top answer: 1 16 Title of Paper Goes Here in Bold Font Student’s Name Goes Here School Affiliatio

  

1

16

Don't use plagiarized sources. Get Your Custom Essay on
top answer: 1 16 Title of Paper Goes Here in Bold Font Student’s Name Goes Here School Affiliatio
Just from $10/Page
Order Essay

Title of Paper Goes Here in Bold Font

Student’s Name Goes Here

School Affiliation

Instructor’s Name

Date goes here

Title of Capstone Project Goes Here in Bold Font

Discuss the background of your Capstone project. Use a 12-point font and double-space the assignment as per APA guidelines. Indent the first sentence of each new paragraph.

Clinical Problem Statement

Place the week 2 Capstone Topic Summary assignment here, applying any changes as advised by your instructor.

Ans; Type 2 diabetes causes impairment in how an individual’s body controls and uses glucose as fuel. This is a long-term condition that results in excess sugar circulating in the bloodstream, which can cause the development of disorders in the nervous, circulatory, and immune systems. The most suitable intervention for this disorder is to expose the patient to intensive lifestyle interventions through improved lifestyle through proper dieting to keep the sugar levels constant. The qualitative initiative for this disorder is to play the lead role in improving diabetes care quality by deploying real-time feedback with consistent glucose monitoring techniques and coaching on effective dietary practices for reduced carbohydrate consumption for patients with type 2 diabetes (Johansen et al., 2017). The education on this disorder will contribute to improved type 2 diabetes outcomes with fewer scenarios of extreme glucose levels. The patients will improve confidence in regulating an individual’s health, leading to a better quality of life. The inter-professional model of care employed in this case will incorporate various health professionals, including diabetes educators, nurses, pharmacists, dieticians, and family physicians. These professionals will work together towards developing effective strategies to manage diabetes care, offer the necessary services, and make reference to community programs whenever possible (Huang et al., 2016). The place where these interventions will take place is in the healthcare facility.

Description

Type 2 diabetes is a common chronic disease in the United States with a prevalence estimated to affect more than 30 million people accounting for around 9.4% of the United States population (Gillani et al., 2017). As time progresses, the number of individuals with this condition continues to rise steadily, with a steady rate of 1.5 million American adults every year. Although lifestyle modifications and medications are increasing to improve diabetic control, a high proportion of patients contracting diabetes type 2 contribute to advanced contributions. Prolonged exposure to this form of diabetes can progress into many complications, including stroke and heart disease, which arise from induced oxidative stress (Fink et al., 2019). Type 2 diabetes also increases the risk of exposing the patient to microvascular complications such as neuropathy, retinopathy, nephropathy, and kidney failure.

In this case, effective intervention for type 2 diabetes will be intensive lifestyle interventions for the patient, which will involve practitioners working closely with patients to enable them to integrate new diet programs and healthy practices into their lives. This will be done better by coaching, counseling, and providing individualized guidance to the patient to assist them in undergoing successful changes in diet and improving the level of physical activity. The patients must follow up with practitioner’s multiple times during six months or longer (Chatterjee et al., 2017). The dietary elements can include provision with physical activity elements and tailored advice. The intervention will develop nutrition programs that will include a wide range of information, including weight loss goals or other elements associated with weight maintenance or loss.

On the other hand, the qualitative initiative will adopt a patient-centered approach by incorporating the patient preferences numeracy and focusing on addressing the underlying cultural barriers that threaten to compromise the efficiency of the intervention. Also, treatment decisions should be formulated on a timely basis to support critical evidence based on the patient’s comorbidities, preferences, and prognoses (Gummeson et al., 2017). The collaborative efforts will be executed between different practitioners to ensure that the patient will access quality care that will enable them to enjoy a quality life and accomplish their life goals.

Impacts

Diabetes imposes a momentous economic burden on families and society because it is one of the most expensive chronic diseases to treat, including a total cost of $176 billion alone in direct medical costs in 2012 (Aminian et al., 2019). Therefore, enabling the patients to understand the different coping strategies that they can use to improve the quality of their lives will be important in providing a productive workforce and a reduction in healthcare costs. The intensive lifestyle intervention will ensure that the patient can follow up since it is not a strategy that will incur an additional cost from the patient’s pocket. They have to make healthy choices by using the products they already have around their homes. On the other hand, the education programs will play an integral role in improving knowledge on strategies that the organization can use to maintain a steady blood glucose level reduce cardiovascular risk by maintaining an optimum body mass index and managing blood cholesterol. At the same time, the collaboration between different practitioners will increase the opportunity to identify effective measures that will play an integral role in boosting the patient’s overall confidence and wellbeing of the patient.

Significance of the topic and its implication in the nursing practice

The significance of this topic is that it is addressing an issue that is already affecting many people and therefore developing an effective intervention will assist many people to understand effective coping mechanisms and assist the rest of the population on strategies to reduce contracting the disorder (Taheri et al., 2020). The impact of this topic to the nursing practice is that the medical practitioners will be able to accomplish their goals which is to produce a healthy population that is ready to focus on building the economy and nation.

Purpose of the Change Proposal

Discuss the purpose of the change proposal in one to two paragraphs of 4 to 5 sentences at minimum.

PICOT Question

Place the week 3 assignment here, applying any changes as advised by your instructor. Place your PICOT statement/question above the body of this paragraph.

