Population
The project will be conducted on a middle-aged population recently diagnosed with Type 2 Diabetes Mellitus T2DM. The project participants will be males and females between forty and sixty. Type 2 diabetes is a long-term health condition that causes poor insulin regulation, resulting in unstable blood sugar levels. Poor glycemic control in type 2 diabetes is a crucial medical issue with the risk of advancement of diabetic complications. Cardiovascular diseases, stroke, and high blood pressure are health risks of high blood sugar.
Inclusion and exclusion criteria will be applied when selecting sample subjects to create a fine balance in defining samples that will positively respond to my intervention. The inclusion criteria are reliable middle-aged adults recently diagnosed with T2DM with physical fitness and display consistency. The exclusion criteria are participation in another research, comorbidities that could bias the outcomes, poor fitness, disabilities restricting physical exercise, alcohol, drugs, and cigarette dependence. Exclusion and inclusion criteria will enhance the efficacy of the research by ensuring only responsive correspondents are eligible.
Intervention
Low-impact aerobic exercise is an evidence-based intervention for T2DM patients. A systemic review indicated that indoor cycling enhances aerobic capacity, lipid levels, blood pressure, and body composition (Chavarrias et al., 2019). On average, regular exercises effectively improve glucose and glycemic control profiles among T2DM patients. Indoor cycling at a moderate pace is a low-impact, fat-burning aerobic exercise effective in regulating weight and blood sugar in patients with type 2 diabetes (Chavarrias et al., 2019). The participants will perform a moderate one-hour indoor cycling exercise for at least three days a week.
Aerobic exercise enhances insulin sensitivity, enabling the body cells to utilize the available glucose in the blood, minimizing glucose in the blood. Less activity or exercise among T2DM patients is a risk factor for weight gain and stress (Ruissen et al., 2021). Clinical follow-up and training regarding the amount and intervals will be overseen throughout data collection. According to the CDC, people living with T2DM are twice to thrice more likely to suffer from depression than those without (CDC, 2021). Therefore, questionnaires will provide qualitative data on the efficacy of aerobic exercise in regulating stress among T2DM patients.
Moderate aerobic exercise is necessary to enable the muscles to use more glucose and sugar in the blood. However, Poitras et al. (2018) study indicated that T2DM leads to poor adherence levels of physical activity, limiting exercise tolerance. T2DM impairs oxygen delivery in the muscles and limits submaximal exercise intensity (Poitras et al., 2018). Therefore, participants will be warned against vigorous exercise since T2DM restrains oxygen intake in the blood. The Affordable Care Act (ACA) allows T2DM patients to get medical coverage for the therapies, preventing discrimination regarding health status. Medicaid expansion by ACA has improved the long-term outcomes for patients with T2DM (Present et al., 2019). The correspondents’ glucose levels and weight will be evaluated monthly during early treatment and annually after successful implementation of treatment.
Comparison
Reference from the study will be compared with reference studies using Insulin medication to evaluate the efficacy of Insulin. Studies by Rosenstock et al. (2020) and Castellana et al. (2020) indicate that monitored glucose treatment reduces blood sugar levels among T2DM patients. A systemic review of 13 studies reported that regulated Insulin intake-guided Flash Glucose Monitoring FGM is effective in T2DM management (Castellana et al., 2020). A Randomized Controlled Study of 247 patients recently diagnosed with T2DM indicated Insulin has a glucose-lowering efficiency (Rosenstock et al., 2020). Comparing the efficacy of exercise intervention with established outcomes of Insulin treatment will control the study.
However, Insulin treatment is a risk factor for dramatic weight gain, hypoglycemia, cardiovascular diseases, and mortality among patients with T2DM (Castellana et al., 2020). According to Poitras et al. (2018), regulating weight is crucial in overall diabetes management practices, and obesity would lead to frustrating T2DM management outcomes and comorbidity. Physical exercises promote positive lifestyle behaviors among patients and minimize the risk factors for T2DM, whereas medical treatment with Insulin magnifies T2DM risk factors. Stress is also common in patients with T2DM and causes a rapid yet severe increase in glycemic levels (Munan et al., 2020). The side effects of both treatment methods will be compared to determine the safest intervention. The study will highlight the most successful intervention between physical exercise and Insulin treatment.
