Grand Canyon Link Between Diet and Diabetes Type II Research Paper Using the input and suggestions from the peer-edited first draft, write the final versio

Grand Canyon Link Between Diet and Diabetes Type II Research Paper Using the input and suggestions from the peer-edited first draft, write the final version of your research paper in 2,500 and 3,000 words.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.  Use your chosen peer-reviewed journal for in-text citations and references.
This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment. Running head: THE LINK BETWEEN DIET AND DIABETES TYPE II
The Link Between Diet and Diabetes Type II
Wendy Fernandez
Grand Canyon University
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Abstract
Type 2 diabetes mellitus is seen as one of the most common diseases worldwide. The etiology of
this disease is complex and may be correlated with irreversible risk factors like genetics,
ethnicity, age, and race, and with factors that are reversible like diet, lifestyle and physical
activities. This study’s objective is to review previous studies and to explore the correlation of
type 2 diabetes with dietary patterns and practices as well as the complications that may arise.
Dietary patterns and the lifestyle of an individual are the major enhancers of diabetes worldwide.
Creating awareness about complications in diabetes, its knowledge base and the practices
involved will help individuals control this disease better than it is being controlled currently. In
this research paper, previous prospective studies are reviewed to identify the relationship
between diet and type 2 diabetes mellitus. The findings supported the existence of a causal link
between diet and diabetes type II.
Key words: Type 2 Diabetes Mellitus, diet, correlation.
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The Link Between Diet and Diabetes Type II
Introduction
Diabetes mellitus (DM) was first discovered around 3000 years ago by the Egyptians and
Indians. Diabetes mellitus is formed from two words; diabetes, a Greek word which means
siphon- to go through, and mellitus, a Latin word which means sweet. Britain was the first
country to discover excessive sugar in urine and blood (Waqos, 2017). As time went by, more
knowledge on the disease accompanied by detailed causes and pathogenesis was obtained.
Diabetes mellitus is a metabolic disorder that is associated with hyperglycemia, which results
from either the shortage of insulin secretion or the insulin action. Diabetes mellitus can damage
the kidney, eyes, nerves and the cardiovascular system if it is not properly controlled. There are
basically three major types of diabetes Mellitus namely; type 1(T1DM), type 2 (T2DM) and
gestational diabetes Mellitus (GDM). Diabetes mellitus 1 involves the shortage of absolute
insulin because of the destruction of B cells found in the pancreas through the process of cellular
mediated autoimmune. In diabetes mellitus type 2, there is a shortage of relative insulin and
resistance of insulin is also present. Gestational diabetes mellitus, on the other hand, is any given
amount of glucose intolerance that is present during pregnancy. Diabetes mellitus can, however,
occur because of other illnesses, drugs like the genetic syndrome, malnutrition, surgery,
infections or ingestion of corticosteroids.
Hypothesis
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There is a direct correlation and causal relationship between individual dietary patterns
and lifestyle and diabetes mellitus.
Epidemiology
Diabetes mellitus type 2 (T2DM) is among the diseases that are common globally. The
estimated value of people who had T2DM by 2011 was 366 million, which was about 83%
between the ages of 20-79 years. This estimation is expected to reach 9.9% by the year 2030
(Waqos. 2017). Over half of the people diagnosed with diabetes perish due to cardiovascular
disease (CVD). It is the only cause of the end-stage renal disease, which presses for the need for
dialysis or a kidney transplant. The disease also causes blindness because it damages the retina in
adults and is called diabetic retinopathy (DR). Individuals diagnosed with T2DM are at a greater
risk of being amputated the lower limbs, 25 times greater than those who do not have the disease.
This disease killed 4.6 million people between ages 20-79 in 2011.
Physical Activity and Lifestyle.
Significantly large amounts of research data and studies show that there is a correlation
between DMT2 and the physical inactivity of an individual. In Pima, India, a high-risk
population was put under study. Non-diabetic people were observed for a period of six years.