ANSWER

Patient

Currently, the United States has over 37 million citizens who have diabetes which is about 1 in every ten individuals, and about 90.95% of them are suffering from Type 2 diabetes. This type of diabetic disorder is common to people above 45, but more children, young adults, and teenagers have been developing this disorder with time. Reports by the center for disease prevention reveal that the rate of people developing Type 2 diabetes has remained consistent, making many researchers categorize this as an area of concern. In 2015, the disease was ruled out to be the seventh cause of demise across the United States, with evidence revealing that the government is now experiencing a greater burden with the rising medical costs (Bi et al., 2021). diabetes is turning out to be a serious disease. Still, it can be effectively managed through positive lifestyle changes such as proper dieting, participation in physical activities, the appropriate use of insulin, and other medications to aid in regulating blood sugar levels. Another problematic area about diabetes type 2 is that individuals with diabetes are at an increased risk of experiencing serious health complications such as premature death, vision loss, stroke, heart disease, and kidney failure. Worse still, diabetic patient is still at the risk of getting their body organs such as feet, toes, or legs amputated.

Intervention

Developing an effective intervention strategy for type 2 diabetes is important in enabling healthcare practitioners and scholars to identify new opportunities that will bring effective and reliable interventions. In this case, the proposed intervention technique used in managing type 2 diabetes is intensive lifestyle changes for the patient (De Vries et al., 2019). This strategy will be effective and realistic since most hospitals are already awarded robust human resources, capital, and an environment that can support full adoption, implementation, and assessment of the technique. This involves mobilizing nursing practitioners and dieticians to establish techniques that will enable their patients to effectively cope with the new lifestyle changes to provide them with timely and more effective blood sugar control. Another reason why this intervention was selected in this case because the strategy is completely inexpensive since it does not consume a lot of resources and funds. After all, it does not necessitate the patient to purchase a wide array of equipment (Gregg et al., 2012). Apart from that, the healthcare facilities are already supplied with trained personnel who can easily follow up to determine how the clients are coping with the new schedule and how it affects their lives.

Comparison

Another alternative to control this disorder is to use different types of pharmaceutical treatments which work in diverse ways. The pancreas can be encouraged using a diabetes drug to create and release more insulin, restraining the production and dispatch of glucose from the liver, the sensitivity of body cells to insulin is improved, and blocking the activity of the stomach enzymes that reduce carbohydrates. Other ways that these pharmaceuticals work to lower blood sugar levels are by reducing the reabsorption of glucose into the kidneys and slowing down the movement of food throughout the digestive systems. These medications can be consumed orally or be injected directly into the bloodstream (Schmidt et al., 2020). A medicine like Metformin is normally preferred as the first medical preference for treating Type 2 diabetes unless the patient has an underlying condition that limits them from consuming the drug. This medication is safe, effective, and inexpensive, and the risk of cardiovascular attacks have been found reducing. Metformin has other useful impacts on minimizing A1C outcomes, and it may assist with weight management. The drug works by slowing the rate of producing glucose by the liver.

Generally, Metformin is the favored initial medication for treating type 2 diabetes unless there’s an exact reason not to use it. Metformin is inexpensive, safe and effective. It may reduce the risk of cardiovascular events. Other types of pharmaceutical treatment for diabetes type 2 include a sulfonylurea, which comprises various medications, including glyburide, glipizide, and glimepiride. Although these drugs are pretty inexpensive, they may risk triggering low blood sugars and substantial weight gain. Apart from that, insulin sensitizer can also be used, and it is effective and poses zero risks to low blood sugar. Nonetheless, it can contribute to increased weight gain.

Outcome

The intervention selected is using intensive lifestyle changes for diabetes type 2 patients. The outcome of this intervention is that it will focus on improving diabetic care and self-administration behavior among the patients. The intervention begins by recommending physical exercises, an ideal opportunity for overweight patients to manage their weight and maintain a favorable body mass index. This intervention is expected to contribute to a reduction in the number of individuals who are succumbing to the issues linked to weight-related diabetic complications, including cardiovascular disorders and kidney failures (Johansen et al., 2017). Another outcome is that dietary counseling will enable patients to be aware of the substances they should avoid. In this case, patients will be able to identify the substances they should avoid as they contribute to high glycemic value, which triggers increasing blood sugar levels.

Additionally, dietary consultation will offer individuals diverse food alternatives that will help them manage their glucose levels and weight. In addition, social support is important in contributing to behavior change. Thus, it will allow the intervention to empower family members and medical practitioners to support their loved ones living with diabetes by enabling them to cope with their new routines (Huang et al., 2016).

Time

To accomplish these outcomes, it will take 30 days to provide an opportunity for practitioners to observe the patient progress.

Literature Search Strategy Employed

Discuss the literature search strategy that you used to locate your peer-reviewed articles. What data bases and key words did you use? Be sure to include your literature table as an appendix.

Evaluation of the Literature

Place the week 6 assignment here, applying any changes as advised by your instructor.

ANS;

Introduction

Diabetes is a significant health problem that is prevalent in contemporary society. It is a condition characterized by high concentrations of sugar in the blood that is precipitated by either inadequate production of insulin or failure of the bodies of those affected to respond to the hormone (Johansen et al., 2017). It is one of the leading causes of mortalities in the U. S. Therefore, it is necessary to find adequate strategies for managing the condition to reduce its prevalence in society. According to studies, lifestyle modifications are an effective strategy that can reduce sugar levels in patients with diabetes (Huang et al., 2016). Several authors explore the efficacy of lifestyle modification as a strategy for lowering blood sugar levels. This literature review compares the research questions, sample populations, and limitations in different write-ups that discuss the topic. The data compiled will help make conclusions about the study and recommendations for further studies.