Outcome
I want to improve glycemic control in participants of the study using indoor cycling. Blood glucose levels, A1C, weight, and stress management are the parameters to indicate the adequacy of physical exercise in managing T2DM. I expect the patients’ blood glucose levels to reduce after indoor cycling activities commence. The participant’s weight and stress levels will be regulated following the aerobic exercise. Aerobic exercise treatment is safe from hyper and hypoglycemia. Although there are fewer side effects resulting from exercise intervention than insulin treatment, severe exercising puts the participants at risk of cardiovascular complications. Varying outcomes are expected among the patients regarding assessment parameters. The overall T2DM status of the patients will have improved at the end of the study.
Timeline
The project will be implemented over 12 months. The first three months after the intervention will include monthly one evaluation of the patient’s blood sugar level and medication risk factors, such as induced hypoglycemia. Intervals of evaluation and insulin medication over the next six months will vary according to the health conditions. The last three months will be for data evaluation and participants’ follow-up.
Factors that will Influence the Intervention
Nursing science, social determinants of health, and epidemiologic, genomic, and genetic data will support the management of T2DM in the patient. Nursing science will help identify diabetes, provide a physical and emotional response to the diagnosis, and educate the patient on indoor exercise. Social determinants of health, such as age, work, lifestyle, and economic status, will indicate risk factors of the medical condition and will influence the intervention. Epidemiological data will describe the possible causes, prevalence, and progression of T2DM. Genomic and genetic data will describe the possibility of genetic influence in T2DM diagnosis.
References
Castellana, M., Parisi, C., Di Molfetta, S., Di Gioia, L., Natalicchio, A., Perrini, S., & Giorgino, F. (2020). Efficacy and safety of flash glucose monitoring in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis.BMJ Open Diabetes Research and Care, 8(1), e001092. Web.
CDC. (2021). Diabetes and mental health. Centers for Disease Control and Prevention. Web.
Chavarrias, M., Carlos-Vivas, J., Collado-Mateo, D., & Pérez-Gómez, J. (2019). Health benefits of indoor cycling: A systematic review.Medicina, 55(8), 452. Web.
Munan, M., Oliveira, C. L., Marcotte-Chénard, A., Rees, J. L., Prado, C. M., Riesco, E., & Boulé, N. G. (2020). Acute and chronic effects of exercise on continuous glucose monitoring outcomes in type 2 diabetes: a meta-analysis.Frontiers in endocrinology, 11, 495. Web.
Poitras, V. J., Hudson, R. W., & Tschakovsky, M. E. (2018). Exercise intolerance in Type 2 diabetes: is there a cardiovascular contribution?Journal of applied physiology, 124(5), 1117-1139. e1003434. Web.
Present, M. A., Nathan, A. G., Ham, S. A., Sargis, R. M., Quinn, M. T., Huang, E. S., & Laiteerapong, N. (2019). The impact of the affordable care act Medicaid expansion on type 2 diabetes diagnosis and treatment: a national survey of physicians.Journal of community health, 44(3), 463-472. Web.
Rosenstock, J., Bajaj, H. S., Janež, A., Silver, R., Begtrup, K., Hansen, M. V.,… & Goldenberg, R. (2020). Once-weekly Insulin for type 2 diabetes without previous insulin treatment.New England Journal of Medicine, 383(22), 2107-2116. Web.
Ruissen, M. M., Regeer, H., Landstra, C. P., Schroijen, M., Jazet, I., Nijhoff, M. F.,… & de Koning, E. J. (2021). Increased stress, weight gain, and less exercise in relation to glycemic control in people with type 1 and type 2 diabetes during the COVID-19 pandemic.BMJ Open Diabetes Research and Care, 9(1), e002035. Web.