The finding was that the rate of diabetic occurrences increased in individuals that were
physically inactive. The physical activity by individuals increases the sensitivity of an individual
to insulin. In a report that was published in 2015 by the Department of Health and Human
Services showed that physical activity greatly improved the unusual glucose endurance, in an
individual, that is caused by insulin tolerance, rather than when diabetes mellitus is due to the
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insufficient amounts of insulin circulation. Twenty-five studies were randomly carried out in a
controlled environment. Most of these studies involved aerobic exercises and they showed a
positive effect on the prevention of T2DM (Thent, 2013). Another form of exercise that had a
positive effect on T2DM is resistant to exercise. Minimal evidence was obtained based on other
forms of exercise. The mechanisms of protecting an individual’s immune system, making it
appear to have a collaboration effect with insulin. During this study, it was discovered that
contracting the skeletal muscle will promote glucose incorporation into the bloodstream. This, in
turn, increases circulation of blood in the muscles which enhances the transportation of glucose
into cells of the muscles. Internal abdominal fat is another risk factor in the insulin resistance of
an individual. Physical activity helps to reduce this risk.
The Relation Between Diet and Type 2 Diabetes Mellitus
The dietary role in the causal effect of DMT2 was put across by the Indians. The Indians
observed that diabetes was common among the rich people that were fond of consuming oils,
flour, and sugar in large amounts. Statistical evidence shows that the mortality rate of diabetes
declined during the second world war because of food shortages; therefore, implying there is a
link between diet and diabetes. A significant number of reviews have suggested the correlation
between sugar intake and the development of DMT2. Carbohydrates and fat intake only pose a
low-risk factor in this matter. A recent study resulted from the Finnish Diabetes Prevention
Study (FDS) as well as the diabetes Prevention Program (DPP) strongly support the hypothesis
that actions towards diet and physical activity of an individual can help in the prevention or
slowing down the growth of T2DM, in individuals at high-risk (Marshall, 2017). The pressing
factor, however, will be the incorporation of these results into real-life medical practice. This
section seeks to show if there is a link between diet and DMT2 coupled with evidence from
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studies. Van Dem et al, study the correlation between diet and the growth of diabetes mellitus
type 2 over a period of 12 years, with the help of Health Professionals Follow-Up Study (HPFS).
The result is that the consumption of high-fat diet and the ingestion of saturated fat are related to
an increase in the risk of DMT2. This correlation, however, dissolves when BMI is adjusted into
the study. They also came across how the frequent meat intake leads to an association of
increased risk for diabetes (Marshall, 2017).
Dietary Knowledge of DMT2
Self-dietary management is a critical factor in the provision of knowledge and skills
required by an individual in relation to their medication, nutrition, treatment, and complications.
Poor knowledge among individuals faced with DMT2 is not uncommon. Diabetes is a major
health problem affecting millions of people, an estimated 425 million in 2017 (Forouhi, 2018).
Diet is way up the chain in the cause and contribution to morbidity and mortality, globally. The
importance of diet, especially nutrients, to manage and/or prevent DMT2 is evident, but nutrition
is a difficult factor to maintain for the better management of this disease. In Saudi Arabia, for
instance, there is a rising case of a high risk of obesity because the poor choices of food, the
proportion to eat and the luxurious lifestyle has been on the rise in the country. Obese people in
Saudi Arabia are increasing, unfortunately, and the majority because of the consumption of fast
foods. This rise most definitely adds to the count of diabetes, which is sad and scary. They
indulge in low much sugar drinks leading the high risk of DMT2. Dietary behaviors of an
individual will significantly be affected by the dietary knowledge he has. There is a strong
correlation between the diet recommended for a diabetic and the number of calories required.
Over half of the diabetic patients in Saudi Arabia confirmed that they did not change their dietary
behavior even after being diagnosed indicating the lack of knowledge present in the diabetic
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community. However, the notion of consuming a specified diet for a chronic disease is enough to
put off a lot of diabetics since having a dietary knowledge does not necessarily mean it will be
implemented. In order to try and manage the diabetics, a medical nutrition therapy was
introduced to offer guidance in a systematic way. The program has been effective but it is faced
with challenges. Most physicians do not receive training on nutrition interventions, and this
becomes a barrier to offering counsel to the patients. Moreover, it is time-consuming to talk to
patients about nutrition. Most centers simply print out a menu and hand it out to the diabetics.
