Free Nursing Dissertations - (knowler Wc Et Al 2002). There Is A Particularly Pertinent Set Of Comments
(Knowler WC et al 2002). There is a particularly pertinent set of comments relating to pharmacotherapeutics and obesity related surgery. (Wing RR et al 2001).
This paper sets itself apart from many other similar papers with comments relating to the long term strategies associated with successful weight maintenance. A critical assessment of this review would have to conclude that although written by UK based authors, there are some comments in it which are aimed at the USA and this may well be a reflection of the fact that it was supported by the USA veterans association. On the positive side, the references cited are wide ranging and authoritative, giving a balanced overview of the current situation relating to obesity control.
Lean & Hankey (2004) offer an editorial on the use of aspartame. Again, this article is a general piece, but it has distinct relevance to the management of the Type II diabetic. This piece is particularly relevant to our considerations because apart from providing an authoritative statement on the current evidence base for aspartame, it points to the fact that current dietary recommendations for Type II diabetes mellitus include the fact that up to 10% of total metabolic energy can safely come from sugars. (DNSG 2000).
Artificial sweeteners can help to avoid counterproductive weight gain. It also produces an authoritative opinion on the argument that increasing the carbohydrate component of a diet tends to displace the fat content, (Bolton Smith C et al 1999) with the associated health benefits there. (Ludwig DS et al 2001).
Nutritional management in Diabetes Mellitus was traditionally part of the almost exclusive remit of either the specialist diabetic nurse or the dietician. More modern considerations have included the concept of patient empowerment and education (Howe and Anderson 2003), which can now come from independent web-based sources.
Two eye-catching articles on this topic appeared in the same issue of the BMJ. The first (Eyesenbach G et al 2004), produces an extremely comprehensive review of the availability, accuracy and effect of this phenomenon. It provides an authoritative assessment of the literature available on this topic. Of particular relevance to our considerations was their findings that, of the five peer-reviewed studies examined that gave dietetic advice and also measured the clinical outcome (by HbA1), only one showed a statistically significant improvement. It has to be noted that the particular study was not a controlled reference study, and therefore has a great potential for experimental bias. (Gary TL et al.2003)
A more qualitative approach was taken by the second of the two papers (Ralston JD et al 2004). This paper looked at the patient’s experiences with the use of the web-based advice facilities.
Dissertations - Free Nursing Dissertations
