Research Critiques and PICOT Statement Final Draft

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PICOT Question and Literature Search

Summary of Clinical Issue (200-250 words): Diabetes mellitus is a metabolic disorder that results in persistent hyperglycemia. The disease condition may either result from impaired insulin secretion or insulin resistance. Type 2 diabetes mellitus is caused by insulin resistance and develops at an older age compared to type 1 diabetes. More than 400 million people are living with diabetes mellitus from 29 to 79 years. Among other chronic non-communicable diseases, diabetes is becoming one of the major global health burdens in recent years. Comorbidity of chronic hyperglycemia with other metabolic conditions such as hyperlipidemia and hypercholesterolemia can result in damage to various body organs leading to the development of life-threatening conditions such as retinopathy and neuropathy.

Various intervention strategies have been established to aid in the treatment and management of patients with diabetes mellitus. Although the most common intervention strategy has been the use of pharmacological agents such as metformin, other prevention strategies such as physical exercise and dietary practices have been implicated. Being a metabolic disorder, physical exercise has been determined to increase energy expenditure and thus lower body mass index, a key risk factor in the development of diabetes. Healthy dietary patterns have also been prescribed to diabetic patients and high-risk individuals to mitigate the factors that contribute to the development and complications arising from the disease.

PICOT Question: In adult patients with type 2 diabetes mellitus, how do healthy dietary practices affect the development and

severity of the condition?

Criteria	Article 1	Article 2
APA-Formatted Article Citation with Permalink	Ghiasvand, R., Beigrezaei, S., Feizi, A., & Iraj, B. (2019). Relationship between dietary patterns and the incidence of type 2 diabetes. International Journal of Preventive Medicine, 10(1), 122. https://doi.org/10.4103/ijpvm.ijpvm_206_17 Permalink: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639850/	Forouhi, N. G., Misra, A., Mohan, V., Taylor, R., & Yancy, W. (2018). Dietary and nutritional approaches to the prevention and management of type 2 diabetes. BMJ, k2234. https://doi.org/10.1136/bmj.k2234 Permalink: https://www.bmj.com/content/361/bmj.k2234
How Does the Article Relate to the PICOT Question?	The article investigates how dietary patterns contribute to the incidence of type 2 diabetes which is relevant to my PICOT question	The article details the approaches used in the prevention and management of type 2 diabetes
Quantitative, Qualitative (How do you know?)	Semi-quantitative	Qualitative
Purpose Statement	To investigate the relationship between major identified dietary patterns and type 2 diabetes	To examine the influence of nutritional transition in diabetic management
Research Question	The research question is not indicated	The article lacks a research question
Outcome	There is an inverse relationship between adherence to healthy dietary practices and direct association with Western dietary pattern and the risk of type 2 diabetes	Weight management is an important factor in diabetes management and can be achieved through healthy dietary practices
Setting (Where did the study take place?)	Isfahan Center of Metabolism and Endocrinology	Not indicated
Sample	315 study participants	Meta-analysis study
Method	Case-control study	Scientific review
Key Findings of the Study	There was a significant inverse relationship between Western dietary pattern and the development of type 2 diabetes mellitus	Low carbohydrate diets are preferred in managing diabetes
Recommendations of the Researcher	People can select nutrients without decreasing the quality of their diet with more flexibility to achieve a longer duration of adherence	High-quality research is needed to compare calorie restriction and carbohydrate restriction to assess effectiveness.

Criteria	Article 3
APA-Formatted Article Citation with Permalink	Ley, S. H., Hamdy, O., Mohan, V., & Hu, F. B. (2014). Prevention and management of type 2 diabetes: dietary components and nutritional strategies. The Lancet, 383(9933), 1999–2007. https://doi.org/10.1016/s0140-6736(14)60613-9 Permalink: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4751088/#:~:text=Diets%20rich%20in%20whole%20grains,lipids%20in%20patients%20with%20diabetes.
How Does the Article Relate to the PICOT Question?	The article examines the dietary components that can be effective in the management of type 2 diabetes
Quantitative, Qualitative (How do you know?)	Qualitative
Purpose Statement	The purpose statement is missing
Research Question	To examine dietary components and their effects on glycemic control
Outcome	Mediterranean diet improves glycemic control compared to the conventional diet
Setting (Where did the study take place?)	The location of the study is not indicated
Sample	A meta-analysis of cohort studies
Method	Meta-analysis review study
Key Findings of the Study	Moderate alcohol consumption lowers the risk of complication in people with diabetes
Recommendations of the Researcher	Lager and longer random clinical trials are needed to compare the efficacy and effectiveness of various dietary approaches in managing diabetes.

