Literature review on Prevention of Diabetes by use of lifestyle modifications

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Diabetes is a chronic disease for the world population whose impacts are detrimental to the future state of health. The inadequate control of diabetes increases despite the advancement in technology, methods of diagnosis, and treatment. The increased poor control of the disease is due to the failure of the intervention to the healthcare professionals and also inadequate management by the patients. It is important to focus on evidence-based practice changes that result in reduced cost of diabetes, improved documentation, quality of life, and the nursing care outcomes. The research paper focuses on a literature review on the prevention of diabetes by the adoption of lifestyle modifications. The review of literature follows a defined problem and research question using the PICOT style.

Problem Statement

Diabetes is a threat to the lives of the people living in the United States and beyond. The Center for Disease Control and Prevention, as well as other health care related agencies, have proposed and implemented several informative materials and strategies to reduce the prevalence and incidence of Diabetes. However, diabetes remains to be a major health problem and among the leading causes of death in the United States. The increased prevalence of diabetes in the United States is a clear indication that the prevention of diabetes ought to be a priority. It is probable that there is a knowledge gap in the prevention strategies for diabetes both for the providers and the patients.

PICOT question

Following the problem identified, PICO was used to formulate a question for the project. The purpose of formulating the PICO question was to provide relevant evidence research that applies to practice. The PICO question was: For the people at high risk for diabetes, will lifestyle modifications and education promote the prevention of diabetes based on a community-based care program?

Literature Review

A study was conducted to review physical activity and sedentary behavior intervention studies for the youth with type 1 diabetes. According to MacMillan, Kirk, Mutrie, Matthews, Robertson, Saunders (2014), physical activity is a recommendation for the management of type 1 diabetes, and there have been guidelines for the safe physical activity participation for the youth and adolescents. Previous studies have revealed that adequate physical activity is not adequate in diabetes management if the individuals spend a large amount of time in sedentary lifestyles. The study was a systematic review of several articles reporting on randomized controlled trials in the youth with type 1 diabetes. From the results analyzed, the intervention used had a beneficial effect on health to most of the samples. The studies faced limitations in reporting methods making comparison of the findings challenging. In most of the studies analyzed, there is a lack of unsupervised physical activity interventions that target sedentary behavior. The physical activity interventions have a significant impact on physical fitness and health.

Jaacks, Ma, Davis, et. al. (2014) explains that the changes in nutrient intake for lifestyle intervention programs can be effective in managing diabetes for the people at risk. Research conducted to assess the long-term changes in dietary and food intake behavior revealed positive impacts in a diabetes prevention program. As a randomized study, the participants for the lifestyle intervention program were obtained from the Diabetes Prevention Program for an average of 3 years and the results released after a modified lifestyle intervention. From the research, $471 billion was spent on diabetes treatment worldwide in 2012 (Jaacks, Ma, Davis, et. al., 2014).

The diabetes prevention program and other randomized controlled trials regarding lifestyle interventions have proven to be efficacious and cost-effective. The prospective observational studies have revealed that some types of food and dietary patterns results to the high risk of diabetes type 2. A lifestyle change requires that the American population adopt the whole grain foods, low-fat dairy products, and low-fat dietary patterns to decrease the risk of diabetes. Some demographic factors like age, gender, race and ethnicity have a relationship to the achievement of dietary intervention goals and present an important point for intervention. The achievement of dietary goals in diabetes prevention programs requires an active involvement of both the care providers and the community in implementing the recommended measures to diabetes management.

As further explained, disease management is crucial in type 2 diabetes. A diabetes self-management education program provides the necessary knowledge in making and maintaining lifestyle changes. However, few studies exist that focus on investigating the impact of diabetes self-management education (Rise, Pellerud, Rygg & Steinsbekk, 2013). From a study that focused on making and maintaining lifestyle changes after participating in self-management educations, it is evident that knowledge is necessary for disease management. People are motivated to make and maintain lifestyle changes though getting support from others, experiences, the fear of complications, and the formation of new habits. When the community has appropriate knowledge about disease management, they can make and maintain changes in diet, medication, and physical activity. The health care professionals in diabetes education need to be aware of the challenges encountered in convincing patients about the benefits of adhering to self-management behavior.

