PICOT Question - Type 2 Diabetes(T2DM) In Obese Patients

PICOT Question – Type 2 diabetes(T2DM) In Obese Patients

Background of Nursing Practice Problem (one paragraph; no more than 250 words):

Type 2 diabetes mellitus (T2DM) remains a global health concern. The global prevalence of the disorder stands at over 425 million. In the US, over 38 million people have diabetes (Dambha-Miller et al., 2023). The numbers are expected to double by the end of the century. Notably, comprehensive management of diabetes focuses on preventive efforts and aggressive hyperglycemic control using pharmacological and non-pharmacological interventions. Carbohydrate control is one of the lifestyle measures continuously implemented to optimize glucose control in diabetics. However, there is a growing concern about the effectiveness of complying with a carb-controlled diet in increasing the probability of remission of diabetes (Dambha-Miller et al., 2023).

PICO(T) Question:

PICO(T) Question Template
P	Population	Obese patients with type 2 diabetes
I	Intervention	Compliance with carb-controlled diet.
C	Comparison	Standard medical therapy
O	Outcome	Increasing probability of remission of diabetes
T	(optional)
Intervention
In obese patients with type 2 diabetes (P), is compliance to a carb-controlled diet (I) more effective than standard medical therapy (C) at increasing the probability of remission of diabetes (O)?
Problem Statement
It is not known if compliance with a carb-controlled diet (I) would increase the probability of remission of diabetes (O) among obese patients with type 2 diabetes (P) (Dambha-Miller et al., 2023).

Criteria	Article 1	Article 2	Article 3	Article 4
APA Reference Include the permalink or working link used to access the article	Tricò, D., Masoni, M. C., Baldi, S., Cimbalo, N., Sacchetta, L., Scozzaro, M. T., Nesti, G., Mengozzi, A., Nesti, L., Chiriacò, M., & Natali, A. (2023). Early time-restricted carbohydrate consumption vs conventional dieting in type 2 diabetes: A randomised controlled trial. Diabetologia, 67(2), 263–274. https://doi.org/10.1007/s00125-023-06045-9	Unwin, D., Delon, C., Unwin, J., Tobin, S., & Taylor, R. (2023). What predicts drug-free type 2 diabetes remission? Insights from an 8-year General Practice Service Evaluation of a lower carbohydrate diet with weight loss. BMJ Nutrition, Prevention & Health, 6(1), 46–55. https://doi.org/10.1136/bmjnph-2022-000544	Poon, J. L., OHara, L., Kendal, H., Sully, K., Guy, M., Bradley, H., Tolley, C., & Mason, B. (2024). Perceptions and experiences of people with obesity and type 2 diabetes around appetite and eating behaviors: A qualitative study. Advances in Therapy, 41(5), 2028–2049. https://doi.org/10.1007/s12325-024-02846-5	Viljoen, A., Yu, K., Witchell, E., & Conklin, A. I. (2023). Prescribing diabetes nutrition therapy: A qualitative study of dietitians’ experiences of carbohydrate restriction in Canada. BMJ Nutrition, Prevention & Health, 6(1), 83–90. https://doi.org/10.1136/bmjnph-2022-000532
Purpose/Aim of Study	To provide insights into the feasibility, efficacy, and safety of early time-restricted consumption of carbohydrates (eTRC) in people with type 2 diabetes	To evaluate the effectiveness of standard care plus a web-based health education of low carbohydrate diet program compared to standard care only on glycemic control in adults with T2DM.	To explore the perceptions and experiences of people with obesity or diabetes regarding appetite and eating behaviors	To explore dietitian experiences prescribing carbohydrate-restricted diets.
Research question(s)	What is the impact of early time-restricted consumption of carbohydrates on glucose homeostasis?	Does standard care plus a low carbohydrate diet result in low HbA1c levels?	What are the perceptions and experiences of obese individuals and diabetics regarding appetite and eating?	What are dietitians’ experiences prescribing diabetes nutrition therapy?
Design Is the article qualitative, quantitative, or mixed methods? Explain how you determined the type of research design.	The study is quantitative. It utilizes numerical figures to represent its findings.	Quantitative study: It utilizes numerals to represent its findings.	Qualitative design: Data is presented in non-numerical forms.	Qualitative: Data is represented in non-numerical forms.
Setting Where did the study take place? What type of setting: inpatient, outpatient, etc.?	The study took place in a University hospital and targeted obese patients in either inpatient or outpatient care.	The study took place in a community setting.	The study took place in a community setting.	The study took place in an outpatient setting.
Sample Number and characteristics of participants	The sample size was 27. Participants were obese and had a diagnosis of type 2 diabetes.	The study had 98 participants. The participants were all adults.	The participants were 45 adults. Participants were either diabetics or obese.	The sample size was 47 respondents. The participants were dietitians.
Methods Interventions/Instruments	A randomized control trial in which the intervention group was placed into two groups and observed over 12 weeks,	Randomized control trials, in which participants were placed into two groups and observed over 16 weeks.	Semi-structured qualitative interviews	Qualitative study using free-text responses.
Analysis How were the collected data analyzed?	Data was collected through observation and HbA1c analysis. The data obtained was scrutinized through statistical and exploratory data.	Data was collected through observation. Collected data was analyzed through statistical analysis.	Data was collected through interviews and analyzed through descriptive analysis.	Data was collected through survey forms and analyzed through thematic analysis.
Outcomes/key findings of the study and implications for nursing practice Summary of study results	An analysis of a 14-day average glucose profile showed that eTRC diets had only two early postprandial glucose peaks compared to three in Mediterranean diets.	Reduction in HbA1c, weight, and medication requirements was noted in patients on standard care plus a low carbohydrate diet.	Participants recognized the significance of food in diabetes management and described the need to make food-related decisions based on the carbohydrate content.	Carbohydrate-restricted diets are effective in optimizing glycemic control. Knowledge of their use was informed by scientific literature.
Recommendations of the researcher	eTRC diets are feasible and effective in optimizing glycemic control.	A low-carbohydrate diet should be incorporated into the management of patients with diabetes.	Educating adults on the factors that guide their food choices is important in ensuring healthy food choices that are restrictive of carb intake.	There is a growing desire for evidence-based discussion and education on diabetes nutrition within the community.
Explain how this article supports your proposed PICO(T) question.	The article addresses the intervention and outcome components of the PICOT. They affirm the effectiveness of carb-controlled diets in optimizing glycemic control and subsequently increase the probability of remission of diabetes.	The article addresses the intervention and outcome components of the PICOT. They affirm the effectiveness of carb-controlled diets in optimizing glycemic control and subsequently increase the probability of remission of diabetes.	The article addresses the population and the intervention component. The target population is diabetic adults. The researchers affirm the significance of expanding diabetics’ knowledge of healthy food choices and underline the role of carb-controlled diets in diabetes control.	The article addresses the intervention component. It demonstrates dietitians’ perspective on using carb-controlled diets in controlling diabetes.

