Free Nursing Dissertations - Extended Literature Review: The Role Of Nutrition In The Management Of Type
Extended literature review: The role of nutrition in the management of type 2 diabetes
Undergraduate Degree Level Dissertation
1,500 words
Methodology
In this review we have used both hard copy (library based) access and Internet search facilities, to derive appropriate material. This was done at both the local University library and the local post-graduate medical centre library. Initial searches were made under the heading of Type II diabetes mellitus nutritional management.
Because it was important to provide a firm evidence base for the review, the searches were restricted solely to peer reviewed publications which, it was hoped, would make the selection process more efficient. (Berwick D2005)
This highlighted more than enough good quality material for our initial examination of the literature.
As it transpired the four articles chosen were all from the BMJ. This is partially a coincidence, as over thirty different articles in twelve different publications were assessed in the preparation of this piece. The final decision that was made to include articles was based, not only on their relevance to the issue, but also on the fact that they were on aspects of diabetic nutritional management that was not more commonly covered in some of the more routine articles.
Many of the articles examined were discarded because they had obvious methodological flaws in their construction. (Mohammed, D 2003).
Many were effectively opinion pieces which had little in the way of cited references to validate their findings. Others were trials which may have had a number of potentially confounding sources of bias.
Literature review
There are a great many authoritative sources in the modern literature on the subject of dietary management of the diabetic state. In any meaningful review of these resources one must always be mindful of the need for a strong evidence base. It is therefore vital to be dispassionately critical in one’s review of any literature presented. (Sackett, 1996).
We know, from established evidence, (Lean ME 2005), that obesity is an independent risk factor in the aetiology of Type II diabetes mellitus and that obesity management is a vital ingredient for good control of the diabetic state. (HSG 1997) This correlates with evidence that the incidence of long term side effects of diabetes is inversely proportional to the HbA1 readings. (Stratton I et al 2000)
A good place to start our review is a recent review paper by Hitchcock & Pugh (2002). This is a tour de force in the management of obesity in general terms, but, for the reasons outlined above, it is very pertinent to our discussions in this piece.
The review itself is cited here because it provides a particularly comprehensive overview of other work in the area together with some personal observations of patients who are both diabetic and involved in the weight management process.
