How to Deal With Diabetes in the Western World Research Paper

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Patients With Type 2 Diabetes

I --all-natural, all-organic, locally grown/produced diet plus exercise

C --insulin injections

O --reduction in body's challenge to create/absorb insulin

In patients experiencing Type 2 diabetes (P), is the intervention of a traditional, organic, all-natural diet consisting of locally grown and produced foods plus exercise (I) more effective in curbing the body's challenge to absorb insulin (O) than insulin injections (C)?

There is an educational deficit in the clinic where I previously worked regarding the positive effect that an all-natural, organic diet consisting of locally produced foods can have on a patient with diabetes. Most patients believe that if their pancreas is not producing enough insulin that they need to receive insulin injections. This is the conventional attitude because of the widespread use of this method to treat the disease. Yet there are numerous studies that link obesity to diabetes and even some studies that show that diabetes can be eradicated with the proper restoration of diet and exercise to one's daily life (Davis, 2008).

The problem in this clinic is that this literature is not discussed or disseminated among health care providers or patients and so there is no educational approach to treating diabetes using alternative means. This problem can be observed directly in the clinic. There is no literature available for alternative methods of combating diabetes, and while healthy practices might be recommended, they are not prescribed with the same assurance that insulin is prescribed. But this is like allowing the patient to continue to go on leading an unhealthy life by just continually treating the symptoms instead of the disease itself. The gravity of this situation is discernible in the fact that all over obesity rates are increasing and in this clinic especially one should think that an alternative approach to this question of diabetes would be of tantamount importance but both patients and physicians are content to treat the symptoms only.

This issue is significant to nursing because the nurse is the individual who goes between the patient and the physician and often understands what the patient is experiencing and understands the implications of alternative methods and is more willing to promote them than the physician who operates within the status quo standards of established practice.

The solution to this issue is to run trials in which the only prescription is a healthy diet and exercise that conforms to eating and exercising habits of the time before fast food and manufactured diets became commonplace. The effect that this prescription has on the lives of patients with diabetes will be monitored directly over a 12 to 18-month period in order to describe the extent to which it actually combats Type 2 diabetes.

Part Three

Ajala, O., English, P., Pinkney, J. (2013). Systemic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. American Journal of Clinical Nutrition, 97(3): 505-516.

This study assesses the impact of different diets on diabetes and finds that low-carb, low-GI, Mediterranean and high-protein diets can be effective in treating people with diabetes by strengthening the cardiovascular system. This study supports the proposed changes.

Barnard, N., Cohen, J., Jenkins, D. et al. (2009). A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. The American Journal of Clinical Nutrition, 89(suppl): IS-9S.

This study shows a low-fat vegan diet can "improve glycemia and plasma lipids" more than a conventional diet. It does not assess whether there is clinical value to this study but its findings do support the proposed changes of this study as it notes the positive impact of diet on the disease.

Billings, L., Florez, J. (2010). The genetics of type 2 diabetes: what have we learned from GWAS? Annals of the New York Academy of Sciences, 1212: 59-77.

This study mainly focuses on the genetic aspect of the disease and how it develops. It does not focus on causes such as diet or exercise, nor does it focus on morbidity or rate of incidence. It does not focus on the gravity of the issue nor does it provide support for the proposed change of this study.

Catalano, P, Kirwan, J., Mouzon, S., King, J. (2003). Gestational diabetes and insulin resistance: Role in short- and long- term implications for mother and fetus. The Journal of Nutrition, 133(5): 16745-16835.

This study focuses on the impact of gestational diabetes on mothers and the possibility for Type 2 developing after birth in the mother.

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The study links obesity to the development but it does suggest that the disease is treatable during pregnancy. It neither supports nor denies support for the proposed changes of this study.

Crowther, C., Hiller, J., Moss, J. et al. (2005). Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. The New England Journal of Medicine, 352: 2477-2486.

This study notes the importance of identifying and treating diabetes during pregnancy so that the baby is not harmed. The study does not focus on rate of incidence but does provide a window into the effect of diabetes on pregnancies. Like the study by Catalano et al. (2003) it neither supports nor denies support for the proposals of this study.

Cunningham-Myrie, C., Theall, K., Yonger, N., et al. (2015). Associations between neighborhood effects and physical activity, obesity, and diabetes: The Jamaica Health and Lifestyle Survey, 2008. Journal of Clinical Epidemiology, 68(9): 970-978.

This article describes the problem in the same terms as I have identified it although it also includes the impact of society/environment on the spread of diabetes and how bad examples of others having bad diets and poor exercise reinforces the danger. It provide quantitative data to show the relationship between environment, activity, obesity and diabetes. The morbidity in this area has increased exponentially. This article implicitly supports the change recommended by this study and does stress the gravity of the issue.

Davis, B. (2008). Defeating Diabetes: Lessons from the Marshall Islands. Today's

Dietitian, 10(8): 24.

This article serves as the basis for the idea of this study because it was this one which posed the problem in this specific context of diet and diabetes. The article does provide quantitative data showing how diabetes rose in the Islands as a result of importing a bad Western diet and how it dropped as a result of the natives going back to their traditional natural diet. The incidence of morbidity dropped and went almost completely away by the end of the experiment. This article supports the proposed change of this study.

Ferguson, T., Tulloch-Reis, M., Wilks, R. (2010). The epidemiology of diabetes mellitus in Jamaica and the Caribbean: a historical review. West Indian Medical Journal, 59(3): 259-64.

This article traces the history of diabetes in the tropics and shows how the rate of incidence has exploded in the last 50 years since modernization has taken place in the region. The introduction of Western fast food has also risen alongside the rate of incidence of diabetes suggesting that there is a correlation between diet and disease. The disease is widespread among men and women in a population that traditionally has never suffered from this disease and obesity has become a major problem especially among women. This article implicitly supports this study.

Holmer, K., Ogden, L., Burda, B., Norris, S. (2013). Quality of clinical practice guidelines for glycemic control in Type 2 diabetes mellitus. PLoS One, 8(4): e58625.

This article discusses the standard clinical guidelines for treating diabetes. It recognizes the gravity of the disease but does not focus on morbidity or rate of incidence. Its focus is not on alternative treatment and therefore does not necessarily support the proposed changes of this study, though it also does not reject them categorically.

Kaku, K. (2010). Pathophysiology of Type 2 Diabetes and Its Treatment Policy. JMAJ,

53(1): 41-46.

This study examines the pathophysiology of diabetes and discusses methods of treatment. It focuses primarily on quality of life rather than eradication, accepting the notion that diabetes must be lived with. It does not support the proposed changes of this study and does not discuss rate of incidence or morbidity.

Liu, X., Li, C., Gong, H. et al. (2013). An economic evaluation for prevention of diabetes mellitus in a developing country: a modeling study. BMC Public Health, 13: 729.

This article concentrates on how an economy affects diabetes in the developing world and what can be done to prevent diabetes from occurring. It focuses mainly on how developing countries do not have government programs or agencies in place to combat diabetes because they are still poor. This study discusses the rate of incidence as growing but does not address causes. This article is indifferent to my proposed change because it makes no mention of the relation between diet and disease.

Reece, A. (2010). The fetal and maternal consequences of gestational diabetes mellitus.

The Journal of Maternal-Fetal & Neonatal Medicine,.....

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