The type and quantity of food consumed are essential to the management of diabetes. They
influence blood sugars. A diabetic should ensure he or she consumes meals at regular intervals,
ensuring the meal contains low fats and high fiber contents, inclusive of small carbohydrate
amounts (Mayo, 2019). Fruit and vegetable intake are also recommended but the cost of
maintaining this diet is high, especially to low-income households. This becomes a major barrier
in the dietary behavior of an individual.
Methods
The study was accomplished by searching the Medline and the Web of Science databases,
as well as the University databases to look for studies about dietary patterns that were published.
The strategy of research combined the terms and headings used in medicine and partially
truncated words. The parts covered were; epidemiology, physical activities and lifestyle, the
relationship between diet and DM and the dietary knowledge of DMT2. Extraction of data was
done in a standardized form, which was created by investigators such as the author’s
information, publication year, country, name and duration of the study, the design, the population
of the study, age, number of cases, sex, the method of dietary assessment, the outcome and
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definition, the method of interpreting the dietary pattern, how the dietary pattern was labeled, the
parameters with a 95% confidence interval, the p-value and variable adjustments.
The meta-analyses were done with Cochrane RevMan version 5.3, and the pooled
estimations were calculated based on the individual approach pattern (Jannasch, 2019).
Moreover, the approaches that happened to be repeated were pooled into one study population
where they were restricted to the most recent data published. Exploratory methods that were
derived from the patterns needed generally considered as a specific population which hence
limited the summarization of the meta-analytic potential. This, therefore, ensured that a pattern
was only put into consideration for meta-analysis only if it was distinguished by a set of food
groups, where one food group was not present.
The RRR method originally interpreted and confirmed the patterns through the metaanalysis summary. This was due to the huge differences across the data sets (heterogeneity), of
the scores that were formed by RRR which used different responses of the diabetes biomarkers.
To eliminate the risk for a confirmatory bias posed by two data sets, the estimations were
recalculated according to their correlation in order to ensure comparability with the original
patterns of the diet. In order to estimate the weight of individual studies that was included in my
research, inverse matrix method was used to calculate the standard error of the logarithm.
Heterogeneity in the population was established using the; I² statistic and a 25% resulting value
showed that heterogeneity was present but moderate.
Results
The search for information in Medline and Web of Science ended with a total of 1047
articles, after the combination and elimination of all duplicate materials. The screening was done
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to the articles which resulted in only 48 articles remaining. The study included different sets of
comprehensive dietary patterns located in different regions. A major part of the study was
conducted in the United States of America where the sample was equal to 22, Europe where the
sample was equal to 18, Asia with a sample equal to 5 and Australia where the sample was 3.
Unfortunately, no African contribution was sort. A total of 16 population studies were conducted
individually. An overall of 10 articles were used to examine the participants will to cling to the
pre-explained index.
Mediterranean Diet
A total of eight studies investigated the cling to the Mediterranean diet and the correlation
with type 2 diabetes among different populations. Fruits, legumes, vegetables, nuts, average
consumption of alcohol, and fish were part of the dietary index. Olive oil is a critical part of the
Mediterranean diet. A total of 5 out of 6 studies found that there was a reduction in the risk of
type 2 diabetes. The study suggested that a higher intake of the Mediterranean diet would lead to
risk reduction as shown in figure 1A below. Heterogeneity was low in this case (I²=0.26).
DASH
This index comprised of 10 food groups: vegetables, fruits, grains, fiber-grains, legumes,
meat, low-fat dairy, nuts, total dairy, seeds, fats and oils and sweet. The index incorporated six
studies in total which investigated the correlation of the index to the type 2 diabetes. Two of the
studies in this index were considered of high quality while the rest simply passed the acceptable
mark. A high index of DASH was related to a reduction in the risk of type 2 diabetes. All studies
reported an inverse relationship with type 2 diabetes although heterogeneity was significantly
high (I²=0.62).
