Nutrition Therapy As An Effective Management Strategy

Research Topic

Sharifirad, Entezari, Kamran, and Azadbakht (2009) do not indicate the benefits and risks of participating in the study. Furthermore, they do not expressly show whether informed consent of the participants was sought for prior to the start of the study. The authors only indicate that the reluctant patients were not involved in the research, hence showing that it was voluntary. The study does not also suggest whether it was approved by an institutional review board.

Data were collected from 88 type 2 diabetic patients who were enrolled in the Iranian Diabetes Association Seminars. The participants were equally categorized into the control and intervention groups. The intervention comprised of two educational sessions which took 80 minutes each. A questionnaire containing 58 questions and four sections was utilized to data collection. The patients filled in the questionnaires before and after the intervention. The authors do not provide the rationale for using a questionnaire. Data analysis was conducted using SPSS and the student’s t-test used in the comparison of the correlation between the two study groups before and after the intervention. The study’s rigor was accomplished by using standard methods to test the validity and reliability of the questionnaires and the use of a nutritional education endorsed by the World health organization and the ADA (Powers et al., 2017). The authors found out that the health belief model was useful in diabetes management through nutrition education. Global Estimates Of Prevalence Of Diabetes Discussion Paper

The topic of the effectiveness of nutrition in the prevention and control of diabetes is significant for improving the health of diabetic patients. Several studies have recommended the use of healthful eating pattern as the most effective strategy of preventing and managing diabetes. The American Diabetes Association (ADA) holds that nutrition therapy is central in the general control of diabetes, and has in the past proposed diabetic patients to dynamically be responsible in self-management and education with regard to their eating plan (American Diabetes Association, 2014).

There is a distressing increase in diabetes incidence both in developing and developed countries (Shaw, Sicree, & Zimmet, 2010). Additionally, the increasing cost of managing diabetes has led to the recommendation of alternative treatment methods such as self-management and nutritional management. The involvement of Patients having type 1 diabetes in a rigorous, flexible education program on insulin while utilizing the approach of carbohydrate counting meal planning can lead to enhanced glycemic regulation (Evert et al., 2014).

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Alternatively, people with type 2 diabetes can adopt a simple meal planning which involves the regulation of food quantity or making choices of healthful foods only (Psaltopoulou, Ilias, & Alevizaki, 2010).  Ello-Martin et al. (2007) observe that obese adults having type 2 diabetes can reduce and manage their weight by minimizing energy intake while sustaining an eating pattern of healthful foods. According to Skamagas, Breen, and LeRoith (2008), nutritional management in diabetes is economical and leads to better results such as lowering weight loss and regulation of energy intake.

Literature Review

Evert et al. (2014) contend that nutritional therapy is much more effective in the deterrence and management of diabetes because the mutual connection between high blood pressure and hyperlipidemia in diabetic patients necessitates close observation of metabolic factors such as renal function, body weight, and blood pressure. The author’s reason that this approach will ensure improved outcomes.

A study by Sharifirad, Entezari, Kamran, and Azadbakht (2009) used the health belief model to assess the usefulness of dietary training in the knowledge of diabetic patients and found out that nutritional education could improve the understanding of the patient regarding diabetes and lower their fasting glucose. The authors reported average mean scores for both the experimental and placebo groups before the intervention. However, there was a substantial increase in the average grade scores after the intervention. The authors concluded that the use of the health belief technique enhanced the knowledge, practice, and attitude of patients, thus confirming the efficacy of the health belief approach in dietary training.

The outcomes of these findings affect successful nursing practice because it necessitates the nurses to be aware of the HBM and apply it in practice to ensure the success of their treatment procedures. Stellefson, Dipnarine, and Stopka (2013) observe that regardless of the abundant studies on the effectiveness of national therapy in the deterrence and control of diabetes, a substantial percentage of diabetic patients have not received any organized education on diabetes or nutritional therapy. This, therefore, implies that even the medical care practitioners such as nurses are not well conversant with the alternative treatment of diabetes such as nutritional therapy.

Choi (2009) studied the impact of diet family support on sugar results using the Korean Immigrants as a case study. The study findings indicate that substantial diet family support was highly linked to glycosylated hemoglobin (A1C) and was stronger in men than women, demonstrating the significance of the effect of the diet family support on the regulation of glucose. Similar findings were arrived at by Ikeda et al. (2008) who found out that low social support was linked to increased death rates due to stroke in men more than women. The literature on social support indicates an increased involvement by women in both receiving and providing social support than men (Kelly, Tyrka, Price, & Carpenter, 2008). However, the variation with regard to gender in the findings of Choi (2009) can be attributed to the difference in culture.

