Reversal Of Type-2 Diabetes Through A Vegetarian Diet Research Proposal

In this appraisal, CONSORT checklist has been used to appraise the articles. CONSORT stands for Consolidated Standards of Reporting Trials. It was developed by CONSORT group to help address problems that commonly occur as a result of inadequate reporting of randomized controlled trial. CONSORT statement as used in this appraisal. It comprises of a 25-item checklist and a flow diagram. Each item or sub item holds a maximum score of 1; hence, the maximum CONSORT score should be 38. While appraising articles the using CONSORT statement, one has to determine a scale for each item. Then, the totals scores are determined by adding the scores on all items. The items seek to assess the level of compliance of an article with the standards set by CONSORT in various respects. Articles that scores high in CONSORT is said to be compliant with CONSORT standards. While the items of the checklist address how a trial is designed, interpreted, and analysed, the flow diagram focuses on the progress of the participants during the entire trial. The proposed study seeks to determine the possibility of using a diet to reverse type 2 diabetes mellitus. Random control study design is appropriate for this study. Since CONSORT statement provides the standards for reporting random controlled studies and is widely accepted, it has been used widely here in appraising articles that report random controlled studies. All the articles used in this review have been appraised based on the 25 items contained in CONSORT statement.
The flow diagram used alongside CONSORT statement shows the progress of participants throughout a study. In this case, the flow diagram shows the phases of the activities in which both the control and experimental group are taking part. The flow diagram describes the chronological sequence of activities involving the recruitment, enrolment, intervention, allocation, follow-up, and data analysis.
Type II diabetes is perhaps one of the most major public health problems facing the whole world. However, that should not be the case. A growing body of research from health care professionals observes that diabetes can be reversed through dietary changes alongside an exercise overhaul. According to Sassi and Hurst, (2012), low-fat vegetarian diet is associated with increased insulin sensitivity, reduced body weight, and reductions in cardiovascular risk factors. Notably, the potential benefits of a vegan and vegetarian diets benefits to cardiovascular may be equally important for individuals with type II diabetes. Type II diabetes mentions the inability of the pancreas to respond to insulin in the body system resulting in high blood sugar. The risk factors for developing the condition mentions inactivity, obesity, a history of gestational diabetes, age among others (Kida, Takemoto, Yang & Likitmaskul, 2005). Type II diabetes is curable, essentially, through nutritional guidelines, however, conventional treatment of diabetes type II dangerously control blood glucose while allowing similar unhealthy dietary behaviours and lifestyle habits that caused diabetes to proceed. Disease reversal refers to the changes of direction of a particular disease. Besides, disease reversal means that the biomarkers undergo a substantial improvement that the previously diagnosed condition may no longer be diagnosable (Englert, Diehl, Greenlaw, Willich & Aldana, 2007). Reversal of a disease means that the diabetes biomarkers improve so much so that the previously diagnosed condition may no longer be diagnosed. Type II diabetes, according to Englert et al. (2007), is a lifestyle disease that tends to develop over a given period and worse as days pass by, and reversal using diet refers to the change of direction of the disease processes. In particular, type II diabetes follows a procedure that involves a constant worsening of biomedical indices, including worsening HgbA1C levels, worsening of blood sugar levels, BMI increase, progressive loss of neurological function, and increased distribution of body fat (Ferdowsian & Barnard, 2009). The terminologies used to describe diabetes worsening states includes prediabetes and diabetes, insulin resistance, where insulin resistance elevates the risk of developing prediabetes and diabetes as well as where diabetes often lead to full-blown diabetes (Ferdowsian & Barnard, 2009). Each terminology describes a particular condition and defined by levels of functioning and biomedical indices.Blood Biomarkers of Type II diabetes Biomarkers are significant for conducting clinical trials and treating diabetic patients through