Diabetes self-management that includes healthy eating, physical activity, and lifestyle changes is crucial for the achievement of sustainable weight loss and glycemic control. Thus, patients with the condition ought to take responsibility in managing the disease that challenges the daily lives of patients. Thus, diabetes patient education is a major priory in ensuring effective diabetes care as well as improving the patient’s health status and quality of life. The self-management education facilitates knowledge, skills, and the abilities necessary for the achievement of behavioral and lifestyle changes.

Johnson, Jones, Freeman, et. al. (2013) reviewed whether diabetes prevention program can be translated effectively into real world settings and delivers the improved outcomes. In a synthesis of evidence from randomized trials, it is evident that intensive lifestyle interventions lead to dietary and physical activity changes and prevents Type 2 diabetes. However, there have been limited impacts of interventions for the community settings with high-risk populations. There is a potential for the interventions to be feasible and also have an impact on the future progression of diabetes in the at-risk individuals. The intervention on diabetes management and prevention results to weight change and changes in blood glucose levels.

Cardiovascular disease and type 2 diabetes are the common health problems and account for 80 % of the cases which are preventable by lifestyle modifications. There have been previous studies on the physiological effects of lifestyle focused treatment, but the experiences of the patients in the treatments remain unclear (Ljung, Olsson, Rask & Lindahl, 2013). The participants who underwent a group-based lifestyle treatment passed through a process of self-development that deepened their understanding of the responsibility for health and support for others. The main risk factors for the cardiovascular and diabetes diseases have a direct relationship to lifestyle, and most of the morbidity is preventable through lifestyle changes. Physical inactivity, tobacco use, and poor eating habits are the common risk factors for diabetes and other cardiovascular diseases.

From the reviewed articles, the evidence provides strong support for a change of practice in the strategies used to address the increasing prevalence to diabetes. The care providers ought to be more resourceful in identifying the appropriate lifestyle modifications that help to prevent and manage diabetes. The studies also cite the importance of self-management practices which can be effective in addressing the issue. The integration of the information obtained from the studies provides a rich background for the project on the Prevention of Diabetes by use of lifestyle modifications.


Jaacks, L. M., Ma, Y., Davis, N., Delahanty, L. M., Mayer‐Davis, E. J., Franks, P. W., … &          Wylie‐Rosett, J. (2014). Long‐term changes in dietary and food intake behavior in the         Diabetes Prevention Program Outcomes Study. Diabetic Medicine, 31(12), 1631-1642.

Johnson, M., Jones, R., Freeman, C., Woods, H. B., Gillett, M., Goyder, E., & Payne, N. (2013)   Can diabetes prevention programs be translated effectively into real‐world settings and   still deliver improved outcomes? A synthesis of evidence: Diabetic Medicine, 30(1), 3-   15.

Ljung, S., Olsson, C., Rask, M., & Lindahl, B. (2013) Patient experiences of a theory-based          lifestyle-focused group treatment in the prevention of cardiovascular diseases and type 2      diabetes: International journal of behavioral medicine, 20(3), 378-384

MacMillan F, Kirk A, Mutrie N, Matthews L, Robertson K, Saunders DH. (2014) A systematic    review of physical activity and sedentary behavior intervention studies in youth with type       1 diabetes: study characteristics, intervention design, and efficacy. Pediatric Diabetes: 15: 175–189. doi: 10.1111/pedi.12060

Rise, M. B., Pellerud, A., Rygg, L. Ø., & Steinsbekk, A. (2013) Making and maintaining lifestyle             changes after participating in group based type 2 diabetes self-management educations: a    qualitative study. PLoS one, 8(5), e64009.

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