Comparison of Research Questions

Different authors used varying research questions to investigate the impact of making lifestyle modifications on patients’ blood sugar levels. Aminian et al. (2019) hypothesized that using metabolic surgery to control the dietary intake of obese patients who have diabetes will help to reduce the concentration of sugar in their blood. The study would test whether this preposition was factual or the data that would be compiled would yield contrary outcomes. On the other hand, the study conducted by Fink et al. (2019) aimed to answer the research question: What are the challenges associated with Type 2 Diabetes, and what changes do individuals make to cope with the condition effectively? The authors focused on compiling views from participants to compile content that would answer this critical question.

Unlike Aminian et al. (2019) and Fink et al. (2019), Gillani et al. (2017) focused on a single population in their investigation. They conducted research that aimed to answer the research question: What lifestyle changes should physically disabled diabetes patients make, and how do they impact their blood sugar levels? Similarly, Taheri et al. (2020) focus on a different population often affected by high blood sugar levels. They used the research question: Does implementing comprehensive lifestyle modifications positively impact young diabetic patients? to explore the impact of lifestyle modification in the lives of patients diagnosed with the condition at an early age. Another practical approach used to compile evidence on the approaches that can help control sugar levels is identifying a specific lifestyle modification technique and determining its effectiveness. For example, Hallberg et al. (2018) focused on answering the research question: What impact does controlling carbohydrate intake in diabetic patients have on glycemic control in patients with diabetes?

Comparison of Sample Populations

The authors use different sample populations to compile data on the topic of lifestyle changes, an intervention that purposes to reduce blood sugar levels in patients with diabetes. While Aminian et al. (2020) used a large sample size of over 13 722 patients, Huang et al. (2016) incorporated only 16 participants. Using a large number of participants is a significant aspect of investigative research. However, when using models such as qualitative studies, researchers often prefer to use a limited study population because of limited funds and the need to compile comprehensive information about a topic. However, all the studies were conducted in healthcare facilities which increases the dependability of the compiled content because the studies were conducted by experts in the medical field.

Comparison of the Limitations of the Studies

The studies exploring the efficacy of lifestyle changes in controlling the blood sugar levels in diabetic patients have different limitations that affect their dependability. For example, the possibility of their being errors such as coding errors, misdiagnosis, and misclassifications are significantly high in the study conducted by Johansen et al. (2017) and Aminian et al. (2019). Another significant limitation of the study is difficulties in confirming whether high glycemic levels precipitated the fatality of patients with diabetes. Another considerable limitation noted in the studies was the failure to incorporate diverse participants in the investigative process. For example, Fink et al. (2019) and Hallberg et al. (2020) included only participants from one region. This interfered with the generalizability of the study because populations such as immigrants were not incorporated into the study. Gilani et al. (2017) also explored a significant limitation experienced during the study. The lack of adequate funds limited the number of participants who could be incorporated into the study. Huang et al. (2016) was limited by the possibility of there being performed biases during the study. These aspects were also factual in the study carried out by Taheri et al. (2019) and Sebire et al. (2018)

Conclusion

A review of the literature shows that lifestyle modification is a significant evidence-based intervention that is guaranteed to elicit positive outcomes when applied in the clinical setting. The studies use different research questions to compile information about various aspects related to the study, such as the impact of the intervention on diverse populations, including the physically disabled and young diabetic patients. Analysis of the sample also shows differences in the number of participants incorporated in the study. However, a notable similarity between the different studies is that they were conducted in healthcare organizations which increases the dependability of the compiled data. Further explorations also show significant limitations that affected the reliability of the studies. Therefore, it is recommended that further studies be carried out to investigate the gaps that the study did not cover, such as the impact of the cultural inclination of patients on the effectiveness of using lifestyle modification as an intervention for controlling blood sugar levels.

Applicable Change or Nursing Theory Utilized

Discuss one of nursing theorist you discussed in the Topic 4 DQ 2 that best fits in with the applicable change of your Capstone Change Project Proposal. This section should be at least two complete paragraphs.

Ans;

On the other hand, Rogers’ change model comprises five essential steps: creating awareness, stimulating interest in an issue, evaluating it, implementing changes, and adopting the new changes in the clinical setting. Rogers change model uses different processes, including creating awareness, triggering interest, evaluating, evaluating, implementing, and adopting changes (Burnes, 2019). The model that is most suitable in implementing the changes in diabetic management is Rogers’ change theory. This is because the steps inherent in the change model will ensure that the effectiveness of the planned changes is proven before they are adopted. For example, during the awareness step, the healthcare providers will be notified about the need to change the approaches used in managing diabetes in the clinical setting.

Proposed Implementation Plan with Outcome Measures

Discuss your proposed implementation plan with outcome measures in no less than two complete paragraphs.

Question; Not all EBP projects result in statistically significant results. Define clinical significance, and explain the difference between clinical and statistical significance. How can you use clinical significance to support positive outcomes in your project?

Discussion of How Evidenced-based Practice was Used in Creating the Intervention Plan

Plan for Evaluating the Proposed Nursing Intervention

Identification of Potential Barriers to Plan Implementation, and How These Could be Overcome


Question; Sustaining change can be difficult, as there are many variables that can affect implementation. One critical component of EBP is to ensure that practice change is part of an organization’s culture so it will continue to impact outcomes over time. Name two potential barriers that may prevent your EBP change proposal from continuing to obtain the same desired results 6 months to a year from now, and your strategies for overcoming these barriers

References

Aminian, A., Zajichek, A., Arterburn, D. E., Wolski, K. E., Brethauer, S. A., Schauer, P. R., … & Nissen, S. E. (2019). Association of metabolic surgery with major adverse cardiovascular outcomes in patients with type 2 diabetes and obesity. Jama322(13), 1271-1282.

Chatterjee, S., Khunti, K., & Davies, M. J. (2017). Type 2 diabetes. The lancet389(10085), 2239-2251.

