Introduction
Type 2 diabetes is a chronic metabolic disorder affecting the body’s sugar (glucose) processing. The prevalence of type 2 diabetes is higher in obese patients compared to normal-weight individuals and much higher in those with a body mass index (BMI) higher than 35kg. Obese patients are at a higher risk of developing future health complications like heart attacks that can be fatal. A nutrition-based approach for losing weight therapy known as the ketogenic diet (sometimes known as the “keto diet”) has been developed as a means of lowering HbA1c levels in overweight diabetics. To determine their influence on weight loss and the decrease in hgbaic levels, the performance of the ketogenic diet and insulin administration are compared in this research paper.
Overview
Obesity is a chronic illness that affects adults and children worldwide. It is the leading risk factor for non-communicable diseases such as type 2 diabetes, cardiovascular disease, certain cancers, and heart disease. According to the world health organization (WHO), obesity constitutes 44% of diabetes cases, 7-41% of certain cancers, and 23% of heart disease (Chooi et al., 2019). The rates of obese patients doubled globally since 1980, with an increase of 39% in adults 18 years older being overweight, and 13% were obese in 2014 (Chooi et al., 2019). The main factors leading to being overweight are high-calorie consumption, a shift towards a sedentary lifestyle, and less physical exercise. Obese patients who have type 2 diabetes are more likely to develop complications that may later lead to death.
Effective management of body weight and changes in diet with regard to the content of carbohydrates and the glycemic index is beneficial to individuals with glucose intolerance. Overweight patients diagnosed with type 2 diabetes use a ketogenic diet to control body weight, lipids, and blood glucose. A keto diet is high in fat, moderate in protein, and low in carbs; thus, it helps to regulate weight loss, reduce appetite and food intake, and lower insulin levels. Staple carbohydrates include fish, butter, eggs, nuts, avocados, and seeds. Insulin use is effective for overweight patients with diabetes who aim to lose weight. Patients with non-insulin-dependent diabetes use insulin if they fail to respond to diet, oral hypoglycemics, and physical exercise.
Background
Applications in recent times have benefited from data gathered from earlier studies on diabetes and obesity. Clinical staff lacks the time and expertise to engage patients in weight management talks, according to earlier studies (Jing et al., 2018). Clinicians lacked the time necessary to follow up with patients, provide continuing support and encouragement, and provide counseling for obesity and diabetes. Previous studies demonstrate that nurses’ knowledge of how to counsel patients on weight management was incomplete (Bril et al., 2019). The study highlights the significance of clinicians comprehending type 2 diabetes patients’ obesity therapies (Lisco et al., 2020). Weight loss of 3–5% of body weight delays diabetic complications, improves glucose intolerance and stops prediabetes from turning into type 2 diabetes (Roden & Shulman, 2019).
Currently, obesity and type 2 diabetes counseling are offered at a number of hospitals all around the world. The adoption of ketogenic diet is gaining popularly among scholars and practicing nurses. Support groups have been established to motivate those who struggle with weight and blood sugar management. It is important to raise awareness of the problems with obese diabetic patients in order to discover appropriate tactics and techniques. However, the advantages of keto diet over insulin administration are yet to be recognised at a large scale. The PICO framework is a helpful tool in exhibiting these pros among diabetic and obese patients.
Statement of the Problem
Diabetes in obese patients is a global issue that threatens individuals’ well-being and general health. Risk factors such as heart disease and certain types of cancer are increasing daily (Chooi et al., 2019). It is not clear how insulin compares to the ketogenic diet in decreasing hgbaic levels as well as facilitating weight loss, and thus, it is studied in this paper.
Purpose
Obesity is a crucial issue that must be examined to reduce the health risks of diseases such as type 2 diabetes, strokes, and coronary heart disease. Being overweight is also associated with dementia, mental health issues, osteoarthritis, and sleep apnea. Besides the various conditions related to being obese, the illness increases healthcare costs. The purpose of this research is to compare the effect of the ketogenic diet and insulin in decreasing hgbaic and facilitating of weight loss. Addressing obesity will reduce the number of diseases and improve general well-being.
PICO
For obese patients with diabetes, does a ketogenic diet, compared to insulin use, decrease HbA1c levels and aid in weight loss?
- P- Obese Patients with Type 2 Diabetes
- I – Ketogenic Diet
- C- Insulin Use
- O- Weight Loss
The prevalence of obesity and diabetes increase with age worldwide. Although other factors may play a significant role, obesity is a key factor. For instance, Price et al. (2022) note that the elderly are more likely to be obese than the young. Administering a ketogenic diet impairs one’s appetite, increasing the rate of fat breakdown and subsequent loss of weight. This is an effective way of regulating both diabetes and obesity without administering ant drugs of hormones. Compared to insulin administration, a keto diet directly influences HbA1c levels, daily glucose values and the blood–glucose variability in type 2 diabetes patients. With key emphasis on obese and diabetic individuals, the keto diet is more advantageous that convectional insulin administration as it reverses the adverse effects of insulin resistance in the patients body.
