Nursing Research (Due 24 hours)

 Background of Study

The first article “Dietary fiber intake and glycemic control:coronary artery calcification in type 1diabetes (CACTI) study” by Basu, Alman and Snell-Bergeon, seeks to examine dietary fiber intake and glycemic control. The number of individuals diagnosed with diabetes type 1 increases daily, with the aged being the most venerable population. The study examines dietary fiber's influence in controlling glucose and reducing intake into the human body (Basu et al., 2019). This research's results are essential in nursing as it reaffirms the importance of dietary fiber in controlling diabetes health condition, which has affected many people. The primary question in this research is can dietary fiber assist in controlling diabetes type 1.

The second article “Benefits of a Paleolithic diet with and without supervised exercise on fat mass, insulin sensitivity, and glycemic control: a randomized controlled trial in individuals with type 2 diabetes” by Otten et.al, is a research that tries to provide an answer on the benefits of a Paleolithic diet accompanied by supervised and unsupervised exercise on insulin sensitivity, fat mass, and glycemic control (Otten et al., 2017). There is an urgent need to reduce the future risk of cardiovascular disease, which is highly associated with type 2 diabetes. It is believed that the Paleolithic diet plays a major role in improving individuals' fat mass and metabolic balance, including glycemic control, insulin sensitivity as well as leptin in subject to type 2 diabetes. Therefore, this research is essential in determining the Paleolithic diet's effectiveness when accompanied by either supervised or unsupervised exercise. The study's researchers answer the question raised by conducting randomized controlled trials on different individuals with type 2 diabetes.

How two articles support the nurse practice issue

The two articles' findings offer a comprehensive solution to the PICOT question, which compares healthy dietary patterns with physical exercise in glycemic control. Findings from the two articles provide an insight that exercise and diet alone can control diabetes for a certain percentage of people (Basu et al., 2019). exercise helps muscles to use sugar and glucose in the bloodstream, while on the other hand, healthy dietary patterns reduce the absorption of these sugars in the body (Otten et al., 2017). The findings of these research works compare data from different age groups among the adults who are the key focus of the Picot Question. The intervention measures examined in the article are also majorly focused on healthy dietary patterns and physical exercise, the focus areas of the picot question.

Method of Study

The first article “Dietary fiber intake and glycemic control:coronary artery calcification in type 1diabetes (CACTI) study” on dietary fiber intake and glycemic control used data from the Coronary Artery Calcification in Type I Diabetes using a sample size of 1257, 568 of which were TID, and 689 were from non-diabetic controls. The research also used a linear regression model adjusted for age, total calories, and age and adjusted age (Basu et al., 2019). The regression analysis used in this research is an essential and reliable method for identifying specific variables that impact glycemic control. However, this method looks at the linear relationship between the independent and dependent variables, which assumes a direct relationship between the two variables (Otten et al., 2017). The method can result in wrong findings when two variables are not directly related.

Data on the second article “Benefits of a Paleolithic diet with and without supervised exercise on fat mass, insulin sensitivity, and glycemic control: a randomized controlled trial in individuals with type 2 diabetes” on the other case used 32 patients who have type 2 diabetes who are aged between 51 and 67, followed by one week's Paleolithic diet. Unlike in the first article, participants in this research were randomized to either aerobic exercise and resistance training or standard care exercise recommendations three times a week. The primary advantage of this method is that it is accurate and represents a large population. However, the method required a large sample size, which was not the case in this research.

Results of Study

In “Dietary fiber intake and glycemic control:coronary artery calcification in type 1diabetes (CACTI) study”, the results revealed an inverse association between the total dietary fiber with poor glycemic control (Basu et al., 2019). The results of this research showed serum HbA1c and baseline dietary fiber intake in the T1D group to be 7.9 ± 1.3% mean (SD) and 16 g [median (IQ): 11–22 g), respectively and in the non-diabetic control were 5.4 ± 0.4% and 15 g respectively. Pearson partial correlation coefficients from the research showed a large but very weak association of HbA1c with dietary fiber when adjusted for sex, age, total calories, and diabetes status. On the side of adjusted linear regression, the baseline model, a total dietary fiber, proved to have a significant inverse association with HbA1c in the non-diabetic controls and HbA1c in the T1D group.

The “Benefits of a Paleolithic diet with and without supervised exercise on fat mass, insulin sensitivity, and glycemic control: a randomized controlled trial in individuals with type 2 diabetes” results either show that a Paleolithic diet helps improve fat mass and metabolic balance, including glycemic control, insulin sensitivity, and leptin in subjects with type 2 diabetes. Unlike unsupervised exercise training, supervised training may not promote the effects on these outcomes. Centrally, they increase cardiovascular fitness and preserve lean mass in men (Otten et al., 2017). As presented in this research, the results prevent a proper way of controlling diabetes among many aged patients. The findings suggest that combining healthy dietary patterns and physical exercise can assist in glycemic control. It, therefore, increases confidence in nurses when prescribing these essential activates to patients.

Ethical Considerations

Ethical consideration is an essential factor when conducting research. Among the two major ethical considerations is the research is beneficence (Do not harm) and respects confidentiality and anonymity (Connelly, 2017). The beneficence's ethical consideration insists on being of benefit to the participants rather than causing harm. Before seeking any permission to conduct research, researchers should First analyze the potential benefits and risks of this research to the participants. Examples of possible risks to research participants include loss of privacy, physical harm, emotional distress, unforces side effects, loss of time, and physical discomforts. Possible benefits include increased understanding of the self-health condition, access to a potentially valuable intervention, and growth of confidence and satisfaction of helping other people with health issues (Connelly, 2017). In abiding by this ethical consideration, these benefits and risks should appear in the written consent form. The participant should sign before the start of the study.

On the other hand, confidentiality and anonymity insist on respect for the participant's fidelity and dignity (Connelly, 2017). Both confidentiality and anonymity are set to maintain the research participant's privacy when collecting primary data, analyzing, and reporting the research findings. In this case, confidentiality refers to separating any participant's personal information from the research data (Connelly, 2017). In contrast, anonymity means a collection of the data without capturing the identifying and personal information. In both cases, researchers gather data from participants, and it is this data. It is analyzed to give out final findings. During the data collection and analysis exercise, researchers are expected to respect each participant and ensure that the research will negatively impact their lives.

In conducting their research, the two articles' researchers paid attention to these ethical considerations by not disclosing the key participants' identities. This means that these researchers respect their confidentiality and worked to ensure the research was of benefit to them. Considering that most of the research participants already have an existing health issue, two research data collection processes equipped these participants with proper knowledge, which will help them manage their condition and help the other close friend and family members. The results presented in both types of research are outlined without giving personal details of the participants, which means that the researcher paid much attention to ethical considerations' confidentiality and anonymity.

References

Basu, A., Alman, A. C., & Snell-Bergeon, J. K. (2019). Dietary fiber intake and glycemic control: coronary artery calcification in type 1 diabetes (CACTI) study. Nutrition Journal, 18(1), 23.

Otten, J., Stomby, A., Waling, M., Isaksson, A., Tellström, A., Lundin‐Olsson, L., ... & Olsson, T. (2017). Benefits of a Paleolithic diet with and without supervised exercise on fat mass, insulin sensitivity, and glycemic control: a randomized controlled trial in individuals with type 2 diabetes. Diabetes/metabolism research and reviews, 33(1), e2828.

Connelly, L. M. (2017). Ethical considerations in research studies. Medsurg Nursing, 23(1), 54-56.

Connelly, L. M. (2017). Ethical considerations in research studies. Medsurg Nursing, 23(1), 54-56.