Fink, A., Fach, E. M., & Schröder, S. L. (2019). ‘Learning to shape life’–a qualitative study on the challenges posed by a diagnosis of diabetes mellitus type 2. International journal for equity in health18(1), 1-11.

Gillani, S. W., Sulaiman, S. A. S., Abdul, M. I. M., & Saad, S. Y. (2017). A qualitative study to explore the perception and behavior of patients towards diabetes management with physical disability. Diabetology & metabolic syndrome9(1), 1-10.

Gummesson, A., Nyman, E., Knutsson, M., & Karpefors, M. (2017). Effect of weight reduction on glycated haemoglobin in weight loss trials in patients with type 2 diabetes. Diabetes, Obesity and Metabolism19(9), 1295-1305.

Taheri, S., Zaghloul, H., Chagoury, O., Elhadad, S., Ahmed, S. H., El Khatib, N., … & Abou-Samra, A. B. (2020). Effect of intensive lifestyle intervention on bodyweight and glycaemia in early type 2 diabetes (DIADEM-I): an open-label, parallel-group, randomised controlled trial. The lancet Diabetes & endocrinology8(6), 477-489.

Bi, S., Ding, X., Yu, S., Guo, B., Mu, L., & Wang, B. (2021). A machine learning model for quantifying the effect of lifestyle interventions for patients with type 2 diabetes mellitus. In Journal of Physics: Conference Series (Vol. 1732, No. 1, p. 012006). IOP Publishing.

De Vries, T. I., Dorresteijn, J. A., Van Der Graaf, Y., Visseren, F. L., & Westerink, J. (2019). Heterogeneity of treatment effects from an intensive lifestyle weight loss intervention on cardiovascular events in patients with type 2 diabetes: data from the Look AHEAD trial. Diabetes Care42(10), 1988-1994.

Gregg, E. W., Chen, H., Wagenknecht, L. E., Clark, J. M., Delahanty, L. M., Bantle, J., … & Look AHEAD Research Group, F. T. (2012). Association of intensive lifestyle intervention with remission of type 2 diabetes. Jama308(23), 2489-2496.

Huang, X. L., Pan, J. H., Chen, D., Chen, J., Chen, F., & Hu, T. T. (2016). Efficacy of lifestyle interventions in patients with type 2 diabetes: a systematic review and meta-analysis. European Journal of Internal Medicine27, 37-47.

Johansen, M. Y., MacDonald, C. S., Hansen, K. B., Karstoft, K., Christensen, R., Pedersen, M., … & Ried-Larsen, M. (2017). Effect of an intensive lifestyle intervention on glycemic control in patients with type 2 diabetes: a randomized clinical trial. Jama318(7), 637-646.

Schmidt, S. K., Hemmestad, L., MacDonald, C. S., Langberg, H., & Valentiner, L. S. (2020). Motivation and barriers to maintaining lifestyle changes in patients with type 2 diabetes after an intensive lifestyle intervention (The U-TURN Trial): a longitudinal qualitative study. International Journal of Environmental Research and Public Health17(20), 7454.

Be reminded that the reference page is a separate page and should include all references used to develop your Capstone project to include the eight peer-reviewed articles. All resources cited within the body of the assignment should be listed on the reference page. Likewise, all references listed on the reference page, should be cited within the body of the assignment. The reference page is double-spaced throughout and formatted as hanging indent, like this paragraph.

Appendix Section

Appendix section, if tables, graphs, surveys, educational materials, etc. are created (BE SURE TO INCLUDE THE LITERATURE TABLE HERE in addition to any tables, graphs, surveys, education materials, etc. that you created).

3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide

https://www.thecommunityguide.org/findings/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 1/8

Systematic Review

Topic  Diabetes, Obesity

Recommended (suf�cient evidence)

Audience  Adults, Older Adults

Setting  Clinical/Health Systems, Community

Strategy  Counseling, Health Education

Diabetes Management: Intensive Lifestyle Interventions
for Patients with Type 2 Diabetes

October 2016

This webpage summarizes information available in the CPSTF Findings and Rationale Statement, located under the Snapshot tab.

The Community Guide (https://www.thecommunityguide.org)

Summary of CPSTF Finding

The Community Preventive Services Task Force (CPSTF) recommends intensive lifestyle interventions for

patients with type 2 diabetes to improve glycemic control and reduce risk factors for cardiovascular

disease.

Intervention

CPSTF Finding and Rationale Statement

Intensive lifestyle interventions provide ongoing counseling, coaching, or individualized guidance to

patients with type 2 diabetes to help them change their diet, level of physical activity, or both. Patients

must interact with program staff multiple times for a period of six months or longer.

Dietary components may include tailored advice, and physical activity components may include

structured and personalized guidance or supervised exercise training. Programs may have weight loss

goals or include additional components related to weight loss or maintenance.

The largest and longest trial to date provided intensive individual and group counseling and extended

interpersonal support for dietary changes, regular physical activity, and weight management.

3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide

https://www.thecommunityguide.org/findings/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 2/8

Read the full CPSTF Finding and Rationale Statement [PDF – 793 KB] for details including implementation

issues, possible added benefits, potential harms, and evidence gaps.

Promotional Materials

Community Guide News

One Pager:

Users who viewed this also viewed

About The Systematic Review

Summary of Results

Intensive Lifestyle Interventions Reduce Cardiovascular Risk Among People with Type 2 Diabetes

Intensive Lifestyle Interventions for Patients with Type 2 Diabetes

Mental Health: Targeted School-Based Cognitive Behavioral Therapy Programs to Reduce Depression and

Anxiety Symptoms

Violence Prevention: Primary Prevention Interventions to Reduce Perpetration of Intimate Partner Violence

and Sexual Violence Among Youth

Diabetes Prevention: Interventions Engaging Community Health Workers

The CPSTF uses recently published systematic reviews to conduct accelerated assessments of

interventions that could provide program planners and decision-makers with additional, effective

options. The following published review was selected and evaluated by a team of specialists in

systematic review methods, and in research, practice, and policy related to diabetes management

Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2

diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016;27;37-
47.

