Introduction
In nursing practice, healthcare professionals face numerous issues when finding solutions that need a long and thorough analysis of scientific research. This is especially true for the provision of assistance to the elderly population aged above 60 years who are exposed to many health risks. One of the most severe health problems in this population group is type 2 diabetes, as this disease negatively affects the condition of the entire body.
Thus, the purpose of this research paper is to study the effectiveness of using nutrition consultations and food diaries to keep blood sugar levels within the appropriate range for older patients with diabetes. The PICOT Question of this research paper is “In elderly patients (60 years and above) with type 2 diabetes, will a nutrition consult and food diary help to keep blood glucose levels within normal range better than with exercise alone?”
Background of Studies
The first article is by Reber et al. (2019), whose problem of focus is on the effectiveness of nutritional screening and assessment methods in managing patients under care. The significance of nutritional risk screening and assessment to nursing is that it helps identify patients with increased malnutrition risk and how to help them, especially older adults with type 2 diabetes. The purpose of this study is to evaluate how effective nutritional risk screening tools and assessment methods are in patients with type 2 diabetes. This article aims to identify the effectiveness of the tools and methods necessary for screening and assessing patients’ nutritional risks. Its research question is, “Are nutritional risk screening tools and assessment methods effective in identifying malnutrition risks among hospitalized patients?”
The second study considered in this paper is Wang et al. (2018). The problem that this article explores is the effectiveness of low-carbohydrates on glycemic control in population with type 2 diabetes. The significance of this study to nursing is based on glycemic control’s influence in managing diabetes and how dietary interventions play a part in managing diabetes (Wang et al., 2018). Its purpose is to investigate how a diet with low carbohydrates can affect blood glucose control in patients with type 2 diabetes. It aims at determining the effectiveness of a low carbohydrate diet in diabetes management through glycemic control. The research question guiding the study is “How does a low-carbohydrate diet affect glycemic control in patients with type 2 diabetes?”
The third study on dietary intervention on blood glucose levels in patients with type 2 diabetes is by Corley et al. (2018). The effect of intermittent fasting on the incidence of hypoglycemia in individuals with type 2 diabetes is the issue that the study looks at. Exploring the effects of intermittent fasting intervention for patients offers nurses an alternative strategy for caring for elderly patients with type 2 diabetes. Its goal is to assess how intermittent fasting affects the incidence of hypoglycemia. Its objective is to investigate the effect of one-intermittent fasting on the hypoglycemia rate. The research question guiding the study is, “Does intermittent fasting increase the rate of hypoglycemia in patients with type 2 diabetes?”
The last study utilized in this paper is Carter et al. (2018). The problem that this study focuses on is the effects of intermittent and continuous energy-restricted diets on glycemic control among patients with type 2 diabetes. This study expands nurses’ understanding of the potential effect of an intermittent energy-restricted diet as an alternative intervention for glycemic control in managing diabetes (Carter et al., 2018). It aims to determine which intervention is better between intermittent and continuous energy-restricted nutrition plans. Its objective is to compare the effectiveness of intermittent and continuous energy-restricted aliment for sustaining normal glucose level in type 2 diabetes patients. The research question that guides this study is “Is an intermittent energy-restricted diet non-inferior to a continuous energy-restricted diet in managing type 2 diabetes?”
Relevance of the Articles to Dietary Intervention on Diabetes Type 2
This article will contribute to answering this paper’s PICOT question by offering insights on various interventions and their effects on blood glucose levels among adult patients with type 2 diabetes. For instance, Carter et al. (2018) compare the impacts of periodic and sustained energy-restricted diets on the regulation of glucose levels in individuals with type 2 diabetes. Even though this article does not focus on one specific intervention, it offers information on alternative interventions for managing type 2 diabetes.
Additionally, Reber et al. (2019) answer the PICOT question of this paper by suggesting that nutritional assessment and intervention play a critical role in glycemic control. Thirdly, Corley et al. (2018) answer the PICOT question by offering more insight into alternative interventions that nurses can utilize to manage patients with type 2 diabetes by impacting the rate of hypoglycemia. Lastly, Wang et al. (2018) answer the PICOT question by examining the effects of a diet rich in low carbohydrates in glycemic control, which plays a significant role in managing a patient’s blood glucose levels. The insights that these articles offer comprehensively answer the PICOT question.
The interventions and comparison groups in the articles above are significantly compared to those identified in this paper’s PICOT question. Although the four articles have not explicitly addressed the consult and food diary intervention in the PICOT question, Carter et al. (2018) and Wang et al. (2018) examine how some dietary interventions, such as intermittent energy and low-carbohydrate diet, influence glycemic control.
Additionally, the comparison groups in some of the articles include different comparison interventions. For instance, Wang et al. (2018) compare the effect of a diet with low carbohydrates on patients with type 2 diabetes with a control group that consumes a standard diet. To study the impact of intermittent fasting on hypoglycemia rate, Corley et al. (2018) compared it with a control group receiving standard care. Though different comparison groups were used in each article, they provide valuable insights into the effects of various interventions on glycemic control.
