Sample Nursing Essay Paper on Evidence-Based Article on Diabetes

Evidence-Based Article on Diabetes

Diabetes is one of the most common health conditions affecting children and adults alike. As a disease related to chemical imbalances in the body, there are intervention and treatments measures available for control of the disorder. Lifestyle modification, and specifically following an apposite dietary pattern, is one of the widely used measures for the treatment of type 2 diabetes (Coppell et al., 2010). In a research on nutritional intervention and its effect on patients (aged below 70) Coppell et al. (2010) present the findings of the evidence-based research in a the paper titled “Nutritional intervention in patients with type 2diabeteswho are hyperglycemic despite optimized drug treatment—Lifestyle Over and Above Drugs in Diabetes (LOADD) study: randomized controlled trial.”

            In conducting the research, Coppell et al. (2010) were looking to find out the effect of nutritional intervention on type 2 diabetic adults. The objective of the research was to determine to what extent intensive dietary interventions could influence glycemic control and risk factors for cardiovascular disease for type 2 diabetes patients with hyperglycemia regardless of optimized treatment by drugs (Coppell et al., 2010). The research follows the fact that despite evidence, through research, of the effectiveness of nutrition for glycemic and cardiovascular risk factor control, the use of hypoglycemic agents, insulin, and prescriptions of statins has increased the reliance of pharmacological interventions instead of nutritional treatment (Coppell et al., 2010).

In the study, dubbed Lifestyle Over and Above Drugs in Diabetes (LOADD) conducted between October 2006 and July 2009, the researchers used 93 participants all below 70 years and diagnosed with type 2 diabetes nine months before the commencement of the study (Coppell et al., 2010). The participants additionally had to meet the requirement of being overweight or obese with a body mass index of ≥25, have hypertension, and dyslipidemia (Coppell et al., 2010). 

The intervention used by the researchers was two-pronged involving advice and intensive dietary intervention. The advice on physical activity included the need for the patients to achieve a minimum of 30 minutes of physical activity of medium intensity for a better part if not the whole week (Coppell et al., 2010). On the other hand, the intensive dietary intervention had its foundations on the recommendations fronted by the Diabetes and Nutrition Study Group of the European Association for the Study of Diabetes (Coppell et al., 2010). The Association’s recommendations on the distribution of micronutrients includes 10-20% of proteins of total energy, total fat at less than 30% of total energy, carbohydrate at 45-60% of total energy among others. The association additionally recommends 40 grams per day of dietary fiber intake, half of which should be soluble fiber (Coppell et al., 2010).

The study’s findings were groundbreaking for the treatment and management of type 2 diabetes, as well as for the prevention of cardiovascular diseases and the risk factors. From the study, intensive nutritional treatment was successful in achieving improvements in glycemic control and anthropometric measures in participants with type 2 diabetes and at high risk of cardiovascular disease (Coppell et al., 2010). The improvements were especially commendable given the unsatisfactory consideration of the control, regardless of the optimum drug treatment as recommended by the international management guidelines (Coppell et al., 2010). The intervention was especially effective for patients on maximum drug prescription, and on starting the intervention, reduced their dosage of tablets and insulin (Coppell et al., 2010).

Despite a small reduction in HbA1c at only 0.4 percent, such a reduction is commendable due to the relationship between HbA1c and diabetes complications. The relationship between the two is such that the complications are continuous to a point that any reduction in the levels of HbA1c is sure to reduce the risk of complications (Coppell et al., 2010). Perhaps to put the value of reduction of HbA1c in perspective is the fact that a reduction of HbA1c by 1 percent reduces the risk of cardiovascular disease by 21 percent.

In comparison, participants in the control group showed no changes in glycemic control even with increased dosage and changes in the hypoglycemic drugs (Coppell et al., 2010). The finding of the study therefore is in line with other studies conducted on the relationship between nutritional modification and improvements in glycemic control and cardiovascular risks for type 1 and 2 diabetes patients. According to Coppell et al. (2010), the study only goes to confirm the promise and effectiveness of intensive nutritional intervention in the control of diabetes and cardiovascular risk factors among adults.

The findings of the study have implication, particularly in relation to nutritional intakes. Coppell et al. (2010) posit that the guidelines on nutritional intervention, particularly those provided by the Diabetes and Nutrition Study Group are less prescriptive in comparison with the previous guidelines. For the intervention, the guidelines encourage the use of different dietary patterns in the treatment of type 2 diabetes, emphasizing on the appropriate intake of total energy as well as a dietary pattern with intact fruits, vegetables, wholegrain cereals and low fat protein sources become the predominant foods in the diet. The new guidelines are in contrast with the previous guidelines, which insisted on precise proportions of total energy from major macronutrients, and whose precise combination is hard to achieve.

Reference

Coppell, K., J. et al. (2010). Nutritional intervention in patients with type 2diabeteswho are hyperglycemic despite optimized drug treatment—Lifestyle Over and Above Drugs in Diabetes (LOADD) study: randomized controlled trial. British Medical Journal, 341(3337), 1-7