Role of Physical Activity in Management of Diabetes – Initial Steps for an Evidence-Based Project

Introduction

Diabetes is one of the most significant health problems that affect the general population.  This project focuses on establishing the impact that physical activity has on the prevention and management of diabetes. A greater understanding of the relationship that exists between exercise and diabetes can help improve how diabetes is managed.

Overview of the Problem

Diabetes is a significant health problem due to its chronic tendency and difficulty to manage. The prevention of diabetes plays an important in the management of the condition worldwide. However, considering that there has been an increase in the number of people diagnosed with the health condition, it is important to explore alternative means of prevention and management of d. Physical activity has been shown to play an essential element in the management of this condition and thus forms the basis of this paper.

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Purpose Statement

The purpose of this paper is to establish the link between exercise and diabetes. This is significant in shedding more light on how best the condition can be prevented, especially for those in high risk of developing diabetes. The second significance is in establishing whether exercise can be effectively employed in the management of diabetes. 

Background and Significance

There has been an increase in the number of people who have diabetes. Lifestyle changes have been a significant contributor to this fact. One of the considerable factors in lifestyle has been diet and physical activity. A big part of management has been on nutrition and medication aimed at either preventing or managing acute symptoms and complication. Exercise has been shown to have a high potential in contributing to a better outcome in the management of the condition. Because increased activity improves the utilization of glucose, it has a huge potential in contributing to the management of diabetes.

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PICOt Clinical Question

To be able to carry out impactful research on a given topic, it is of considerable significance to develop a relevant question that correctly captures the aims and the objectives of the study. This helps to guide a researcher in its mission to establish credible findings that can be adequately applied to develop a solution. The PICOt structure is an essential element that is widely used in the formulation of a relevant clinical question while researching a given subject.

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The PICOt question for this paper is: Does increased physical activity improve health outcomes in patients who have diabetes type 2? The following table illustrates the breakdown of this question into various parts of the PICOt.

PICOt element    Part of the Question
P= Population    Patients with diabetes type 2
I= Intervention    Increased physical activity
C= Comparison    Those leading sedentary lifestyles
O= Outcome    Improved management of diabetes
t= Time    Not applicable in this question

The population of the study must be captured in the question when it is of interest to the researcher. In this case, the population of interest is the patients that are suffering from diabetes type 2. In some instances, the population is not indicated, especially when the intervention under study is expected to apply to a wide range of the population. An intervention is defined as the element that is introduced and its effectiveness is to be tested. It is included in all questions where the intervention is the principal element under study. It is what is expected to give an outcome that can be compared with previously used interventions. Time is an essential element when a given study is to be restricted. However, there is no need for time restriction in this study, and, therefore, the aspect of time is not included.

Literature Review

A literature review is an essential element in any research project, and especially one that seeks to establish and highlight the existing knowledge regarding a given topic of interest. For this evidence-based project paper, a search was conducted on Google Scholar, PubMed, NCBI, and PsychINFO. These resources were used because they contain peer-reviewed and scholarly articles and research materials that are essential in forming the basis for sound evidence-based project paper. The terms and phrases used in the search process include: “diabetes type 2”, “role of exercise in diabetes”, “how exercise affect insulin function”, and “impact of exercise on health outcomes diabetics”. From the extensive search process, the following research studies were found to be most relevant for this paper.

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Way et al. (2016) assess the effect that regular exercise has on a patient’s body tissues sensitivity to insulin. The study focused on randomized controlled trials that demonstrated that exercise played a big part in the control of type 2 diabetes. The authors explained that when established exercise regimes were stopped, the patients’ diabetes control went down. The authors conclude that this clearly shows the link between exercise and control of diabetes.

According to Colbert et al. (2017), physical activity has a central role in the prevention of type 2 diabetes. The study establishes that regular physical activity is needed if the patient is to realize any meaningful outcomes. Participation in daily physical activities helps the body’s tissues to utilize glucose better. In the process, responsiveness to insulin is scaled up, and this is found to be necessary for long-term management of diabetes. Kharroubi and Darwish (2015) establish the standard regulatory mechanisms employed by the body in the usage of glucose and the control of the excess levels. Although the authors focus on the distribution and the epidemiology of the condition in terms of different regions across the world, the link between exercise and diabetes is made. The authors establish the areas where people are more sedentary face poor outcomes as regards diabetes.

