured program based on Kurt Lewin’s Change Theory is suggested. This will include
education of the patients whereby they will be taught on nutrition plans so as to enhance their diets, along with structured exercise routines, so as to ensure strict observation is made on the patterns followed adhered to.
Relevancy to the Problem
Pros:
A proper workout and healthy diet have a positive impact on the glycemic level You did not demonstrate this on your articles description.and general wellbeing. Reduced dependency on medications, patient satisfaction and reported quality of life the proved better in the experimental group as compared to the control group and reduction of the risk of developing complications of the disease.
Cons:
Possible problems of patients’ compliance to medications, lack of maintenance and encouragement and increase in the overall healthcare expenditure when planning to underwrite covering the costs of the lifestyle programs.
Current State of the Problem
T2DM represents an important public health problem due to its high prevalence and complications. Historically, a lot of patients have always exhibited poorly controlled glycemic levels despite effective medications at one's disposal, attributed to risks associated with lifestyle. Medication alone cannot control diabetes because care is multifaceted in nature.
To conclude, participation in structured dietary and exercise activities in the management of T2DM is strongly supported by evidence. Guided by Kurt Lewin's Change Theory, such interventions could bring great improvements in patient satisfaction and health outcomes.
Addressing key barriers to lifestyle changes and providing follow-on support is thus very important for success. It is by integrating these evidence-based practices into routine care that
healthcare providers can really enhance the quality of life for patients with T2DM and reduce the burden on healthcare systems.
References
Almutairi, N., Hosseinzadeh, H., & Gopaldasani, V. (2019). The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: A systematic review of RCTs. Primary Care Diabetes, 14(1). https://doi.org/10.1016/j.pcd.2019.08.009
Bekele, H., Asefa, A., Getachew, B., & Belete, A. M. (2020). Barriers and strategies to lifestyle and dietary pattern interventions for prevention and management of TYPE-2 diabetes in africa, systematic review. Journal of Diabetes Research, 2020(1), 1–14. https://doi.org/10.1155/2020/7948712
Cannon, M. J., Masalovich, S., Ng, B. P., Soler, R. E., Jabrah, R., Ely, E. K., & Smith, B. D. (2020). Retention Among Participants in the National Diabetes Prevention Program Lifestyle Change Program, 2012–2017. Diabetes Care, 43(9), 2042–2049. https://doi.org/10.2337/dc19-2366
Courcoulas, A. P., Gallagher, J. W., Neiberg, R. H., Eagleton, E. B., DeLany, J. P., Lang, W., Punchai, S., Gourash, W., & Jakicic, J. M. (2020). Bariatric Surgery vs Lifestyle Intervention for Diabetes Treatment: 5-Year Outcomes From a Randomized Trial. The Journal of Clinical Endocrinology and Metabolism, 105(3), 866–876. https://doi.org/10.1210/clinem/dgaa006
Goldberg, R. B., Orchard, T. J., Crandall, J. P., Boyko, E. J., Budoff, M., Dabelea, D., Gadde, K. M., Knowler, W. C., Lee, C. G., Nathan, D. M., Watson, K., & Temprosa, M. (2022).
Effects of Long-term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study. Circulation, 145(22), 1632– 1641. https://doi.org/10.1161/circulationaha.121.056756
Jiménez-Maldonado, A., García-Suárez, P. C., Rentería, I., Moncada-Jiménez, J., & Plaisance, E.
P. (2020). Impact of high-intensity interval training and sprint interval training on peripheral markers of glycemic control in metabolic syndrome and type 2 diabetes. Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease, 1866(8), 165820. https://doi.org/10.1016/j.bbadis.2020.165820
Li, J. H., Perry, J. A., Jablonski, K. A., Srinivasan, S., Chen, L., Todd, J. N., Harden, M., Mercader, J. M., Pan, Q., Dawed, A. Y., Sook Wah Yee, Pearson, E. R., Giacomini, K. M., Giri, A., Hung, A. M., Xiao, S., L Keoki Williams, Franks, P. W., Hanson, R. L., & Kahn, S. E. (2023). Identification of Genetic Variation Influencing Metformin Response in a Multiancestry Genome-Wide Association Study in the Diabetes Prevention Program (DPP). Diabetes, 72(8), 1161–1172. https://doi.org/10.2337/db22-0702
Milenkovic, T., Bozhinovska, N., Macut, D., Bjekic-Macut, J., Rahelic, D., Velija Asimi, Z., & Burekovic, A. (2021). Mediterranean Diet and Type 2 Diabetes Mellitus: A Perpetual Inspiration for the Scientific World. A Review. Nutrients, 13(4), 1307. https://doi.org/10.3390/nu13041307
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Association of Intensive Lifestyle Intervention, Fitness, and Body Mass Index With Risk of Heart Failure in Overweight or Obese Adults With Type 2 Diabetes Mellitus.
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Taheri, S., Zaghloul, H., Chagoury, O., Elhadad, S., Ahmed, S. H., El Khatib, N., Amona, R. A., El Nahas, K., Suleiman, N., Alnaama, A., Al-Hamaq, A., Charlson, M., Wells, M. T., Al- Abdulla, S., & Abou-Samra, A. B. (2020). Effect of intensive lifestyle intervention on bodyweight and glycaemia in early type 2 diabetes (DIADEM-I): an open-label, parallel- group, randomised controlled trial. The Lancet Diabetes & Endocrinology, 8(6), 477–
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