The systematic review and meta-analysis included 17 studies (Huang et al., 2016; search period

through July 15, 2014). The CPSTF finding is based on results from a subset of 7 studies that evaluated

intensive physical activity programs (5 studies) and intensive dietary programs (3 studies) in addition

to expert input from team members and the CPSTF. The largest and longest study (Look AHEAD trial)

evaluated both intensive dietary and physical activity programs.

3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide

https://www.thecommunityguide.org/findings/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 3/8

Summary of Economic Evidence

Huang et al. did not consider evidence or information on the economic benefits of these interventions.

An economic evaluation of the Look AHEAD trial reported lower health-care costs over 10 years.

Applicability

Based on evidence from the review, the CPSTF finding is applicable to interventions offered to adults

with type 2 diabetes through healthcare settings in the United States.

Evidence Gaps

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement [PDF –

793 KB].

The systematic review included 7 studies. The largest and longest study (Look AHEAD trial) evaluated

both intensive dietary and physical activity programs.

Dietary Programs (3 studies)

Intensive dietary programs led to favorable changes in reported outcomes.

Body Mass Index: non-significant decrease

Blood glucose (A1c): significant decrease

Systolic blood pressure: significant decrease

Diastolic blood pressure: significant decrease

LDL cholesterol: non-significant decrease

HDL cholesterol: significant increase

Physical Activity Programs (5 studies)

Intensive physical activity programs led to favorable changes in reported outcomes.

Body Mass Index: non-significant decrease

Blood glucose (A1c): significant decrease

Systolic blood pressure: non-significant decrease

Diastolic blood pressure: significant decrease

LDL cholesterol: non-significant decrease

HDL cholesterol: non-significant increase

3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide

https://www.thecommunityguide.org/findings/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 4/8

Study Characteristics

Analytic Framework

No content is available for this section.

Summary Evidence Table

A summary evidence table for this Community Guide review is not available because the CPSTF finding

is based on the following published systematic review:

The CPSTF identified several areas that have limited information. Additional research and evaluation

could help answer the following questions and fill remaining gaps in the evidence base. (What are

evidence gaps?)

How does effectiveness vary between specific programs in different populations (e.g., by race,

SES, educational attainment, age, cognitive or physical disabilities)?

How effective are programs delivered through the internet, email, apps, or social networking?

What is the relative effectiveness of individual and group sessions?

What structures and systems are needed to maintain program effectiveness and help participants

continue their improvements to diet and physical activity following program completion?

What are long-term effects on participants’ glycemic control, weight loss, cardiovascular disease

risk factors, morbidity, and mortality?

What are program attrition rates? Why do participants drop out, and how can they be retained?

Are these interventions effective with children and adolescents?

All included studies were randomized controlled trials.

Evaluated interventions provided a median of 11 sessions that were individual (3 studies) or a

combination of individual and group sessions (4 studies).

Studies evaluated interventions that provided patients specific, tailored instruction on lifestyle

changes through multiple interactions over extended periods of time.

Four of the programs provided additional, extended telephone contact and 2 of the programs had

frequent, ongoing contact with patients through regular exercise sessions.

The median intervention duration was 12 months. All 7 studies established clear goals for

patients’ dietary changes (3 studies), physical activity levels (5 studies), or weight loss (2 studies).

3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide

https://www.thecommunityguide.org/findings/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 5/8

Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2

diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016;27;37-
47.

Included Studies

The number of studies and publications do not always correspond (e.g., a publication may include several studies

or one study may be explained in several publications).

Effectiveness Review

Studies from Huang et al. (2016) Included in this Review

Ali M, Schifano F, Robinson P, Phillips G, Doherty L, Melnick P, et al. Impact of community pharmacy

diabetes monitoring and education programme on diabetes management: a randomized controlled

study. Diabet Med 2012;29(9):e326–33.

Balducci S, Zanuso S, Nicolucci A, De Feo P, Cavallo S, Cardelli P, et al. Effect of an intensive exercise

intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes

mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med
2010;170:1794–803.

Chan CW, Siu SC, Wong CK, Lee VW. A pharmacist care program: positive impact on cardiac risk in

patients with type 2 diabetes. J Cardiovasc Pharmacol Ther 2012;17:57–64.

Coppell KJ, KataokaM, Williams SM, Chisholm AW, Vorgers SM, Mann JI. Nutritional intervention in

patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment—Lifestyle

Over and Above Drugs in Diabetes (LOADD) study: randomised controlled trial. BMJ 2010;341:c3337.

Crasto W, Jarvis J, Khunti K, Skinner TC, Gray LJ, Brela J, et al. Multifactorial intervention in individuals

with type 2 diabetes and microalbuminuria: the Microalbuminuria Education and Medication

Optimisation (MEMO) study. Diabetes Res Clin Pract 2011;93: 328–36.

Dobrosielski DA, Gibbs BB, Ouyang P, Bonekamp S, Clark JM,Wang NY, et al. Effect of exercise on blood

pressure in type 2 diabetes: a randomized controlled trial. J Gen Intern Med 2012;27:1453–9.

Ko GT, Li JK, Kan EC, LoMK. Effects of a structured health education programme by a diabetic education

nurse on cardiovascular risk factors in Chinese type 2 diabetic patients: a 1-year prospective

randomized study. Diabet Med 2004;21:1274–9.

