19 Apr How might you go about replicating this approach in your institution or organization? ?GUIDELINES Post the following: 1. How your population matches the populations in your research a
How might you go about replicating this approach in your institution or organization?
GUIDELINES
Post the following:
1. How your population matches the populations in your research articles.
2. The intervention you would implement
3. Define baseline data collection sources (EMR, datasets, etc), method, and measures.
4. Expected outcome (Include a specific plan of how you will measure/evaluate your change in practice: Specifically, Who, What, When, Where, and How).
2
PICOT Question:
In patients with type 2 diabetes (T2D), does the implementation of a lifestyle intervention program focusing on a low-carbohydrate diet and increased physical activity, when compared to standard diabetes management, result in better glycemic control and improved cardiovascular risk factors over a 12-month period?
Patient Population of Interest: The population in this PICOT question is adults diagnosed with type 2 diabetes. According to the World Health Organization, approximately 422 million people worldwide have diabetes, with type 2 diabetes accounting for around 90% of all cases. This diverse population includes individuals from various age groups, ethnic backgrounds, and socioeconomic statuses. Type 2 diabetes is a significant public health concern associated with increased morbidity and mortality and reduced quality of life (de Hoogh et al., 2021). As a chronic condition, T2D requires continuous medical care, often in pharmacological interventions and lifestyle management, to prevent or manage acute and long-term complications.
Intervention/Issue: The intervention of interest is implementing a comprehensive lifestyle intervention program, focusing on a low-carbohydrate diet and increased physical activity. Diet and exercise are essential components of diabetes management, as they can help to regulate blood glucose levels, promote weight loss, and reduce the risk of diabetes-related complications. Low-carbohydrate diets effectively manage T2D by reducing postprandial hyperglycemia, improving insulin sensitivity, and promoting weight loss (Davis et al., 2019). Physical activity also improves glycemic control and insulin sensitivity and has numerous additional health benefits, such as reducing cardiovascular risk factors.
Comparison Intervention: The comparison intervention is standard diabetes management, which typically consists of medical nutrition therapy, physical activity recommendations, blood glucose monitoring, and pharmacological interventions as needed. Medical nutrition therapy may include individualized meal planning, carbohydrate counting, or other approaches to dietary management, while physical activity recommendations generally include engaging in regular aerobic and resistance exercise (Newson & Parody, 2022). Blood glucose monitoring helps to assess glycemic control and inform any necessary adjustments to diabetes management. At the same time, pharmacological interventions may involve oral antihyperglycemic agents or insulin, depending on the individual's needs.
Outcomes: The primary outcomes of interest for this PICOT question are improved glycemic control and reduced cardiovascular risk factors in patients with type 2 diabetes. Improved glycemic control can be assessed through changes in hemoglobin A1c (HbA1c) levels, fasting plasma glucose, and postprandial glucose levels (de Hoogh et al., 2021). Reduced cardiovascular risk factors can be evaluated through changes in body weight, blood pressure, lipid profiles (including total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides), and markers of inflammation (such as C-reactive protein).
Time: The time frame for this study will be 12 months, allowing for a sufficient duration to observe the potential effects of the intervention on glycemic control and cardiovascular risk factors. It is essential to consider the long-term sustainability of lifestyle interventions, as maintaining lifestyle changes over time can be challenging for patients with type 2 diabetes (Newson & Parody, 2022). A 12-month period provides an opportunity to assess the effectiveness and sustainability of the intervention and allows for the observation of potential seasonal variations in patient outcomes.
References
de Hoogh, I. M., Oosterman, J. E., Otten, W., Krijger, A. M., Berbée-Zadelaar, S., Pasman, W. J., … & Wopereis, S. (2021). The effect of a lifestyle intervention on type 2 diabetes pathophysiology and remission: the Stevenshof Pilot Study. Nutrients, 13(7), 2193. https://doi.org/10.3390/nu13072193
Davis, B. C., Jamshed, H., Peterson, C. M., Sabaté, J., Harris, R. D., Koratkar, R., … & Kelly Jr, J. H. (2019). An intensive lifestyle intervention to treat type 2 diabetes in the Republic of the Marshall Islands: protocol for a randomized controlled trial. Frontiers in nutrition, 6, 79. https://doi.org/10.3389/fnut.2019.00079
Newson, L., & Parody, F. H. (2022). Investigating the experiences of low-carbohydrate diets for people living with Type 2 Diabetes: A thematic analysis. PloS one, 17(8), e0273422. https://doi.org/10.1371/journal.pone.0273422
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