Exercise for Type 2 Diabetes & Obesity Control Assessment Answer

PART A:

PART B:

Introduction

The study title is "effectiveness of combined exercises on glycemic control and weight loss among patients with type 2 diabetes and obesity". The study aims to evaluate if implementing physical activities or combined exercises in the care strategies of patients suffering from t2d and obesity will help regulate the glycemic index in the patients and reduce weight loss. As per reports, the prevalence of obesity in Australia is as high as 31%, which significantly impacts the risk of developing type 2 diabetes (AIHW, 2022). The prevalence rate for diabetes is reported amongst 2.2% of Australian adults and contributes up to 0.3% of the national health burden (AIHW, 2022). The association of glycemic index or concentration in the patients is significantly identified for both- obesity and t2d. Glycemic regulation in the body leads to different pathological pathways stimulating the maintenance of blood glucose levels and fat accumulation within the body (Magkos et al., 2020). The higher glycemic level in an individual has been clinically identified as a risk for facilitating the symptoms of type 2 diabetes by causing disruption in the biological metabolism and hampering the efficient release of insulin within the body. Another significant risk associated with a higher glycemic index or enhanced consumption of a diet with excessive carbohydrate content is that it leads to unregulated weight gain, progressing into the chronic condition of obesity (Clemente-Suarez et al., 2022). Studies have revealed that consumers often consume 60–70% additional caloric intake in subsequent meals due to the insulin spike brought on by eating high-GI meals. Low-glycemic diets, on the contrary, do not activate the hormones that can contribute to hunger urges (Kaur et al., 2021).

This paper explores the impact of incorporating clinical interventions like combined exercises, which enhance patients' physical activity rate. Both people without t2d and the public at large can reduce their heart disease risk by engaging in physical activity (PA). Research also points to a reduction in HbA1c in individuals with t2d. The reduction of glycemic variability in diabetic individuals was substantially influenced by the physical exercise treatment (Gaesser & Angadi, 2021). Vigorous exercise therapy may be more advantageous for individuals with higher BMI levels and fewer disease durations. NEFA, glycerol, hormones, cytokines, proinflammatory chemicals, and other compounds implicated in the formation of insulin sensitivity are in higher amounts in obese people (Dragano et al., 2020). Diabetes is brought on by insulin sensitivity and a decline in -cell functionality. Thus, the interdependency of obesity and t2d becomes evident, implying that weight loss can also help regulate the glycemic index. A healthier diet and consistent physical activity are both better for weight reduction than calorie reduction alone. Certain disorders' consequences can be avoided or even reversed by exercise. Exercise reduces cholesterol and blood pressure, which may help to ward against cardiac arrest (Magkos et al., 2020). This paper highlights the efficiency of employing a combined exercise intervention in facilitating glycemic control and weight loss for obese and t2d patients.

Literature Review (Conclusion)

Different cross-sectional and longitudinal pre-existing clinical studies support the research objective for the evaluation and implementation of combined exercises. The importance and benefits of physiological exercise training for type 2 diabetes and obesity patients are based on the metabolic and pathological responses of the body. Glycemic control is a significant aspect that contributes to the prevalence and prevention of both t2d and obesity. As per reports, a significant ratio of the adult Australian population (30%) do not partake in adequate physiological activities in their everyday routines (AIHW, 2022). The lack of physical activity has led to an evident increase in the risks of developing chronic ailments like t2d and obesity due to the unregulated glycemic levels in the body. Cross-sectional research was conducted to evaluate the impact of extensive physical exercises and dietary modifications causing an evident difference in efficient glycemic regulation (Kim et al., 2021). The manipulation of the outcome strategy based on the various confounders while evaluating the effect of intermediate or moderate physical activities found a difference of less than 0.001 prevalence between the control and intervention groups. The research also showed that approximately 0.049 prevalence rate difference was observed among the patients complying with the physical exercise intervention (Kim et al., 2021).

A longitudinal study conducted for five years with a range of Asian patients reveals that a distinguished rate of glycemic control can be observed based on the varying healthcare interventions implemented. A mean difference of less than 0.1% was highlighted as the primary research finding among the different groups of participants and the different kinds of healthcare interventions (Tan et al., 2015). The study established a positive relationship between glycemic control and t2d in patients. The interdependency of the variables helps understand the effect and significance of glycemic regulation for maintaining the symptoms of t2d in the patients. The study also emphasises the effect of ethnicity on the ability to regulate the glycemic levels in the individual (Tan et al., 2015). The cross-sectional research was carried out for the estimation of the self-efficacy of exercises and glycemic control among adult participants who have diabetes. The study findings show that 32.7% of participants had an insufficient physical activity or took part in regular exercise routines. The evaluation of glycemic control among diabetic patients with insufficient physical activities revealed that approximately 76.9% of participants had poor glycemic regulation capabilities. This research outcome is significant in understanding the significance and impact of physical activities or combined exercises among diabetic patients to effectively control and manage the glycemic index (Mahmudiono et al., 2021). Based on the analysis of the research outcomes as discussed and supported by the pre-existing studies, it can be estimated that the implementation of combined exercises can help efficiently reduce weight and regulate the glycemic levels among individuals with t2d or obesity. This further helps highlight the positive enhancement in the abilities to control the glycemic index and weight loss by integrating combined exercises in patients with t2d and obesity.

