Multidisciplinary Diabetes Care with and without Bariatric Surgery in Overweight People: A Randomised Controlled Trial

This research paper analyses the problem of type 2 diabetes and the role of multidisciplinary diabetes care in the reduction of their effects. The paper discusses methodologies and design, data collection, literature review and findings and recommendations.

Research in nursing

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Contents
Introduction....................................................................................................................................................... 2
Methodology and design............................................................................................................................... 2
Data collection................................................................................................................................................... 3
Literature review and sampling design.................................................................................................. 4
Findings and recommendation.................................................................................................................. 5
Conclusion........................................................................................................................................................... 6
References........................................................................................................................................................... 8

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Introduction
The title of journal paper is Multidisciplinary diabetes care with and without
bariatric surgery in overweight people: a randomised controlled trial in the year 2014.
Type 2 diabetes is one of the common health diseases which is growing rapidly and the
researcher described the multidisciplinary diabetes care with the without bariatric
surgery (Wentworth, et al., 2014). The purpose of this study is to analyse the problem of
type 2 diabetes and the role of multidisciplinary diabetes care in the reduction of their
effects. Diabetes is a very serious health disease which also increases the problem of
obesity and chronic health infections. This report is divided into major three parts such
as methodologies and design, literature review and findings and recommendations.
According to this journal paper, the bariatric surgery increase the glycaemia in the
obese patients with the type 2 diabetes diseases but their effects are uncertain in
overweight individuals.
Methodology and design
In this journal study, the interpretivism philosophy is used in order to gather the
theoretical information about diabetes health disease and it also provides real data
about the research topic (Wentworth, et al., 2014). Moreover, research methodology
help researcher to evaluate both qualitative and quantitative data and information. In
this researcher paper, the investigator involved research design, data analysis, data
collection and data interpretation methodologies for improving the effectiveness of the
investigation.
In this research article, the mixed research design is presented that involves both
quantitative and qualitative research design. It is observed that the quantitative
research design provide numerical information about the type 2 diabetes and the
researcher used this method for enhancing the effectiveness of the paper. Moreover,
qualitative research design provides theoretical information and data about the
research topic and relevant information collected from the previous investigation and
study. The major strength of the mixed research design is that it provides both
qualitative and quantitative information about the research topic by which students can
evaluate both theoretical and numerical information. There are few other strengths of

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this design such as more efficient, accurate, reduce time and cost. It is analysed that the
main key weakness of this design is that it reduces the quality of the information due to
which reader cannot understand the significance of the diabetes care (Wentworth, et al.,
2014). Moreover, it also effects the overall results and outcomes identified from the
research and it reduces the flexibility and in depth analysis about the research topic.
From this research design, it is analysed that the BMI value of individual that age
between 18 and 65 years are around 25 to 30 kg/m2. Moreover, if the value of HbA is
less than 6.5% then the patient can suffer from the issue of diabetes (Wentworth, et al.,
2014). The theoretical information is collected from various resources, for example,
online libraries, journal papers, previous studies and American diabetes association
reports. A survey is also conducted by the researcher in order to gather the views of
other individuals and the investigator about multidisciplinary diabetes care.
Data collection
In this journal, the paper investigator used the survey through questionnaire
instrument in order to collect the primary data. In which the survey is transferred to the
individuals and collected their opinions on type 2 diabetes. More than 80% of
individuals suggested that the bariatric surgery increase the glycaemia in the
individuals that have an obesity problem but their effects are uncertain in the
overweight patients with this infection. Moreover, research used the open label,
randomised controlled and parallel group trail between 2009 and 2013 and observed
that individuals aged between 18 and 65 years have around 25 kg/m2 body mass index
(Wentworth, et al., 2014). Rest of individuals evaluated that excess body weight is one
of the common drivers of the type 2 diabetes health disease. The secondary data and
information are collected from the recent research studies and literature reviews which
contain the views of another investigator.
Term validity is one of the major concerns with this investigation and researcher
affected by the previous investigation and their research gaps. The researcher also faced
many problems in order to collect the relevant data and reduce the research gaps
occurred in the previous investigation (Wentworth, et al., 2014). Moreover, the internal
validity is affected through the flaws within the investigation such as not monitoring the
issues occurs in the research design and problem with the data collection method. It is

