Comparison of Low and High-Carbohydrate Diets for Type 2 Diabetes Management: A Randomized Trial

Running head: CRITICAL APPRAISAL
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Name of the Student
Name of the university
Author’s note

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Template to complete Assessment 2 – Table format
Assessment 2 Tay, J., Luscombe-Marsh,
N. D., Thompson, C. H.,
Noakes, M., Buckley, J. D.,
Wittert, G. A., ... &
Brinkworth, G. D. (2015).
Comparison of low-and
high-carbohydrate diets for
type 2 diabetes management:
a randomized trial. The
American journal of clinical
nutrition, 102(4), 780-790.
Mody, L., Krein, S. L.,
Saint, S., Min, L. C.,
Montoya, A., Lansing, B., ...
& Rye, R. A. (2015). A
targeted infection prevention
intervention in nursing home
residents with indwelling
devices: a randomized
clinical trial. JAMA internal
medicine, 175(5), 714-723.
Population of Interest Obese and overweight
adults with type II diabetes
of 35 to 68 years
Type of population was
high risk nursing home with
urinary catheter, feeding
tube or both.
Inclusion & exclusion
criteria
Inclusion criteria :
 Overweight and obese
adults with age group
of 35 to 68 years
 BMI ( (in kg/m2) : 26
to 45
 Population with type
two diabetes and
taking medications
Exclusion criteria:
 impaired renal
function
 proteinuria
 type 1 diabetes
 history of
malignancy;
 gastrointestinal
disease
 Smoking
 history of an
eating disorder
 lactation
Inclusion criteria:
 Nursing home stays
with an indwelling
urinary catheter or
feeding tube or both
 Receiving period is
more than 72 hours
 Informed consent
Exclusion criteria :
 Residents
receiving end-
of-life care
Sampling Method The study was conducted in
a clinical where the
participants were block
matched for their sex, age,
HbAc1, diabetes medication
and randomly allocated.
The sample included 12
nursing homes where mean
137 beds and the participants
were included after thorough
assessment of wound care
for mean of 22 residents

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Hemming et al. (2015),
discussed by block
randomization is commonly
used in clinical trials in order
to reduce the bias as well as
archive balance in
allocation of participants,
especially when sample size
is small.
with per year according to
the inclusion criteria.
The researchers used cluster
randomization for nursing
homes for the study rather
than participant (Toye et al.,
2015). The researchers also
used stratified randomization
for hospital.
Sample size The sample size was obese
and overweight115 adults
The sample size 418 NH
residents with indwelling
34 174 device of device-
days
Allocation Method The participants were
randomly allocated into two
groups. One group was
allocated with low-
carbohydrate, high–
unsaturated fat, low–
saturated fat (LC) (n = 57)
and another group was
allocated with a high-
carbohydrate, low-fat (HC)
diet (n = 58) combined with
high aerobic and resistance
exercise
The nursing home was used
as a unit of allocation and
the nursing home was
stratified by profitable or
non-profitable (Kabaghe et
al., 2015). After
stratification, the allocation
was done by using compute
generated randomizations.
Treatment and Control
Groups
The study has no control
group since the study aimed
to compare between two
diet.
The six nursing home with
participants were
randomized into where 6
were intervention group and
other were control
Type of blinding The study used single
blinding for the study. Krogh
et al. (2016), single blinding
method is used when
participants were unaware of
the treatment.
The double blinding method
was used since the field
staffs were unaware of
intervention assignment.
Rossen et al. (2015), double
blinding is the most common
study where experimenters
and participants were
unaware of intervention.
This kind of study was
useful for preventing the

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potential bias
Overall study outcomes Both of the diet facilitate
substantial weight loss and
reduce HbA1c. Low
carbohydrate diet with high
unsaturated fat achieved
greater improvement in term
of reduced requirement of
blood glucose, better lipid
profile and blood glucose
stability.
Multimodal targeted
infection program (TIP)
reduces the multidrug
resistance organism in
patients with indwelling
device and reduces catheter
associated with infection.