References

Dambha-Miller, H., Hounkpatin, H. O., Stuart, B., Farmer, A., & Griffin, S. (2023). Type 2 diabetes remission trajectories and variation in risk of diabetes complications: A population-based cohort study. PLOS ONE, 18(8). https://doi.org/10.1371/journal.pone.0290791

Poon, J. L., OHara, L., Kendal, H., Sully, K., Guy, M., Bradley, H., Tolley, C., & Mason, B. (2024). Perceptions and experiences of people with obesity and type 2 diabetes around appetite and eating behaviors: A qualitative study. Advances in Therapy, 41(5), 2028–2049. https://doi.org/10.1007/s12325-024-02846-5

Tricò, D., Masoni, M. C., Baldi, S., Cimbalo, N., Sacchetta, L., Scozzaro, M. T., Nesti, G., Mengozzi, A., Nesti, L., Chiriacò, M., & Natali, A. (2023). Early time-restricted carbohydrate consumption vs conventional dieting in type 2 diabetes: A randomised controlled trial. Diabetologia, 67(2), 263–274. https://doi.org/10.1007/s00125-023-06045-9

Unwin, D., Delon, C., Unwin, J., Tobin, S., & Taylor, R. (2023). What predicts drug-free type 2 diabetes remission? Insights from an 8-year general practice service evaluation of a lower carbohydrate diet with weight loss. BMJ Nutrition Prevention & Health, 6(1), 46–55. https://doi.org/10.1136/bmjnph-2022-000544

Viljoen, A., Yu, K., Witchell, E., & Conklin, A. I. (2023). Prescribing diabetes nutrition therapy: A qualitative study of dietitians’ experiences of carbohydrate restriction in Canada. BMJ Nutrition, Prevention & Health, 6(1), 83–90. https://doi.org/10.1136/bmjnph-2022-000532

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Question

The purpose of this assignment is to refine the PICOT question you developed in the discussion forum this week and begin evaluating literature that you will use in subsequent weeks to write your research paper.

PICOT Question – Type 2 diabetes(T2DM) In Obese Patients

Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following:

Review the feedback you have received in the discussion forum related to your PICOT question so far. Make any necessary edits to your PICOT question.
Conduct a literature search to locate four research articles focused on your selected nursing practice problem of interest. Note: This literature search should include two quantitative and two qualitative, peer-reviewed, primary research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology. The two articles identified in Topic 1 DQ 2 can be used should you still find them relevant to your PICOT question.
Articles must be published within the past 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

The PICOT question and four peer-reviewed research articles you chose will be utilized for subsequent assignments.

Note: For best search results, do not include the words qualitative and quantitative in your search terms. Do include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic reviews, literature reviews, and metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

PICOT QUESTION:
In obese patients with type 2 diabetes, is compliance to a carb-controlled diet more effective than standard medical therapy at increasing the probability of remission of diabetes?

PICOT Question – Type 2 diabetes(T2DM) In Obese Patients