Kirk A, Mutrie N, MacIntyre P, Fisher M. Effects of a 12-month physical activity counselling

intervention on glycaemic control and on the status of cardiovascular risk factors in people with type 2

diabetes. Diabetologia 2004;47:821–32.

Krein SL, Klamerus ML, Vijan S, Lee JL, Fitzgerald JT, Pawlow A, et al. Case management for patients

with poorly controlled diabetes: a randomized trial. Am J Med 2004;116:732–9.

3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide

https://www.thecommunityguide.org/findings/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 6/8

Search Strategies

Refer to the existing systematic review for information about the search strategy:

Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2

diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016;27;37-
47.

Review References

Huang XL, Pan JH, Chen D, Chen J, Hu TT. Efficacy of lifestyle interventions in patients with type 2

diabetes: A systematic review and meta-analysis. European Journal of Internal Medicine 2016;27;37-47.

Considerations for Implementation

Look ARG, Wing RR. Long-term effects of a lifestyle intervention on weight and cardiovascular risk

factors in individuals with type 2 diabetes mellitus: four-year results of the Look AHEAD trial. Arch

Intern Med 2010;170:1566–75.

Mohamed H, Al-Lenjawi B, Amuna P, Zotor F, Elmahdi H. Culturally sensitive patient-centred

educational programme for self-management of type 2 diabetes: a randomized controlled trial. Prim

Care Diabetes 2013;7:199–206.

Salinero-Fort MA, Carrillo-de Santa Pau E, Arrieta-Blanco FJ, Abanades-Herranz JC, Martin-Madrazo

C, Rodes-Soldevila B, et al. Effectiveness of PRECEDE model for health education on changes and level

of control of HbA1c, blood pressure, lipids, and body mass index in patients with type 2 diabetes

mellitus. BMC Public Health 2011;11:267.

Sevick MA, Korytkowski M, Stone RA, Piraino B, Ren D, Sereika S, et al. Biophysiologic outcomes of the

Enhancing Adherence in Type 2 Diabetes (ENHANCE) trial. J Acad Nutr Diet 2012;112:1147–57.

Sone H, Tanaka S, Iimuro S, Tanaka S, Oida K, Yamasaki Y, et al. Long-term lifestyle intervention

lowers the incidence of stroke in Japanese patients with type 2 diabetes: a nationwide multicentre

randomised controlled trial (the Japan Diabetes Complications Study). Diabetologia 2010;53:419–28.

Trento M, Passera P, Bajardi M, Tomalino M, Grassi G, Borgo E, et al. Lifestyle intervention by group

care prevents deterioration of type II diabetes: a 4-year randomized controlled clinical trial.

Diabetologia 2002;45:1231–9.

Uusitupa M, Laitinen J, Siitonen O, Vanninen E, Pyorala K. The maintenance of improved metabolic

control after intensified diet therapy in recent type 2 diabetes. Diabetes Res Clin Pract 1993;19:227–38.

Wisse W, Boer Rookhuizen M, de Kruif MD, van Rossum J, Jordans I, ten Cate H, et al. Prescription of

physical activity is not sufficient to change sedentary behavior and improve glycemic control in type 2

diabetes patients. Diabetes Res Clin Pract 2010;88:e10–3.

3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide

https://www.thecommunityguide.org/findings/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 7/8

Crosswalks

Healthy People 2030

Healthy People 2030 includes the following objectives related to this CPSTF recommendation.

The following considerations are drawn from studies included in the evidence review, the broader

literature, and expert opinion.

The U.S. Preventive Services Task Force (USPSTF) issued the following in 2015:

The U.S. Preventive Services Task Force recommends screening for abnormal blood glucose as part of

cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese. Clinicians should

offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions to

promote a healthful diet and physical activity. (B recommendation: October 2015)

This recommendation will likely increase demand for early intervention to support patients in

making lifestyle changes and adopting long-term self-management behaviors.

Close coordination between healthcare systems, healthcare providers, and community-based

programs will likely be an essential element of sustainable community-based services.

Healthcare coverage for preventive services recommended by the USPSTF will likely be an

important source of funding for community-based programs once barriers to billing and

reimbursement are addressed.

Patients with, or at increased risk for, cardiovascular disease may need pre-intervention

assessments before initiating changes in physical activity, diet, and weight management.

Patients will need regular, ongoing diabetes care and medication management, which may

require adjustment as lifestyle changes are adopted.

Participants may be at increased risk for injuries associated with changes in physical

activity. This risk can be reduced if walking is emphasized as the primary mode of physical

activity with gradually increasing activity levels added as tolerated.

Reduce the proportion of adults with diabetes who have an A1c value above 9 percent — D‑03
(https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes/reduce-proportion-adults-

diabetes-who-have-a1c-value-above-9-percent-d-03)

Increase the proportion of people with diabetes who get formal diabetes education — D‑06
(https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes/increase-proportion-

people-diabetes-who-get-formal-diabetes-education-d-06)

3/2/22, 1:22 PM Diabetes: Lifestyle Programs for Type 2 | The Community Guide

https://www.thecommunityguide.org/findings/diabetes-intensive-lifestyle-interventions-patients-type-2-diabetes 8/8

The Community Guide

Page last reviewed: September 03, 2020

Page last updated: December 22, 2021

Content Source: The Guide to Community Preventive Services

Disclaimer:The findings and conclusions on this page are those of the Community Preventive
Services Task Force and do not necessarily represent those of CDC. Task force evidence-based

recommendations are not mandates for compliance or spending. Instead, they provide

information and options for decision makers and stakeholders to consider when determining

which programs, services, and policies best meet the needs, preferences, available resources, and

constraints of their constituents.