Methods of Study
In this paper, the methods utilized in four distinct articles have their own merits and drawbacks. How the samples were gathered, the data collected, the data sources, and the manner in which the outcomes were analyzed all contribute to the differences in methodology. Although Reber et al.’s (2019) literature review may include some partiality, it provides a thorough review of prior investigations. Wang et al. (2018)’s employment of a randomized control trial allows for comparisons between the groups used in the study.
While the approach used in Carter et al.’s (2018) study provided a strong comparative analysis, its ability to be applied to other groups or settings may be restricted. Limitations such as selection bias and decreased generalizability might pose an obstacle to this particular randomized noninferiority trial design. Lastly, the randomized controlled trial design used by Corley et al. (2018) enables researchers to establish the relationship between variables. Unfortunately, this study method cannot use a small sample size as it may affect generalizability and is time-consuming.
Results of Studies
The results of four studies suggest that nutritional interventions can effectively manage type 2 diabetes in elderly patients. Corley et al.’s (2018) research showed that intermittent fasting improves blood glucose level control, aids weight loss, and enhances overall health. Utilizing nutritional risk screening tools and assessment can also determine the effects of type 2 diabetes, as revealed in Reber et al.’s (2019) literature review. Additionally, intermittent energy-restricted diets suggested by Carter et al. (2018) can help manage type 2 diabetes, while a low-carbohydrate diet is also effective in enhancing glycemic control, as indicated by Wang et al. (2018). These findings provide nurses with new insight into different intervention methods for managing patients with type 2 diabetes.
Ethical Considerations
The two ethical considerations are protecting participants’ privacy and confidentiality and informed consent. According to Pietrzykowski & Smilowska (2021), the researcher is responsible for ensuring that every participant in their study offers informed consent. Also, it is the role of the researchers to uphold privacy and confidentiality standards in their studies to protect the personal information of their participants (Dougherty, 2021).
The researchers in the four studies used in this paper took account of these ethical considerations. Reber et al. (2019) and Corley et al. (2018) de-identified their participants and securely stored their data to ensure their study aligned with ethical concerns. Additionally, Carter et al. (2018) and Wang et al. (2018) chose to anonymize their participants and securely store their personal information.
Outcomes Comparison
The anticipated outcome for this paper’s PICOT question is that a patient with type 2 diabetes exposed to nutrition consult and food diary would effectively manage their blood glucose level. The outcomes of the four articles chosen in this paper are significantly compared with the answers to the PICOT question. For instance, according to the findings of Carter et al. (2018) and Wang et al. (2018), there were improvements in glycemic management due to nutritional intervention. Corley et al. (2018) also align with the anticipated answer to the PICOT question as they introduce an alternative approach to managing type 2 diabetes. Lastly, the emphasis of Reber et al. (2019) on the benefits of nutritional assessment in managing blood glucose levels in older adult patients with type 2 diabetes indirectly supports the anticipated answer. Therefore, even though these four articles vary, their outcomes align with the expected outcome of the PICOT question.
Proposed Evidence-Based Practice Change
The exploration of different alternative interventions to enhance blood sugar levels in older adults with type 2 diabetes is the link between this paper’s PICOT question, the four research articles, and the nursing practice. Based on this information, implementing a nutrition and food diary for elderly patients with type 2 diabetes is an evidence-based practice change that will help blood glucose levels (Reber et al., 2019). This evidence-based practice change will help improve glycemic management in patients with type 2 diabetes by addressing various dietary factors and offering them individualized guidance on their nutrition.
Conclusion
In conclusion, the four articles chosen for this paper offer comprehensive and in-depth information on various dietary interventions in managing blood sugar levels among elderly patients with type 2 diabetes. Some of the nutritional interventions these articles suggest include fasting, a low-carbohydrate diet, and an intermittent energy-restricted diet. The studies addressed different ethical considerations in their research, including informed consent and ensuring the privacy and confidentiality of participants’ data. Based on the findings from these articles, an evidence-based practice change involves the incorporation of nutrition consults and food diaries.
References
Carter, S., Clifton, P. M., & Keogh, J. (2018). Effect of intermittent compared with continuous energy restricted diet on glycemic control in patients with type 2 diabetes: A randomized noninferiority trial. JAMA Network Open, 1(3), e180756-e180756. Web.
Corley, B. T., Carroll, R. W., Hall, R. M., Weatherall, M., Parry‐Strong, A., & Krebs, sJ. (2018). Intermittent fasting in type 2 diabetes mellitus and the risk of hypoglycaemia: a randomized controlled trial. Diabetic Medicine, 35(5), 588-594. Web.
Dougherty, M. V. (2021). The use of confidentiality and anonymity protections as a cover for fraudulent fieldwork data. Research Ethics, 17(4), 480-500. Web.
Pietrzykowski, T., & Smilowska, K. (2021). The reality of informed consent: Empirical studies on patient comprehension—systematic review. Trials, 22(57), 1-8. Web.
Reber, E., Gomes, F., Vasiloglou, M. F., Schuetz, P., & Stanga, Z. (2019). Nutritional risk screening and assessment. Journal of clinical medicine, 8(7), 1065. Web.
Wang, L.-L., Wang, Q., Hong, Y., Ojo, O., Jiang, Q., Hou, Y.-Y., Huang, Y. H., & Wang, X.-H. (2018). The effect of low-carbohydrate diet on glycemic control in patients with type 2 diabetes mellitus. Nutrients, 10(6), 661. Web.