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observed that there are few key factors that affected that internal validity of the paper
such as subject validity, size of the survey, history of the research topic, attrition and
instrument sensitivity.
Reliability is one of the major key factors in the field of investigation that
produce consistent and stable outcomes at the end of the research study. In this paper,
researcher provided the information and data about the multidisciplinary diabetes care
which is sufficiently reliable and they also evaluated the diabetes care with and without
bariatric surgery in obese individuals (Wentworth, et al., 2014). With the help of the
reliability process individuals can assess the quality of the information produced by the
researcher during the investigation.
Literature review and sampling design
Wentworth, et al., (2014) analysed that the management of the diabetes disease
is framed and designed within the chronic infection model with an expectation of liberal
worsening. In which the researcher conducted a survey and collected the opinions of
other experts and evaluated that overweight is one of the key drivers of the diabetes
heath issue. American Diabetes Association, (2015) identified that the impact of the
bariatric surgery in the excess weight individuals with diabetes issues are limited. The
researcher also suggested that the laparoscopic is a very common method for the obese
individual that has a better security profile rather than bariatric operations
(Garabedian, Ross-Degnan, & Wharam, 2015). A recent study about type 2 diabetes
indicated that the gastric banding persuaded the diabetes reduction more frequently as
compared to medical therapy. Powers, et al., (2017) postulated that the laparoscopic
technique for diabetes care can enhance the glycaemic control with acceptable cost and
security rather than multidisciplinary diabetes care. Moreover, the researcher also
argued that when laparoscopic gastric band added with the multidisciplinary care for
the overweight individuals then it is analysed that this process enhances the glycaemic
control with the better adverse action profile (Zinman, et al., 2015).
Yes, this literature review is sited and explained the information and key
statements which are relevant to the research topic. In which views of other
investigators are also described and they provided enough information about the type 2
diabetes health disease (Menke, Casagrande, Geiss, & Cowie, 2015). The target

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populations of this journal paper are individuals, obese patients, diabetes people and
other diabetes care providers. In this discussion section, the sample sizes are obtained
with the help of probability sampling method. Moreover, the sampling method includes
the age and body mass index of the individual or diabetes patients. The inclusion
criteria were age between 18 and 65, body mass index (BMI) between 25 and 30 kg per
m2, diabetes time was less than the five years and willingness to be randomised to the
group study (Wentworth, et al., 2014).
The exclusion criteria were involved in the positive glutamic acid autoantibody
titre, recent bariatric surgery, hypothalamic infection, history of psychosis, and
laparoscopic adjustable gastric banding surgery (Wentworth, et al., 2014).
In this research, a study researcher is attended to the ethical consideration and
they also follow the proper guidelines of the investigation. For providing credit to other
research scholar author involved the in-text citation in each paragraph (Wentworth, et
al., 2014). The investigator did not influence anyone for delivering the data and info
and they did not provide any manipulative data about the type 2 diabetes infection.
Findings and recommendation
From this journal paper, it is founded that around 51 individuals were
randomized to the multidisciplinary care and gastric band group where around 23
individuals completed follow up of 2 years. More than 12 individuals in the
multidisciplinary care plus gastric band and two experts in only multidisciplinary care
achieved the type 2 diabetes remissions (Wentworth, et al., 2014). One individual in the
gastric band team required revisional surgery and 4 another consumer had an entire
five episodes of food intolerance due to the huge adjustment of the system.
It is concluded that laparoscopic adjustable gastric process linked with the
multidisciplinary diabetes care is more accurate and effective for monitoring the
glucose concentrations as compared to multidisciplinary care. Moreover, the researcher
also evaluated that the multidisciplinary diabetes technique has the potential to
enhance the glucose regulator and decrease the rate of drug burden (Wentworth, et al.,
2014).

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It is recommended that diabetes patient can follow the proper diet and exercise
plan in order to reduce the problem of type 2 diabetes. The researcher recommended a
healthy diet plan for all individuals and participants. Multivitamin elements were
recommended by the author to all diabetes patients in the gastric banding team and
diabetes care focused on the diabetes infection, sick day process and blood glucose
controlling. The limitations of this paper are that the researcher did not provide in
depth analysis about diabetes care and they did not explain the advantages and
disadvantages of multidisciplinary diabetes care.
Conclusion
This study explained the multidisciplinary diabetes care with and without
bariatric surgery in obese individuals. Moreover, the researcher also discussed
methodologies, sampling design, data collection, literature review and ethical
consideration. The findings and results of the investigations are also discussed and a
recommendation is provided by the researcher to monitor the problem of diabetes.

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References
American Diabetes Association. (2015). Standards of medical care in diabetes—2015
abridged for primary care providers. Clinical diabetes: a publication of the
American Diabetes Association, 33(2), 97.
Garabedian, L. F., Ross-Degnan, D., & Wharam, J. F. (2015). Mobile phone and
smartphone technologies for diabetes care and self-management. Current
diabetes reports, 15(12), 109.
Menke, A., Casagrande, S., Geiss, L., & Cowie, C. C. (2015). Prevalence of and trends in
diabetes among adults in the United States, 1988-2012. Jama, 314(10), 1021-
1029.
Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., ... & Vivian,
E. (2017). Diabetes self-management education and support in type 2 diabetes: a
joint position statement of the American Diabetes Association, the American
Association of Diabetes Educators, and the Academy of Nutrition and
Dietetics. The Diabetes Educator, 43(1), 40-53.
Wentworth, J. M., Playfair, J., Laurie, C., Ritchie, M. E., Brown, W. A., Burton, P., ... &
O'Brien, P. E. (2014). Multidisciplinary diabetes care with and without bariatric
surgery in overweight people: a randomised controlled trial. The lancet Diabetes
& endocrinology, 2(7), 545-552.
Zinman, B., Wanner, C., Lachin, J. M., Fitchett, D., Bluhmki, E., Hantel, S., ... & Broedl, U. C.
(2015). Empagliflozin, cardiovascular outcomes, and mortality in type 2
diabetes. New England Journal of Medicine, 373(22), 2117-2128.