Sample Citation:
Guide to Community Preventive Services. Diabetes Management: Intensive Lifestyle Interventions

for Patients with Type 2 Diabetes. https://www.thecommunityguide.org/findings/diabetes-

intensive-lifestyle-interventions-patients-type-2-diabetes. Page last updated: December 22,

2021. Page accessed: March 2, 2022

@CPSTF (https://twitter.com/cpstf)

(404) 498-1827

[email protected]

Citation and Disclaimer

Literature Evaluation Table

Student Name:

Change Topic (2-3 sentences): : In patients with type 2 diabetes, is making intensive lifestyle changes compared to using standard procedures only effective in lowering blood sugar levels in thirty days?

Criteria

Article 1

Article 2

Article 3

Article 4

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

Aminian, A., Zajichek, A., Arterburn, D. E., Wolski, K. E., Brethauer, S. A., Schauer, P. R., … & Nissen, S. E. Published in Jama Journal.
https://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.2019.14231&utm_

Fink, A., Fach, E. M., & Schröder, S. L. Published in the International journal for equity in health.
https://doi.org/10.1186/s12939-019-0924-3

Gillani, S. W., Sulaiman, S. A. S., Abdul, M. I. M., & Saad, S. Y. Published in the Diabetology & metabolic syndrome Journal. https://link.springer.com/content/pdf/10.1186/s13098-017-0257-6.pdf

Huang, X. L., Pan, J. H., Chen, D., Chen, J., Chen, F., & Hu, T. T. E. Published in European Journal of Internal Medicine.
https://doi.org/10.1016/j.ejim.2015.11.016

Article Title and Year Published

Association of metabolic surgery with major adverse cardiovascular outcomes in patients with type 2 diabetes and obesity. Published in 2019

Learning to shape life’–a qualitative study on the challenges posed by a diagnosis of diabetes mellitus type 2. Published in 2019

A qualitative study to explore the perception and behavior of patients towards diabetes management with physical disability. Published in 2017.

Efficacy of lifestyle interventions in patients with type 2 diabetes: a systematic review and meta-analysis. Published in 2016

Research Questions (Qualitative)/Hypothesis (Quantitative)

Metabolic surgery controls dietary intake to manage blood sugar levels, and reduce the need for medication in diabetic patients who are obese.

What are the challenges associated with a diagnosis of T2D, and what changes do individuals make to cope with the condition effectively?


What lifestyle changes should physically disabled diabetic patients make, and how do they impact their blood sugar levels?

Efficacy of lifestyle interventions in patients with type 2 diabetes: a systematic review and meta-analysis

Purposes/Aim of Study

What lifestyle changes should physically disabled diabetic patients make, and how do they impact their blood sugar levels?

The study aims to deduce the health challenges associated with a diagnosis of T2D and the impact of making lifestyle changes on coping with them

The purpose of the study was to determine whether physically disabled individuals with T2D were aware of the lifestyle management strategies such as changes in dietary intake that they should make to lower their blood sugar levels and improve their health and well-being and the impact of these changes.

The purpose of the meta-analysis is to determine the outcomes of three lifestyle changes: dietary management, increased physical activity, and patient instruction on effective self-care

Design (Type of Quantitative, or Type of Qualitative)

Retrospective cohort design

Descriptive design

Exploratory design

Meta-synthesis design

Setting/Sample

Cleveland clinic/ 13722 patients

Martin Luther-King University Hospital in Germany/ 19 participants

Penang Hospital in Malaysia/21 participants

Online research/ 17 articles

Methods: Intervention/Instruments

Observation of selected patients

Semi-structured interviews using open ended questions

Semi-structured interviews using pen-ended questions

Review of the data in the articles

Analysis

Surgical restructuring of the digestive systems is directly linked to a reduction of blood sugar levels

Patients who changed their lifestyle to incorporate healthy habits experienced low blood sugar levels.

Increased physical activity in physically disabled patients with T2D is directly related to lower blood sugar levels.

Dietary management, increased physical activity and effective education of patients are directly linked to improved health in patients with T2D.

Key Findings

Surgical restructuring of the metabolic system helps reduce the prevalence of cardiovascular problems in obese patients who have diabetes. It also helps control blood sugar levels and reduce medication use in diabetic management

Patients with T2D investigated and found new strategies for coping with the challenges precipitated by a diagnosis of the disease. They also adopted new living styles to improve their health and well-being, which lowered their blood sugar levels significantly.

Patients with T2D investigated and found new strategies for coping with the challenges precipitated by a diagnosis of the disease. They also adopted new living styles to improve their health and well-being, which lowered their blood sugar levels significantly.

Lifestyle modification played a significant role in lowering blood sugar levels and improving the health and well-being of patients with diabetes.

Recommendations

The surgical procedure was a practical approach to improving the lifestyle of diabetic patients who are obese. It led to better dietary management and helped lower the blood sugar levels of patients

Healthcare providers should educate patients on the effective lifestyle changes they can make to improve their health and well-being.

It is necessary to instigate measures to help T2D patients with physical disabilities make adequate lifestyle changes for effective glycemic control

The authors recommended that lifestyle changes should be instructed in diabetic patients to promote their health and well-being.

Explanation of How the Article Supports EBP/Capstone Project

The article is related to the PICOT question because it identifies metabolic surgery as a preparatory step that can be used to change the lifestyle of a diabetic patient to reduce the portions of food they consume and reduce weight, hence controlling their blood sugar levels.

The article is related to the PICOT question because it determines the changes individuals are compelled to make after they are diagnosed with T2D and the impact of these lifestyle changes on their health and well-being.

