Epidemiology Discussion: Diabetes, Cardiac Events, and Studies

This discussion board post examines two key areas within epidemiology. The first post discusses the effectiveness of lifestyle changes and metformin in managing type 2 diabetes, referencing studies that compare these interventions with a placebo. It highlights the importance of lifestyle modifications, such as increased physical activity and dietary adjustments, in preventing and managing the disease. The second post analyzes a retrospective study on adverse cardiac events following noncardiac surgery, emphasizing the use of statistical analysis and the challenges posed by confounding variables. It underscores the limitations of observational studies and the importance of randomized trials for generating meaningful conclusions. The post also stresses the significance of minimizing loss in follow-up periods to ensure the reliability of research findings.

Running head: EPIDEMIOLOGY 1
Epidemiology
Student’s Name
Date of Submission

EPIDEMIOLOGY 2
Post 1:
Diabetes type 2 can be countered in different ways, either the use of drugs such as
metformin or changing lifestyles. The study carried out placed a large group of people into three
categories: receiving a placebo, a lifestyle change program and the administration of metformin
(Umpierrez et al., 2014). Use of placebo is important as a control in determining the effects of
the other two approaches. Upon a follow-up, this study concludes that use of lifestyle change and
taking metformin are effective in the reduction of type 2 diabetes. According to Dunkley et al.,
(2014), the lifestyle change program may involve high physical activity and take note of the diet
composition to avoid fat accumulation as well as excess blood sugars that might damage glucose
receptors and result in type 2 diabetes. Use of metformin (an antidiabetic drug) although also
reduces diabetes type 2 incidences, its efficiency is low as compared to lifestyle change program.
Post 2:
In the retrospective study conducted to determine the major adverse effects in noncardiac
surgery, statistical analysis on odds ratio was carried out. This statistical analysis was aimed at
determining the relative proportion of the study population who were at risk of developing major
adverse cardiac effects (Hawn et al., 2013). It is evident that confounding variables are a barrier
to a successful study. The numerous limitations associated with a clinical study may make it
difficult to draw meaningful recommendations. Generally, randomized trials generate more
meaningful conclusions as opposed to other studies which mostly generate the hypothesis
(Pearse et al., 2014). Of great importance is the follow-up period whereby it is necessary to
minimize the rate of loss in follow-up.
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EPIDEMIOLOGY 3
References
Dunkley, A. J., Bodicoat, D. H., Greaves, C. J., Russell, C., Yates, T., Davies, M. J., & Khunti,
K. (2014). Diabetes prevention in the real world: effectiveness of pragmatic lifestyle
interventions for the prevention of type 2 diabetes and of the impact of adherence to
guideline recommendations. Diabetes care, 37(4), 922-933.
Umpierrez, G., Povedano, S. T., Manghi, F. P., Shurzinske, L., & Pechtner, V. (2014). Efficacy
and safety of dulaglutide monotherapy versus metformin in type 2 diabetes in a
randomized controlled trial (AWARD-3). Diabetes care, 37(8), 2168-2176.
Hawn, M.T., Graham, L.A., Richman, J.S., Itani, K.M., Henderson, W.G., & Maddox,
T.M. (2013). Risk of major adverse cardiac events following noncardiac surgery in patients with
coronary stents. JAMA, 310(14), 1462-1472. doi: 10.1001/jama.2013.278787.
Pearse, R. M., Harrison, D. A., MacDonald, N., Gillies, M. A., Blunt, M., Ackland, G., &
Hinds, C. (2014). Effect of a perioperative, cardiac output–guided hemodynamic therapy
algorithm on outcomes following major gastrointestinal surgery: A randomized clinical trial and
systematic review. Jama, 311(21), 2181-2190.
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