Reflection

As a student nurse, it is essential to implement clinical interventions which help in stimulating natural or pathophysiological pathways in primary healthcare strategies. As a healthcare student, I am aware of the health burden caused by the increasing prevalence of t2d and obesity in the population. In my opinion, prominent dietary habits and a deteriorating rate of physical activity are the major risk factors for developing chronic conditions like type 2 diabetes and obesity. During my research and study regarding the discussed study objective, I came across multiple clinical trials conducted across various variables. The evident gaps in accurately identifying the risk factor associated with glycemic control in patients of t2d and obesity; are the environmental, demographical, and socio-economic factors. To overcome the research gaps, I have considered studies from different regions, which has helped me obtain good research outcomes across diverse sections of the population or within different study settings.

During my research for the study objective, I encountered studies with the primary focus on a particular group based on a specific research setting or a particular section of the population, like cohort studies. The healthcare cohort studies are significant in understanding a variable's impact within the defined demographic scenario. Considering such research in my study helps explore the responses towards glycemic control among a varying target population. The consideration of a cohort longitudinal study highlighted the influence of ethnicity on glycemic regulation abilities in a diverse range of community groups. This study helps draw the perception that the frequency or severity of the combined exercises can vary between patients belonging to a particular section or ethnicity. This input or estimation would affect the current approach associated with the research objective.

Being a nursing student, the current research objective will help me in my future clinical practices by helping me understand the importance and effectiveness of implementing the non-pharmacological intervention of combined exercises for significant weight loss and glycemic regulation. Integrating non-pharmacological care strategies helps the patients modify and enhance their quality of life by encouraging lifestyle modifications to eliminate the chances of stimulating the risk factors. Towards the end of my research concerning the study objectives, I felt more knowledgeable. I understood that future clinical studies could be more inclined towards integrating exercises as a glycemic regulation and weight loss intervention for patients with diabetes and obesity. I am aware of the risks associated with prolonged exposure to pharmacological elements employed in treating t2d and obesity, which encouraged me to consider combined exercises as an effective medium to enhance the patient's ability to control the glycemic levels naturally and to lose weight. The current study has helped me identify the existing gaps and the significance of combined exercises in weight loss and t2d, enhancing the quality of care I provide to my patients and ensuring patient-centric health enhancement.

References

AIHW. (2022). Diabetes. https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-many-australians-have-diabetes/type-2-diabetes

AIHW. (2022). Diabetes: Australian Facts. https://www.aihw.gov.au/reports/diabetes/diabetes-australian-facts/contents/diabetes-risk-factors/overweight-and-obesity

AIHW. (2022). Insufficient physical activity. https://www.aihw.gov.au/reports/australias-health/insufficient-physical-activity

Clemente-Suárez, V. J., Mielgo-Ayuso, J., Martín-Rodríguez, A., Ramos-Campo, D. J., Redondo-Flórez, L., & Tornero-Aguilera, J. F. (2022). The burden of carbohydrates in health and disease. Nutrients, 14(18), 3809. https://www.mdpi.com/2072-6643/14/18/3809#

Dragano, N. R., Fernø, J., Diéguez, C., López, M., & Milbank, E. (2020). Reprint of: recent updates on obesity treatments: available drugs and future directions. Neuroscience, 447, 191-215. https://doi.org/10.1016/j.neuroscience.2020.08.009

Gaesser, G. A., & Angadi, S. S. (2021). Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. Science, 24(10), 102995. https://doi.org/10.1016/j.isci.2021.102995

Kaur, J., Kaur, K., Singh, B., Singh, A., & Sharma, S. (2021). Insights into the latest advances in low glycemic foods, their mechanism of action and health benefits. Journal of Food Measurement and Characterization, 1-14. https://doi.org/10.1007/s11694-021-01179-z

Kim, Y.M, Kim, J.D., & Jung, H. A. (2021). Cross-sectional study of the effects of physical activity and nutrient intakes on blood glucose control rates in middle-aged and elderly diabetes patients: Korean national health and nutrition examination survey 2015-2017. Inquiry: The Journal of Health Care Organization, Provision, and Financing. 2021;58. https://doi.org/10.1177/00469580211035727

Magkos, F., Hjorth, M. F., & Astrup, A. (2020). Diet and exercise in the prevention and treatment of type 2 diabetes mellitus. Nature Reviews Endocrinology, 16(10), 545-555. https://doi.org/10.1038/s41574-020-0381-5

Mahmudiono, T., Setyaningtyas, S. W., Rachmah, Q., Nindya, T. S., Megatsari, H., Indriani, D., & Kriengsinyos, W. (2021). Self-efficacy in physical activity and glycemic control among older adults with diabetes in Jagir Subdistrict, Surabaya, Indonesia. Heliyon, 7(7), e07578. https://doi.org/10.1016/j.heliyon.2021.e07578

Mengistu, W., Soromessa, T., & Legese, G. (2020). Method for conducting systematic literature review and meta-analysis for environmental science research. MethodsX, 7, 100777. https://doi.org/10.1016/j.mex.2019.100777

Tan, N. C., Barbier, S., Lim, W. Y., & Chia, K. S. (2015). 5-Year longitudinal study of determinants of glycemic control for multi-ethnic Asian patients with type 2 diabetes mellitus managed in primary care. Diabetes Research and Clinical Practice, 110(2), 218-223. https://doi.org/10.1016/j.diabres.2015.07.010

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