There are two fundamental implications of the results of this study on nursing practice. The first one is that variations in sex regarding the reception and use of family support for nutrition self-management and its effect on the regulation of glucose demand further research. Global Estimates Of Prevalence Of Diabetes Discussion Paper  Considering that females are highly predisposed to poor results and difficulties due to diabetes than men (American Diabetes Association, 2014), caution in managing maximum glucose control is vital for both male and female. Secondly, the differences in gender should be factored in during planning for family support interventions for the management of diabetes. It is likely that additional nutritional family support will benefit men more than women or vices vasa depending on the culture of the study population. Therefore, it is essential that medical practitioners and diabetes educators dealing with a different community to ascertain different sources of social support for diabetic patients for both genders while promoting support from family members.

Yu et al. (2011) examined the association between diet and the development of type 2 diabetes using a Chinese population. The authors considered four nutritional patterns namely additional snacks and drinks, additional vegetables, additional meat and milk products, and additional processes grains. The findings from the study indicate that there was a higher risk of diabetes (39%) in individuals that consumed more animal and animal products whereas those that subsisted more on plant products in addition to fish had a lower diabetes risk of 14%. These relationships were independent of BMI, age, smoking status at present, and involvement in physical exercise.

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These studies are in agreement with who found out that western diet composed of red and processed meat, sweetened drinks, and fried foods were highly linked to type 2 diabetes (Sluijs, Beulens,  Spijkerman, Grobbee, & Van der Schouw, 2009). The antioxidant properties of vegetables and fruits contribute to their protective impact against diabetes in addition to their fiber and Mg content (Schulze et al., 2007). Nevertheless, the connection between fish intake and diabetic risk is still not conclusive (Patel et al., 2009). The outcomes of the study by Yu et al. (2011) have implications for nursing practice and the improvement of health outcomes of patients. First, this study shows that dietary patterns are significant predictors for diabetes. This deserves more attention because it can be considered in ascertaining populations that are more predisposed to diabetes in the absence of some other methods of measuring diabetes risk. Secondly, the study outcomes provide a basis for further research on the function of the plant-based diet in preventing the risk of diabetes in different populations.

Concerning the study by Choi (2009) on the role of diet family support in the control of glucose among diabetic patients, more studies should be conducted to assess the most appropriate way to use family support in both genders in the regulation of body glucose. This is because there are conflicting findings on whether it is men or women that benefit the most from diet-specific family support. Additional studies should also be carried out to examine the family member that is most suited to offer help in diabetes control and whether the member is determined by culture, gender, and role. This is because a comprehensive insight into the gender roles in the family can help in the routine self-management of diabetes. Considering the study by Yu et al. (2011), further investigation is required to investigate the relationship between dietary glycemic load, consumption of rice and snacks and diabetes due to the conflicting findings from other authors. Additionally, more studies should be conducted to ascertain whether the proposed plant-based diet in the management of diabetes has a preventive role.

References

American Diabetes Association. (2014). Standards of medical care in diabetes Diabetes care, 37(Supplement 1), S14-S80.

Choi, S. E. (2009). Diet-specific family support and glucose control among Korean immigrants with type 2 diabetes. The diabetes educator, 35(6), 978-985.

Ello-Martin, J. A., Roe, L. S., Ledikwe, J. H., Beach, A. M., & Rolls, B. J. (2007). Dietary energy density in the treatment of obesity: a year-long trial comparing 2 weight-loss diets–. The American journal of clinical nutrition, 85(6), 1465-1477.

Evert, A. B., Boucher, J. L., Cypress, M., Dunbar, S. A., Franz, M. J., Mayer-Davis, E. J., …& Yancy, W. S. (2014). Nutrition therapy recommendations for the management of adults with diabetes. Diabetes care, 37(Supplement 1), S120-S143.

Hu, F. B. (2011). Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes care, 34(6), 1249-1257.

Ikeda, A., Iso, H., Kawachi, I., Yamagishi, K., Inoue, M., & Tsugane, S. (2008). Social support and stroke and coronary heart disease: the JPHC study cohorts II. Stroke, 39(3), 768-775.

Kelly, M. M., Tyrka, A. R., Price, L. H., & Carpenter, L. L. (2008). Sex differences in the use of coping strategies: predictors of anxiety and depressive symptoms. Depression and Anxiety, 25(10), 839-846.

Patel, P. S., Sharp, S. J., Luben, R. N., Khaw, K. T., Bingham, S. A., Wareham, N. J., & Forouhi, N. G. (2009). The association between type of dietary fish and seafood intake and the risk of incident type 2 diabetes: the EPIC-Norfolk cohort study. Diabetes care. Global Estimates Of Prevalence Of Diabetes Discussion Paper