Oxidative Stress In Type 2 Diabetic Patient †MyAssignmenthelp.com

Question: Discuss about the Evaluate The Effect Of Yoga On Elderly Subjects With Type 2 Diabetes Having High Oxidative Stress. Answer: Literature review There is a high prevalence of type 2 diabetes in Jordan, and the incidence of the illness is increasing. Not only in Jordan but across the world there is an increasing prevalence of diabetes (Cadier et al. 2017). As per the InternationalDiabetesFederation reports in 2015 there were more than 400 million people diagnosed with diabetes. According to the World Health Report, 90% of the people with diabetes have type 2 form. It caused an estimated 1.5 million deaths in 2012. The incidence of death is increasing in low and middle-income countries. It is estimated the deaths due to type diabetes in the world may double by 2030 (World Health Organization 2016). The comorbidities associated with the illness such as heart diseases, hypertension, amputations, mental health problems and skin issues, can be delayed or prevented. Therefore, there is a need for preventive measure. It is found in majority of cases that diabetes is associated with sedentary lifestyle. As per the recent literature, the major risk factor of the type 2 diabetes is the lack of physical activity. For obese individuals and overweight individuals weight loss is recommended. Physical interventions like exercise and corresponding changes in weight result in fitness, improved glycemic control, and offset of other complicationstype 2 diabetes mellitusand reduce the cardiovascular risk factors (Mendham et al. 2015). Exercises like yoga appear to be beneficial in the management of type 2 diabetes. As per the study by Chimkode et al. (2015), yoga is effective in the patients with the type 2 diabetes, in reducing the blood glucose levels. Yoga is the inexpensive lifestyle intervention that can be easily implemented as low cost strategy in the developing country. It can be considered an economical adjuvant and a beneficial method to manage type 2 diabetes. Yoga is the mind-body practice that in cludes breathing exercises, meditation, and physical postures. It had been found to have a different effect on hypothalamus- pituitary-adrenal response, and it has different effect on the sympathetic nervous system as well. Few studies have reported that yoga can be useful mechanism to manage the oxidative stress and blood glucose in type 2 diabetes (Muthuselvi et al. 2017). Oxidative stress is associated with type 2 diabetes. Increased oxidative stress and ageing are known to be a contributory factor of complications in type 2 diabetes mellitus (Stadler 2013). Therefore the present study is focused on determining the effect of yoga on oxidative stress, where the intervention will be tested for the changes in blood pressure, BMI, and the glycemic status. The rationale for choosing this intervention is the cost effectiveness. It is an effective method for the people having sedentary lifestyle as it will increase the effectiveness of the diabetes treatment as evident from literature review that there are a lot of health benefits of Yoga. However, there are few studies that determined the effect of yoga on the oxidative stress in elder patients. The rationale for choosing the older patients with type 2 diabetes is the high level of oxidative stress with ageing (Butterfield et al. 2014). Research questions Is yoga effective therapy for reducing oxidative stress, BMI and blood pressure in type 2 diabetes elderly patients? Is yoga beneficial for improving the antioxidant potentialin the aged patients with type 2 diabetes? Methods Setting For achieving the aim of the study, a quantitative research paradigm is chosen. The study is planned to conduct at two yoga centres of XYZ hospital in Jordan. The Urban hospital setting is selected for conducting the study. Participants The participants for the study will be selected from the diabetes out-patient department of the hospital. The study participants will be divided into two groups. In one group only elderly patients with type 2 diabetes will be allocated, and another group will contain younger subjects. The intervention includes delivering Yoga intervention to elderly diabetic patients as well as younger subjects for one year. Both the groups will be subjected to the intervention for one year. During the intervention, the subjects in both the groups will be allowed to have normal diet and medication. A total of 100 participants will be approached, and each group is proposed to have 42-45 participants. Nor recommendations will be given by the physician for taking vitamin supplements during the period of interventions. The participants may have stable drug dosages for hypertension and diabetes. Inclusion/Exclusion Criteria The age range for elderly subjects with type 2 diabetes is 40-80 years. Subjects less than 59 years old will be allocated to younger group of intervention, and those of 60 and above are allocated to elderly group of intervention. The participants chosen should have diagnosed with type 2 diabetes and are excluded if they are alcoholic, smoker, and do not have stable medication for last 30 days. Participants will be included if they have the willingness to seek yoga intervention. Further participants with cancer, pulmonary tuberculosis, and acute macron vascular complications, history of osteoporosis, rheumatoid arthritis, history of infections or those participating in any weight loss programme are excluded as it may hamper results. Yoga intervention In the yoga centres of