¶ … Patients With Type 2 Diabetes
I --all-natural, all-organic, locally grown/produced diet plus exercise
C --insulin injections
O --reduction in body's challenge to create/absorb insulin
In patients experiencing Type 2 diabetes (P), is the intervention of a traditional, organic, all-natural diet consisting of locally grown and produced foods plus exercise (I) more effective in curbing the body's challenge to absorb insulin (O) than insulin injections (C)?
There is an educational deficit in the clinic where I previously worked regarding the positive effect that an all-natural, organic diet consisting of locally produced foods can have on a patient with diabetes. Most patients believe that if their pancreas is not producing enough insulin that they need to receive insulin injections. This is the conventional attitude because of the widespread use of this method to treat the disease. Yet there are numerous studies that link obesity to diabetes and even some studies that show that diabetes can be eradicated with the proper restoration of diet and exercise to one's daily life (Davis, 2008).
The problem in this clinic is that this literature is not discussed or disseminated among health care providers or patients and so there is no educational approach to treating diabetes using alternative means. This problem can be observed directly in the clinic. There is no literature available for alternative methods of combating diabetes, and while healthy practices might be recommended, they are not prescribed with the same assurance that insulin is prescribed. But this is like allowing the patient to continue to go on leading an unhealthy life by just continually treating the symptoms instead of the disease itself. The gravity of this situation is discernible in the fact that all over obesity rates are increasing and in this clinic especially one should think that an alternative approach to this question of diabetes would be of tantamount importance but both patients and physicians are content to treat the symptoms only.
This issue is significant to nursing because the nurse is the individual who goes between the patient and the physician and often understands what the patient is experiencing and understands the implications of alternative methods and is more willing to promote them than the physician who operates within the status quo standards of established practice.
The solution to this issue is to run trials in which the only prescription is a healthy diet and exercise that conforms to eating and exercising habits of the time before fast food and manufactured diets became commonplace. The effect that this prescription has on the lives of patients with diabetes will be monitored directly over a 12 to 18-month period in order to describe the extent to which it actually combats Type 2 diabetes.
Part Three
Ajala, O., English, P., Pinkney, J. (2013). Systemic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. American Journal of Clinical Nutrition, 97(3): 505-516.
This study assesses the impact of different diets on diabetes and finds that low-carb, low-GI, Mediterranean and high-protein diets can be effective in treating people with diabetes by strengthening the cardiovascular system. This study supports the proposed changes.
Barnard, N., Cohen, J., Jenkins, D. et al. (2009). A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. The American Journal of Clinical Nutrition, 89(suppl): IS-9S.
This study shows a low-fat vegan diet can "improve glycemia and plasma lipids" more than a conventional diet. It does not assess whether there is clinical value to this study but its findings do support the proposed changes of this study as it notes the positive impact of diet on the disease.
Billings, L., Florez, J. (2010). The genetics of type 2 diabetes: what have we learned from GWAS? Annals of the New York Academy of Sciences, 1212: 59-77.
This study mainly focuses on the genetic aspect of the disease and how it develops. It does not focus on causes such as diet or exercise, nor does it focus on morbidity or rate of incidence. It does not focus on the gravity of the issue nor does it provide support for the proposed change of this study.
Catalano, P, Kirwan, J., Mouzon, S., King, J. (2003). Gestational diabetes and insulin resistance: Role in short- and long- term implications for mother and fetus. The Journal of Nutrition, 133(5): 16745-16835.
This study focuses on the impact of gestational diabetes on mothers and the possibility for Type 2 developing after birth in the mother. The study links obesity to the development but it does suggest that the disease is treatable during pregnancy. It neither supports nor denies support...
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