Effectiveness of Lifestyle Modifications in Type 2 Diabetes Management

Running head: EVIDENCE BASED NURSING
Evidence Based Nursing
Name of the Student
Name of the University
Author Note

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EVIDENCE BASED NURSING
Introduction
According to the Australian Institute of Health and Welfare [AIHW] (2018) long
lasting disease condition characterised by persistent symptoms are characterised as chronic
diseases. The economic and social complications associated with chronic diseases disrupt the
health-related quality of life of the affected individuals. AIHW highlights 8 major health
conditions under chronic health diseases and these include asthma, cancer, arthritis, back-
pain, chronic obstructive pulmonary disease, cardiovascular disease, diabetes and mental
health conditions. The following assignment will highlight extensive literature review over
type 2 diabetes management.
Research Question
P Population Individuals with Type-2 Diabetes
I Intervention Lifestyle modifications
C Comparison Diabetes education and social support
O Outcome Improvement in health related quality of life of individuals with
type-2 diabetes mellitus (T2DM)
Research question
According to Chatterjee, Khunti and Davies (2017), diabetes especially T2DM is a
global health concern. Numerous compelling evidences highlight that diabetes can be
prevented and health related quality of life can be improvement through modifications in
lifestyle habits. Lifestyle modifications mainly include physical exercise, diet management
and reduction in smoking and drinking. Venditti and Kramer (2012) are of the opinion the
effective lifestyle modification help to regulate the calories intake and burning of the extra

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calories which in turn helps to control the glycemic level of the body. Thus the main research
question is: How effective is life style management in reducing and complications associated
with type-2 diabetes and thereby promoting subsequent recovery?
Evaluation of the research
According to Gregg et al. (2012), the frequency of remission of T2DM through
lifestyle interventions is unclear. Thus, the principal objective of the research is to analyze the
long-term intensive weight loss intervention in relation to frequency of remission of T2DM
towards normoglycemia and prediabetes. Thus, the research aim of Gregg et al. (2012) was
novel as it specifically highlighted the research gap and structured the research question
accordingly. They conducted ancillary observational analysis under randomized control trial
with 4-year follow-up (April 2001 to April 2004). They randomly selected 4503 US adults
with BMI (body mass index) higher than 25 and have T2DM. The authors mainly
implemented intensive lifestyle intervention (ILI) with proper diabetes support and education
control condition (DSE). They authors randomly assigned one group of participants (n=
2241) to receive ILI and another group of participants (n=2262) to DSE which include
education in diet and management of physical activity. Therefore, the main strength of the
article is its high sample size. According to Charan and Biswas (2013) high sample size helps
to reduce the biased outcome. The analysis of the results highlighted that ILI is associated
with greater likelihood of T2DM remission among over-weight adults in comparison to
diabetes control and education. The research paradigm selected by the authors is positivism
research paradigm. According to Brannen (2017), positivism research paradigm is
appropriate for the quantitative research. Gregg et al. (2012) conducted quantitative research
as used statistical analysis in order to compare the primary outcome of the study (complete or
partial remission of T2DM) with ILI group and DSE group. One of the limitations of the

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study is, Gregg et al. (2012) used 4-year of follow-up in order to study the primary outcomes
and this lead to an overall decrease in the sample size, which might lead to biased outcome.
Research topic
According to the National Strategic Framework for Chronic Condition (2017), the
primary focus must be given on disease prevention in order to promote healthier Australia.
The health promotion strategies must be designed in such a way that it minimizes the adverse
effect associated with the disease outcome along with decrease in the progression of the
disease towards severity among the vulnerable population. The research topic highlighted in
the paper is mainly focused on how modification of the lifestyle helped in reducing the
severity of T2DM in comparison to simple disease education and awareness. The analysis of
the results highlighted that the physicians may provide proper disease education and hopeful
advice but such education and disease awareness is not suitable for the effective prevention of
the disease. Extensive lifestyle interventions like rigorous physical exercise along with
regulation of diet plan helps in decreasing the severity of diabetes via decrease the disease
status into prediabetic of nondiabetic glycemic level. The research undertaken by Gregg et al.
(2012) mainly elucidated that effective lifestyle intervention help in reducing the overall body
mass index (BMI) and this in turn helped to reduce the glycemic load of the body along with
decrease in the threats of developing cardiovascular complications. The overall effect of the
lifestyle interventions as highlighted by Gregg et al. (2012) in their study coincides with
National Strategic Framework for Chronic Condition (2017) as it lead to the promotion of
health, reduction of the associated health risk and with overall improvement of the critical life
stages.