Definition of Terms
- Obesity- a complex multifactorial disease that results from excessive fat accumulation (Chooi et al., 2019).
- Type 2 diabetes– a common metabolic disorder caused by a combination of two factors; defective insulin secretion and the inability of insulin-sensitive tissues to respond to insulin (Galicia-Garcia et al., 2020).
- Ketogenic diet– a low-carbohydrate, high-fat, and adequate-protein diet that contributes to weight loss (Muscogiuri et al., 2019).
- Weight loss- a decrease in body weight from fat, muscle, and water losses (Varkevisser et al., 2019).
- HbA1c levels- average blood sugar levels in a period of months (Chehregosha et al., 2019).
Theoretical Rationale
Diabetes is one of the dominant killer diseases around the world. 37.3 million individuals are diabetic in the United States accounting for 11.3% of the total population (Tam et al., 2020). The fact that it is a non-killer disease makes difficult to control, as it is caused by unhealthy lifestyles and genetics. There are three types of diabetes: gestational, type 1, and type 2 diabetes. The latter is the most popular and is as result of several factors including insulin resistance, obesity, hormonal disease, and genetic mutations or if one is born in a family with a history of diabetes (Tam et al., 2020). There are numerous interventions applied in the treatment and management of type 2 diabetes. However, the scholarly community does not explore the comparison of the performance of such interventions. As a result, there is need to establish how the administration of insulin compares with the adoption of keto diet.
PICO is a result oriented theoretical framework used in medicine and clinical studies. It emphasizes populations, interventions, comparisons and quantitative outcomes. In this context, the population narrows down to diabetic individuals while the intervention is the use of keto diet, which is compared with insulin administration. The target outcome is reduction in weight among the study population. Unhealthy eating habits result in obesity and subsequent diabetes among majority of the diagnosed patients. In addition, insulin administration is the most common clinical mode of regulating type 2 diabetes around the world. However, it is not clear which approach produces the best results in regulating body weight, especially among the obese individuals. Scholars and practitioners dispute the adoption of multiple interventions to contain diabetes in patients. It is thus essential to rely on result driven experiments to conclude on how the keto diet compares with insulin administration to lower obesity in diabetic individuals.
Application to Nursing
Due to improper eating habits, lack of exercise, and poor lifestyle choices, type 2 diabetes and obesity rates are rising globally. Healthcare practitioners now have the chance to learn about methods of controlling obesity to halt the progression of diabetes thanks to information learned from studies on obese individuals with type 2 diabetes (Quality and Safety Education for Nurses, n.d.). Patients and the public can also learn about the causes and effects of obesity and diabetes from healthcare experts. Evidence-based approaches enable lowered risk factors for obesity and lower the likelihood that a patient would become unwell (Arhire et al., 2019).
Nursing professionals need to be knowledgeable about therapies like the ketogenic diet and insulin administration because it aids medical professionals in treating patients’ problems. The nursing profession needs information about the obesity and type 2 diabetes problem because it offers an understanding of the issue, prevention tactics, and solutions.
Nurses should follow the code of ethics whenever they interact with patients. The code’s four guiding principles are to prioritize people, and the practice successfully, foster professionalism and trust, and provide high quality and safe nursing education (Quality and Safety Education for Nurses, n.d.; Cronenwett et al., n.d.). The prevention of type 2 diabetes and obesity depends heavily on health promotion. The Institute of Medicine (IOM) wants to protect patients and give them the care they require. Individuals’ psychological, physical, and social needs must be satisfied, according to nurses. It will be easier to offer individuals with obesity and diabetes the physical health care demands they have (Quality and Safety Education for Nurses, n.d.).
Healthcare professionals must acknowledge and appreciate the role that individuals play in determining their well-being and health. Nurses must counsel patients on how to manage obesity and diabetes and support their coworkers in leading healthy lifestyles (Quality and Safety Education for Nurses, n.d.). The advice should be truthful, and helpful to both patients and coworkers. The code of ethics ensures ethical nursing practices.
Conclusion
From early childhood to old age, obesity is a global problem that affects both adults and children. Due to their sedentary lifestyles, older adults are more prone than younger people to be negatively impacted by being overweight. The eating of high-calorie or high-fat foods and a lack of physical activity are habits that contribute to obesity. Type 2 diabetes, cardiovascular disease, heart disease, and several malignancies are all more common in overweight people. Because it promotes weight loss and lowers HbA1c levels, a ketogenic diet is useful for treating obese people. The connection between type 2 diabetes and obesity is demonstrated by Wilkin’s idea. Theoretical, historical, and current research findings help healthcare providers by supplying pertinent knowledge.
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