The article relates to the PICOT question because it explores the lifestyle modifications that diabetic patients who are physically incapacitated make to improve their health and well-being

The article relates to the PICOT question because it discusses practical lifestyle modification approaches that diabetic patients can use and their impact on their blood sugar levels.

Criteria

Article 5

Article 6

Article 7

Article 8

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

Johansen, M. Y., MacDonald, C. S., Hansen, K. B., Karstoft, K., Christensen, R., Pedersen, M., … & Ried-Larsen, M. Published in Jamanet Journal. https://jamanetwork.com/journals/jama/article-abstract/2648632

Taheri, S., Zaghloul, H., Chagoury, O., Elhadad, S., Ahmed, S. H., El Khatib, N., … & Abou-Samra, A. B. The Lancet Diabetes and Endocrinalogy Journal. https://jamanetwork.com/journals/jama/article-abstract/2648632

Sebire, S. J., Toumpakari, Z., Turner, K. M., Cooper, A. R., Page, A. S., Malpass, A., & Andrews, R. C. BMC Public Health Journal.
https://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-018-5114-5.pdf

Hallberg, S. J., McKenzie, A. L., Williams, P. T., Bhanpuri, N. H., Peters, A. L., Campbell, W. W., … & Volek, J. S. Diabetic Therapy Journal. https://link.springer.com/article/10.1007/s13300-018-0373-9

.

Article Title and Year Published

Effect of an intensive lifestyle intervention on glycemic control in patients with type 2 diabetes: a randomized clinical trial. Published in 2017.

Effect of intensive lifestyle intervention on body weight and glycaemia in early type 2 diabetes (DIADEM-I): an open-label, parallel-group, randomised controlled trial.  Published in 2020

“I’ve made this my lifestyle now”: a prospective qualitative study of motivation for lifestyle change among people with newly diagnosed type two diabetes mellitus. Published in 2018.

Effectiveness and safety of a novel care model for the management of type 2 diabetes at 1 year: an open-label, non-randomized, controlled study. Publised in 2018

Research Questions (Qualitative)/Hypothesis (Quantitative)

How does lifestyle modification impact the glycemic levels of diabetic patients?

Does implementing comprehensive lifestyle modifications have a positive impact on young diabetic patients?

How do people newly diagnosed with diabetes get the motivation needed to make positive changes in their lifestyle and the impact of these changes on their blood sugar levels

What is the impact of controlling carbohydrate intake having on glycemic control?

Purposes/Aim of Study

The study purposed to investigate the hypothetical indication that modifying patients’ lifestyles helped improve their glycemic levels, lowering their need for medications.

The study aims to investigate whether encouraging lifestyle modifications can help young people with T2D to lose excessive weight and have sufficiently low glycemic levels.

The study aims to determine how individuals diagnosed with T2D get encouraged to make lifestyle changes to control their sugar levels and the impacts of this decision

The purpose of the study is to determine the impact of an intervention designed to restrict carbohydrate intake on the sugar levels of diabetic patients

Design (Type of Quantitative, or Type of Qualitative)

Quasi experimental design

Exploratory study design

Descriptive research design

Randomized control design

Setting/Sample

Zealand and Denmark/98 patients

Qatar/ 158 participants

South West England/ 593 participants

Lafayette, Indiana/218 participants

Methods: Intervention/Instruments

Comparison of the two variables

Semi structured interviews

Semi structured interviews

Comparison of dependent and independent studies

Analysis

Lifestyle changes are directly related to the intensity of the lifestyle changes patients make.

Lifestyle changes are directly related to the intensity of the lifestyle changes patients make.

There is a direct connection between healthy lifestyles and low glycemic levels

There is a direct connection between healthy lifestyles and low glycemic levels

Key Findings

Making lifestyle changes reduced the glycemic levels of diabetic patients; hence they took fewer drugs to control the disease.

Lifestyle modifications helped reduce excessive weight, which is a significant factor in diabetes control. It also reduced glycemic levels hence improving the health of the patients.

The diagnosis of diabetes is a significant motivation that makes them make adequate lifestyle changes to control their blood sugar levels

Limiting carbohydrates intake is a significant intervention that helps in lowering glucose intake in patients with T2D

Recommendations

The authors recommended that diabetic patients be encouraged to make lifestyle changes to improve their health and well-being.

Lifestyle modification should be encapsulated as an effective strategy in managing diabetes because of its short-term and long-term benefits to the patients.

It is significant for individuals diagnosed with T2D to have adequate motivations to make them change their lifestyle, which is a necessary process that ensures that their blood sugar levels are controlled adequately

The researcher indicated that the issue should be investigated more to determine the strategies that can be used to adapt the intervention as an evidence-based practice in the clinical setting

Explanation of How the Article Supports EBP/Capstone

The article is related to the PICOT question because it investigates the relationship between making lifestyle changes and reducing blood sugar levels in diabetic patients and how this impacts their medication use.

The article relates to the PICOT question because it examines the impact of modifying lifestyle on controlling glycemic levels and weight and improving the well-being of patients with diabetes

The article relates to the PICOT question because it investigates how the impacts of making lifestyle changes such as dietary changes and engaging in physical exertions can improve the quality of life of a diabetic patient.

The article is related to the PICOT article because it scrutinizes the effects of using a lifestyle model that comprises approaches such as limiting the intake of carbohydrates in patients with T2D.

Place your order
(550 words)

Approximate price: $22

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency
Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.

Read more

Free-revision policy

Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.

Read more

Privacy policy

Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.

Read more

Fair-cooperation guarantee

By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.

Read more
colle writers

Order your essay today and save 30% with the discount code ESSAYSHELP