dietary reversal. A biomarker, according to Ferdowsian and Barnard (2009), is a characteristic that is objectively measured and evaluated as an indicator of pathogenic processes, biologic processes, or pharmacologic responses to a therapeutic intervention. Type II diabetes biomarkers include haemoglobin A1c (HbA1c) that uses chromatograph column to monitor the degree of glucose control in diabetes patients. HbA1c is widely embraced for providing efficacy in clinical trials for diabetes reversal. Notably, HbA1c is considered a perfect blood biomarker as it provides the levels of postprandial and acute fluctuations in levels of glucose that better predicts cardiovascular disease in diabetes. Measurement of glucose and glucose tolerance tests also provides an essential biomarker for reversal of type II diabetes. Diagnosis of diabetes, for many decades, has used an elevated fasting glucose level. The fasting plasma glucose (FPG) and oral glucose tests significantly provide evidence of glucose reversal. The glycemic type II diabetes biomarkers also provide important tools for monitoring the reversal state of the disease. Measurement of glycated proteins and HbA1c potentially measures the risk of development of Type II diabetes (Ferdowsian & Barnard, 2009). The test is appraised for accurate assessment of mean glucose level during the reversal period of between two to three months. Urine blood test is also a traditional method that has efficiently been used for testing diabetic control in patients. The method is simple and uses precise procedures as sample urine is tested for glucose concentration. During reversal, patients are taken through a series of urine tests to determine the reduction of glucose concentration in the urine. In addition, protein in the blood may also be glycated, for instance, glycoalbumin and fructosamine can be measured and used to provide an accurate estimation of blood glucose control (Barnard, 2007). Methods for measuring protein biomarkers such as high-performance liquid chromatography (HPLC), leads to the separation of components based on their structural differences. Moreover, the method of immunoanalysis for HbA-1c that specifically detects Hb-A glucose attached to the terminal of amino chain and the use of ion exchange chromatography that quantifies total HbA-1c are also important blood biomarkers (Barnard, 2007). Glycohemoglobin method used in glycated proteins where protein molecules are joined to glucose molecules by use of a none-enzymatic mechanism and produce stable ketoamines known as fructosamine. Besides, all serum proteins can be glycated, for instance, serum, the most abundant serum protein that serves as an index of glucose mean concentration in blood during reversal period. Accordingly, weight loss is associated with type II diabetic patients that leads to lower blood pressure, improved glycemic control, and improve dyslipidaemia. The mechanism uses glucagon-like peptide (GLP-1) receptor agonists that provide information of weight loss and have potential benefits. The use of body mass index can also provide an essential mechanism for determining weight loss during the reversal process. BMI method is easy to administer and can be used in large group control to determine the changes in body weight (Barnard, 2007). Finally, weight to hip ration may also provide an essential mechanism for detecting changes in girth circumference used to determine body weight loss. Diabetes is associated with obesity and reversal using a vegetarian diet leads to body weight loss that can be determined through such mechanisms.

References

Barnard, N. (2007). Dr. Neal Barnard’s program for reversing diabetes: The Scientifically Proven System for Reversing Diabetes without Drugs. Rodale Books.
Englert, H., Diehl, H., Greenlaw, R., Willich S., & Aldana, S. (2007). The effect of a community-based coronary risk reduction: the Rockford CHIP. Prev Med, 44:513-519
Ferdowsian, H., & Barnard, N. (2009). Effects of plant-based diets on plasma lipids. American Journal of Cardiology 104:947-956.
Kida, K., Takemoto, K., Yang, S., & Likitmaskul, S. (2005). Effects of Western diet on risk factors of chronic diseases in Asia. In Preventive Nutrition: The Comprehensive Guide for Health Professionals. Edited by Bendich A, Deckelbaum RJ. New York, NY: Humana Press.
Roberts, C. K, & Barnard, R. (2005). Effects of exercise and diet on chronic disease. Journal of Applied Physiology, 98(1): 3-30
Sassi F, & Hurst, J. (2012). The prevention of lifestyle-related chronic disease: an economic perspective. OECD Health Working Paper No. 32. http://www.oecd.org/dataoecd/57/14/40324263.pdf (accessed 30/07/2012)