Bckground -- Diabetes Mellitus Is Also Known

Bckground -- Diabetes mellitus is also known as Type II Diabetes, or non-insulin-dependent diabetes (adult onset diabetes in certain cases). The disorder is due to a number of variables that are present in the modern, developed world -- sugary foods, fast foods, lack of exercise, etc. It is characterized by higher than normal blood glucose levels that play havoc with insulin deficiency and resistance. Insulin resistance means that cells do not respond appropriately when there is free insulin in the blood system. Essentially, they body is reacting to an improper balance of sugars and insulin. Because obesity is often present, research suggests that even thought the mechanisms controling glucose and insulin are unclear, the adopose tissue likely plays a crucial role in the lack of proper uptake of sugards. Two new emergent ideas show that there is an issue of ectopic fat storage (fatty deposits in the muscles, liver, and pancreas) and secretion of various chemicals into the endocrine system because of excessive adipose (Medscape News, 2004).

Unfortunately, science has yet to find a complete cure; but if managed through diet and exercise, the condition may be mitigated. Nevertheless, if untreated, Type II Diabetes may become quite serious and require the medication of symptoms in order to the patient to maintain a productive life (American Diabetes Association, 2009).

The Study -- "The Effects of a Pre-Packaged, Portion Controlled Meal Plan on Type 2 Diabetes and Glycemic Control: A Comparison Study."

Location of Study: Philadelphia, Pennsylvania at Temple University

Collaborators: Nutrisystem, Inc., University of Pennsylvania

Condition: Obesity

Intervention: Behavioral portion controlled diet; diabetes support and education

Overview of Study: Diabetes mellitus type II, formerly called non-insulin dependent diabetes or adult onset diabetes is a metabolic disorder that is medically characterized by high blood glucose (with resistant insulin and deficiencies in insulin production and uptake). Initially, the condition is managed by increasing the exercise load for the client and changing their diet. However, at times the condition remains rather unresponsive and more aggressive action may be needed (Kumar, 2005, 1194-5).One of the major determinants of type-2 diabetes is a combination of lack of exercise and obesity, one leading to the other. Type-II diabetes is costly to the public and healthcare industiry, and is changing demographics -- moving from an adult disease to adolescents and children based on lifestyle modifiers -- so much so that it is now a pandemic. No one approach to the condition is available, resulting in researchers suggesting a multidimmensional and multi-disciplinary approach: combining counseling, exercise and diet. When used singly, research shows that interventions alone do not seem to be effective. The key, it seems, is finding the appropriate level of culturally-based counseling combined with realistic dietary and activity programs, along with a great deal of patient education and follow up with management and the evolution of the condition within the individual (See: Hawthorne, 2008),

Eligible volunteers are randomly assigned a group consisting of a set of pre-packaged, portion controlled meal plans plus a group behavior modification group. Random cross-tabulations will occur if patients are taking insulin; the second group is the group behavior modification without the pre-packaged diets. Both groups complete 9 group sessions and 24 weeks on the program. At week 16, each participant will meet individually with the study physician to review products. Participants will be counseled on strategies to prevent hypoglycemia and will be given a blood glucose meter and strips and instructed to measure their blood glucose at least two times per day while participating in the study. In addition, the causes, symptoms and treatment of hypoglycemia will be reviewed including when to contact their health care provider (Foster, 2010).

Clinical Expertise and Patient Preferences- Clinical expertise is a basis of the project in several ways: basis for research plan, expectation of intervention (hypothesis testing), clinical factors in laboratory analysis, preparation and dissemination of implementation plans, counseling efforts:

Basis for research plan -- Evidence-based research was the informational foundation of the study of specific interventions into type-2 diabetes management (Evans, 2010)

Expectation of Intervention -- Protocols show that a tri-part effort to manage type-2 diabetes is more effective. Utilizing diet and exercise alone are effective, but most patients seem to respond better to a coaching and support mechanism that helps them through their initial questions, frustrations, and reluctance to drastic lifestyle change (Griffin, Simmons, & Williams, 2011).