The Prevention of Type II Diabetes Mellitus
The Prevention of Type II Diabetes Mellitus
The Prevention of Type II Diabetes Mellitus
Garrett Cox
Type 2 diabetes is an irreversible disorder in which the body either resists insulin or does
not produce enough insulin to regulate and lower blood glucose levels. Type 2 diabetes mellitus
is a common diagnosis with 422 million people diagnosed across the globe. Over 90% of all
diabetic patients have been diagnosed with type 2 diabetes (Khan et al., 2019). The total number
of diagnoses of type 2 is projected to increase exponentially by the year 2030 with sedentary
lifestyle and obesity being the leading risk factors for the disease. It was also found that Type 2
diabetes mellitus is more common among men than women (Magalhaes et al., 2023). A
does not present with textbook symptoms, screening for prediabetes is important as 70% of
patients who are diagnosed as prediabetic will progress to full type 2 diabetes mellitus at some
point in their lifetime (Shubrook et al., 2018). It is estimated that about 33.9% of the United
States has prediabetes placing them at risk of the progression of the disease. (Cheng et al., 2022).
Type 2 diabetes is commonly associated with many other medical complications such as diabetic
neuropathy, nephropathy that can lead to end-stage renal disease, stroke, cardiovascular disease,
and can eventually result in death (Khan et al., 2019). These complications can drastically lower
the patient’s quality of life if not treated continuously and successfully. Although type 2 diabetes
cannot be cured, adherence to a treatment plan can help the patient keep their blood glucose
levels near the normal ranges (Khan et al., 2019). The following PICO question will help identify
nursing interventions that can be used to prevent a type 2 diabetes diagnosis in patients at risk:
What is the effectiveness of modifying the patient’s modifiable risk factors such as a healthy
lifestyle change versus pharmacological treatment in preventing the diagnosis of Type 2 diabetes
clinical prediabetes, the precursor to a type 2 diabetic diagnosis. The interventions discussed to
prevent the onset of full type 2 diabetes are lifestyle changes and medication. Lifestyle changes
or modifiable risk factors include a healthy diet and exercise (Shubrook et al., 2018).
Medications include oral type 2 diabetes medication such as metformin. In comparison, lifestyle
changes have proved to have a more positive outcome in preventing type 2 diabetes than
medication use. The outcome of this specific PICO question targets the prevention of type 2
Synthesis of Evidence
Lifestyle Changes
In patients with prediabetes, lifestyle changes such as structured diets have proven to be
beneficial in delaying or preventing the onset of type 2 diabetes mellitus. Roberts et al. (2017)
and Diez-Redondo et al. (2015) define prediabetes as an elevated blood glucose level, but not
elevated enough to meet the qualifications of type 2 diabetes mellitus. Studies have shown the
most effective lifestyle intervention in decreasing blood glucose is implementing a healthier diet
(Corgatelli et al., 2022; Gardner et al., 2022; Yamaoka et al., 2019). In a randomized crossover
trial performed by Gardner et al. (2022) placing prediabetic individuals on two different
structured diets, the results proved that a healthy diet had a therapeutic effect on blood glucose
levels, triglycerides, and carbohydrates. Yamaoka et al. (2019) performed a study that proved
these structured diets are only beneficial if patient education occurs and the high risk individual
understands the importance of compliance to the diet. Corgatelli et al. (2022) understood the
importance of nutrition education and studied whether the duration of nutrition education was
effective in increasing compliance and ultimately decreasing blood glucose. The results
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supported lifestyle changes such as structured diets in the prevention of type 2 diabetes mellitus
onset, but the duration of a nutrition education program did not yield significant results.
Pharmacological Treatment
While medications can often be the first line of treatment a healthcare provider turns to
for certain illnesses, studies show pharmacological treatment alone is not the most profitable way
of preventing type 2 diabetes mellitus in prediabetic adults (Roberts et al., 2017; Shubrook et al.,
2018). Medication therapy places patients at a high risk of developing drug-specific side effects.
A systematic review by Roberts et al. (2017) studied the effects of pharmacological therapy on
the patients’ quality of life. The results showed higher quality of life patients who implemented
other interventions such as lifestyle changes compared to patients on a specific type 2 diabetes
mellitus drug, Metformin. The study showed results that lifestyle interventions combined with
pharmacological treatment are cost-effective for patients, however, not cost-saving. Moin et al.
(2018) studied the benefits of pharmacological therapy alone and results showed that Metformin
is safe and cost-effective for high risk individuals who meet specific qualifications such as high
risk patients who are 60 years of age or less or patients who have a BMI of 35 or higher.
preventative measure for prediabetic patients (Gardner et al., 2022; Moin et al., 2018; Yamaoka
et al., 2019). Gardner et al. (2022) performed a study on high risk individuals who implemented
a strict diet. The results showed a significant decrease in HbA1C, triglycerides, and cholesterol
levels. Yamaoka et al. (2019) took this study a step further and studied lifestyle interventions
versus lifestyle interventions with pharmacological therapy. The results showed the effects of
there are interventions to prevent or slow the onset of type 2 diabetes in high risk patients. As a
nurse, supplying the patient with proper education is a necessary intervention to provide the best
outcome for the patient. For a patient who is beginning pharmacological treatment, a nurse is
expected to educate the patient on signs of any possible harmful side effects. Nurses should
emphasize the importance of blood glucose monitoring in order to efficiently treat any signs of
disease progression. They should employ the teach-back method to ensure the patient
understands how to check their blood glucose levels. The nurse could consult with nutrition and
dietetics to learn about the proper diet education that should be provided for a patient at high risk
of type 2 diabetes. In essence, nurses are called to be advocates for their patients and should be a
voice for the patient ensuring that they receive the most appropriate care in the prevention of a
Cheng, H.C., Liu, H.W., & Tsai, S.H. (November 2022). Supervised high-load resistance training
for improving muscle strength and quality in prediabetic older adults: A pilot randomized
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Corgatelli, C., Dodge, E., Bernstein, J., Kruk, J., & Aboul-Enein, B.H. (September 2022). A
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Franch, J., Diez, J., Ezkurra, P., Millaruelo, J.M., Segui, M., Sangros, J.,
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Gardner, C. D., Landry, M. J., Perelman, D., Petlura, C., Durand, L.R., Aronica, L., Crimarco,
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Khan, R.M.M., Chua, Z.J.Y., Liao, Z., Yang, Y.Y., & Zhao, Y. (September 2019). From
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Herman, W., & Walker, E. (2018). Information for CME credit-review of metformin use
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Shubrook, J.H., Chen, W., & Lim, A. (November 2018). Evidence for the prevention of type 2
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Yamaoka, K., Nemoto, A., & Tango, T. (June 2019). Comparison of the effectiveness of lifestyle
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