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Posteriori Approach
PCA
Fourteen studies applied the PCA analysis and half of them confirmed that the labeled
patterns were western or prudent. The studies contradicted with the tools of diet assessment and
the number of food groups. An inverse relationship was observed from 5 of the 32 patterns that
were evaluated to the type 2 diabetes. Of these patterns, only one was labeled as prudent. Metaanalytical summarization, in this case, would be meaningless hence the evaluation of similar
components in the food groups was more successful. This lead to the establishment of two
patterns; mainly healthy which comprised of: legumes, white meat (poultry and fish) and fruits
and vegetables. Seven patterns in the index were put into consideration in this study and the
results showed a clear reduction in the risk, but heterogeneity was barely present (I²=0.06). The
second group was labeled as mainly unhealthy which comprised of high-fat dairy, red and
processed meat, refined grains, and eggs. The meta-analysis showed that there is a significant
rise in the risk of diabetes by 44% and the heterogeneity was not present (I²=0.00).
RRR
Six studies applied RRR analysis as the statistical means to identify the dietary patterns.
Of these, five biomarkers gave efficient responses. One study focused on the nutrients that are
correlated with diabetes. Four studies showed that a high concentration of biomarkers will lead
to a rise in the likelihood of type 2 diabetes. All the RRR patterns that were identified were
correlated to the risk of diabetes, where the strongest correlation was observed in the use of
thrombosis makers. Participants in the highest quartile which comprised of unhealthy foods had a
higher risk of type 2 diabetes compared to those on the lower quartile.
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Figure 1: Meta-Analysis Presenting RRs and 95% CI for Type 2 Diabetes
Discussion
This study’s main objective was to identify the prospective studies done on the dietary
patterns and diabetes to draw a link between diet and type 2 diabetes. The study put into
consideration the methods used and the meta-analyses summarization process. The previous
reviews have mainly focused on the priori approach or they simply failed to clearly separate and
investigate the methodology. It is evident that the dietary patterns differ in contents as well as in
patterns.
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A significant number of studies identified showed that there was an increase in the
likelihood of type 2 diabetes because of intake of unhealthy foods. Six studies that backed
Mediterranean diet were identified to have a correlation with diabetes, where the overall result
displayed a significant risk reduction. There is a slight difference from the previous reviews
although the results were the same. Conclusive evidence was also found showing that DAH
reduces the risk of acquiring type 2 Diabetes. There is a significant difference in the food groups
present in DAH and the Mediterranean diets but the evidence is strong for both cases to support
the hypothesis.
The PCA patterns identified were 32 in total that had any relation to diabetes. Previous
reviews only featured a smaller number. The study shows that PCA patterns are hard to compare
between heterogeneous populations. To critically interpret these patterns, meta-analytics
summary was used to analyze concordant food groups only. Two food groups were identified,
which led to the findings that there is correlation with diabetes. RRR patterns that were evaluated
repeatedly were also found in cohort studies. In this analysis, generation of patterns helps to
attain the maximum variance from a set of responses. This study provided evidence of strong
correlation between diabetes and diet patterns. The results were stronger compared to the other
approaches.
Conclusion
The analysis and review of previous guidelines and studies on diet and their relationship
to Type 2 diabetes show that diabetic patients require knowledge on the management of their
diet. This will ensure that they are encouraged to comprehend the disease for a better quality of
life. The main objective of treating diabetes Mellitus Type 2 is to ensure no complications will
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arise during treatment. Diabetes is a chronic disease; hence proper care should be administered.
Therapy for once is a good way to make sure that the patient adheres to the required diet. A
healthy life incorporates physical activity as well as a good diet. It is an effective and efficient
way to manage and or prevent diabetes to ensure a good life.
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References
Feingold, K. R., Boyce, A. B., & Gray, A. (2015, May 31). Nutritional Recommendations for
Individuals with Diabetes. Retrieved from Ncbi.nlm.nih.gov:
https://www.ncbi.nlm.nih.gov/books/NBK279012/
Forouhi, N. G., Misra, A., Mohan, V., Taylor, R., & Yancy, W. (2018, June 13). Dietary and
nutritional approaches for prevention and management of type 2 diabetes. BMJ , 361.
Jannasch, F., Schulze, M. B., & Kröger, J. (2017). Dietary Patterns and Type 2 Diabetes: A
Systematic Literature Review and Meta-Analysis of Prospective Studies. The Journal of
Nutrition , 147 (6), 1174–1182.
Kumar, Y. (2015). Evidence-Based Quality Improvement: A Knowledge Transformation in
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