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Resistance training has a significant impact on how muscles work and utilize energy (Pesta et al., 2017). The skeletal muscles are the one that takes part in the usage of the majority of the glucose that gets into the body for energy production. The researchers found that resistance training increased the use of glucose by muscles, and therefore, led to improved diabetes management. Increased physical activity improves the sensitivity of the tissues to the effects of insulin (Bird & Hawley). The writers expound that insulin acts to reduce the amount of circulating glucose by either increasing its usage by body tissues or converting the excess into storage forms. Physical activity is shown in this study to improve the management of diabetes type 2.

Critical Appraisal

The research study by Pesta et al. (2017) focuses on the role of resistance training on management of diabetes type 2. The evidence provided is reliable as it directly studies a group of people who have diabetes and how their participation in endurance training helps them manage their diabetes. The research has the weakness of not having considered whether the same findings can be found in the general population. One gap in the study is that there is no way of establishing alternative means of taking part in resistance training for those with disabilities.

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The research by Way et al. (2016) is well structured and follows the correct order. The research takes the form of a literature review which focuses on analyzing existing studies on the topic. In selecting the proper research studies to review, the authors employ a very rigorous process in searching. The articles are derived from credible sources like PubMed. To increase the relevance, the materials reviewed are the most recent, which helps to capture the most updated information on the subject.

Colbert et al. (2017) focus on principles established by the American College of Sports Medicine and the American Diabetes Association. The research study focuses on highlighting the link between exercise and control of glucose levels in people with diabetes. The authors analyze the daily lives of those who have diabetes and finds that those who exercise daily have better control of diabetes. By doing this, the research establishes its relevance as there is the employment of follow-up of people in their daily lives.

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Kharroubi and Darwish (2015) is a research that looks at the global perspective of the distribution of diabetes among different population sets. The study is relevant to this paper’s subject as it focuses on the influence of sedentary lifestyle on the management of diabetes. There is also a focus on the effect of exercise on insulin function and control of glucose levels. By taking this approach, the study can credibly conclude that a sedentary lifestyle is linked to poor control of sugar levels and, therefore, leading to poor health outcomes, especially concerning diabetes. The apparent gap in this research by Kharroubi and Darwish (2015) is whether a sedentary lifestyle contributes to the development of diabetes.

Bird and Hawley (2017) is a credible research study that focuses on the analysis of the available knowledge on the topic. The researchers assembled a wide range of researches that focuses on the subject. Through this, the authors can conclude that exercise increases sensitivity to insulin, and therefore, improve the control of glucose in the body. The central gap in the research is the fact that there is no independent of the extent to which exercise on its own contributes to the management of diabetes without the addition of anti-diabetic drugs.

Evidence-Based Practice (EBP) Standard

Based on the knowledge established above, it is possible to develop a direction on how patients can be advised further on how to prevent or manage diabetes. The table below illustrates a model that can be applied:

Patient history    Recommendations
Patient has no diabetes, but has there is a history of diabetes in family Advise patient to undertake daily exercises and to be keen the kind of diet they take.
The patient is diagnosed with diabetes    Advise the patient to adhere to medications in addition to daily exercises.

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The patient’s preferences in terms of the exercises that they might prefer should be considered. Some patients may prefer light exercises, in which case the healthcare professional should advise the patient to do them for a longer duration and more frequently to match the results that would have been achieved from rigorous exercises.

Implications

The discussion above provides many opportunities for learning and application in the management of patients with diabetes. Considering that diabetes is a chronic illness that requires long-term management, there is the need for a concerted effort to provide patients with a wide array of alternatives with which they can put to use in the management of diabetes. On research, it is clear from the works of literature reviewed above that many areas still need to be worked on. There is the need for research to be conducted on alternative ways of achieving the same resistance as that of resistance training, and especially for people with diabetes who are physically challenged and thus cannot engage fully in physical activities. There are also areas of this topic that can be used for educational purposes to improve literacy on the subject and management of diabetes. Medical professionals should be well informed of the significant contribution that exercise plays in improving the health outcomes of patients with diabetes. The general public should also be informed, frequently, of the importance of engaging in daily exercises to prevent developing diabetes. This is an essential tool for public health and can be conveyed in schools and public gatherings. In practice, it is clear that medical professionals need to seriously consider integrating the aspect of physical activity in the management of diabetic patients. It is a regular practice to rely on medications heavily. However, this paper has established that physical activity contributes to the increase of sensitivity to insulin by body tissues. This is important as it helps to increase the amount of glucose that is utilized by body tissues and therefore leads to improved control of blood sugar levels.

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