Criteria	Article 4
APA-Formatted Article Citation with Permalink	Worku, A., Mekonnen Abebe, S., & Wassie, M. M. (2015). Dietary practice and associated factors among type 2 diabetic patients: a cross-sectional hospital-based study, Addis Ababa, Ethiopia. SpringerPlus, 4(1), 1. https://doi.org/10.1186/s40064-015-0785-1 Permalink: https://springerplus.springeropen.com/articles/10.1186/s40064-015-0785-1#citeas
How Does the Article Relate to the PICOT Question?	The article investigates the dietary practice and the associated factors among patients with type 2 diabetes
Quantitative, Qualitative (How do you know?)	Quantitative
Purpose Statement	To assess the level of dietary practices and their associated factors among type 2 diabetic patients
Research Question	The article lacked a research question
Outcome	The study found out that the level of dietary practice in more than 50% of the study participants was poor
Setting (Where did the study take place?)	The outpatient department of Yekatit 12 Medical College Hospital, Addis Ababa, Ethiopia
Sample	403 study subjects
Method	Institutional based cross-sectional quantitative study
Key Findings of the Study	More than 45% of study participants were found to be obese
Recommendations of the Researcher	The study did not report any recommendations

Criteria	Article 5
APA-Formatted Article Citation with Permalink	Anuruddhika Subhashinie Senadheera, S. P., Ekanayake, S., & Wanigatunge, C. (2016b). Dietary Habits of Type 2 Diabetes Patients: Variety and Frequency of Food Intake. Journal of Nutrition and Metabolism, 2016, 1–6. https://doi.org/10.1155/2016/7987395 Permalink: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5227304/
How Does the Article Relate to the PICOT Question?	The article examines the frequency and variety of food intake among patients with type 2 diabetes
Quantitative, Qualitative (How do you know?)	Qualitative
Purpose Statement	To observe the dietary patterns and food frequencies in patients with type 2 diabetes
Research Question	The article does not have a research question
Outcome	Daily green leafy vegetable intake and quantity consumed were inadequate to obtain beneficial effects
Setting (Where did the study take place?)	Family Practice Center of the University of Sri Jayewardenepura
Sample	100 patients between the age of 35 and 70 years
Method	Cross-sectional study
Key Findings of the Study	More than 45% of study participants consume rice mixed meals for all three meals and only 67% consume fruits at least once a day
Recommendations of the Researcher	The article lacked recommendations

Criteria	Article 6
APA-Formatted Article Citation with Permalink	Anuruddhika Subhashinie Senadheera, S. P., Ekanayake, S., & Wanigatunge, C. (2016). Dietary Habits of Type 2 Diabetes Patients: Variety and Frequency of Food Intake. Journal of Nutrition and Metabolism, 2016, 1–6. https://doi.org/10.1155/2016/7987395 Permalink: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633210/
How Does the Article Relate to the PICOT Question?	The article investigates dietary practices and physical activity perception among patients with type 2 diabetes mellitus which is relevant to the PICOT question
Quantitative, Qualitative (How do you know?)	Quantitative
Purpose Statement	To assess dietary habits and diabetes perception among patients with type 2 diabetes
Research Question	The article has no research question
Outcome	Patients with type 2 diabetes have a higher body mass index and are more likely to skip breakfast
Setting (Where did the study take place?)	Diabetic Center in Tabuk City, Saudi Arabia
Sample	100 patients
Method	Case-control study
Key Findings of the Study	Fast-food consumption, body mass index, and fruit consumption was higher among diabetic patients
Recommendations of the Researcher	The study lacked recommendations

References

Anuruddhika Subhashinie Senadheera, S. P., Ekanayake, S., & Wanigatunge, C. (2016a). Dietary Habits of Type 2 Diabetes Patients: Variety and Frequency of Food Intake. Journal of Nutrition and Metabolism, 2016, 1–6. https://doi.org/10.1155/2016/7987395

Anuruddhika Subhashinie Senadheera, S. P., Ekanayake, S., & Wanigatunge, C. (2016b). Dietary Habits of Type 2 Diabetes Patients: Variety and Frequency of Food Intake. Journal of Nutrition and Metabolism, 2016, 1–6. https://doi.org/10.1155/2016/7987395

Forouhi, N. G., Misra, A., Mohan, V., Taylor, R., & Yancy, W. (2018). Dietary and nutritional approaches to the prevention and management of type 2 diabetes. BMJ, k2234. https://doi.org/10.1136/bmj.k2234

Ghiasvand, R., Beigrezaei, S., Feizi, A., & Iraj, B. (2019). Relationship between dietary patterns and the incidence of type 2 diabetes. International Journal of Preventive Medicine, 10(1), 122. https://doi.org/10.4103/ijpvm.ijpvm_206_17

Ley, S. H., Hamdy, O., Mohan, V., & Hu, F. B. (2014). Prevention and management of type 2 diabetes: dietary components and nutritional strategies. The Lancet, 383(9933), 1999–2007. https://doi.org/10.1016/s0140-6736(14)60613-9

Worku, A., Mekonnen Abebe, S., & Wassie, M. M. (2015). Dietary practice and associated factors among type 2 diabetic patients: a cross-sectional hospital-based study, Addis Ababa, Ethiopia. SpringerPlus, 4(1), 1. https://doi.org/10.1186/s40064-015-0785-1