the hospital, the chosen participants will be instructed to attend the yoga classes as per their convenience. Each of the participants must attend 70-90 minutes of yoga every day and may take a break in weekend. For the participants with heart disease the floor exercises may be waivered (Deshmukh and Bedekar 2015). Based on the literature review the set of yoga interventions selected for the study are: Yoga poses Duration of yoga Triangle pose 3 min Tree pose 3 min Mountain pose 2 min Forward bend pose 3 min Cow faced pose 4 min Seated forward bend pose 4 min Extreme sideways stretch pose 3 min Wind-relieving pose 5 min Twist pose 4 min Thunderbolt pose 3 min Corpse pose 10 min Alternate nostril breathing 10 min (Sources: Deshmukh and Bedekar 2015) Compliance with intervention was determined by maintaining the attendances for at least three days a week for one year Measurements Before the start of the intervention, the eligible participants will be invited for the baseline evaluation. It will include blood glucose measurements, complete medical history, serum creatinine, ECG, microalbuminuria, lipid profile, and for any complications associated with disease. It will prevent the bias in the results (Deshmukh and Bedekar 2015). After the intervention again the same measurements will be taken as in done in similar study conducted by (Chimkode et al. 2015). Physical examination of the participants may include measuring by the electronic scale the weight in Kilogram (Kg) and the height in centimetres (Cm). Plasma will be analysed for glucose. For this purpose 7 ml of venous blood will be collected, red blood cell hemolysate will be prepared to analyse the reduced glutathione levels and malondialdehyde/MDA (Hegde et al. 2013). According to Furukawa et al. (2017), MDA is the marker of oxidative stress. It gives pink colour upon reacting with the thiobarbituric acid reagent. It can be estimated spectrophotometrically at 535 nm. Thus, MDA assay will be measured using suitable assay and using a standard laboratory method the Plasma glucose will be assayed. Ethics Prior to proceeding with the research, approval from the ethical board or local committee will be taken. The participants will be explained about the study design, and informed consent will be taken. Adequate measures will be taken to maintain the confidentiality, privacy and dignity of the participants (Creswell 2013). Statistical analysis The parameters obtained will be statistically analysed using appropriate SPSS tool. For comparing the continuous variables, paired t-test will be used. A difference of the parameters between two groups will be measured by the Mann-Whitney U test. Correlation testing includes Karl Pearson's coefficient of correlation. Statistical significance will be understood by the p-value 0.05 (Alfonso?Rosa et al. 2015). Importance, relevance and impact It is expected that the yoga interventions will improve the oxidative stress in the chosen participants. The results will be relevant for the clinician and the nurses as they can recommend the patients to attend yoga classes for improvement in oxidative stress and decreasing comorbidities of type 2 diabetes. The government can be recommended for establishing the free yoga centres in low socio-economic communities with high prevalence of type 2 diabetes. It will be beneficial for not only the diabetes patient, rather others at risk as well as it may reduce the risk factors. Thus the selection of the topic is justified, and the results are expected to be viable. There are several implications for the future study. For instance, if the results are positive then the intervention can be targeted for larger population to know how long the benefits may last. Further studies can be designed such as to evaluate the yoga poses most beneficial for the diabetes patients. Conclusion In conclusion, a suitable and cost-effective intervention that is Yoga is proposed for determining its effect on the oxidative stress in the elderly subjects with type 2 diabetes. The intervention and the outcome measure is designed based on the literature review of similar studies. This research proposal will help identify if the yoga intervention is beneficial in improving the oxidative stress and the glycemic status. Further, the difference in the effect on oxidative stress due to yoga in elder and the younger patients can be determined. Hopefully, the data obtained from the research will support the intervention and help in further optimising the duration of intervention and its content. It will further increase the research knowledge and help identify any flaws in the research design Bibliography Alfonso?Rosa, R.M., del Pozo?Cruz, B., del Pozo?Cruz, J., Saudo, B. and Rogers, M.E., 2014. TestRetest Reliability and Minimal Detectable Change Scores for Fitness Assessment in Older Adults with Type 2 Diabetes.Rehabilitation Nursing,39(5), pp.260-268. Retrieved from: https://onlinelibrary.wiley.com/doi/10.1002/rnj.111/full Butterfield, D.A., Di Domenico, F. and Barone, E., 2014. Elevated risk of type 2 diabetes for development of Alzheimer disease: a key role for oxidative stress in brain.Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease,1842(9), pp.1693-1706.Retrived from: https://www.sciencedirect.com/science/article/pii/S0925443914001756 Cadier, F., Jallow Gransson, I. and Rosengren, K., 2017. Nursing Students Experiences With Type 2 Diabetes in Jordan: A Qualitative Content Analysis.Home Health Care Management Practice,29(2), pp.103-110. 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