Type 2 Diabetes among Latinas - Research Paper Example

Type 2 Diabetes among Latinas SUMMARY OF FINDINGS The finding of this study shows that type 2 diabetes is strongly linked to low food security among Latina adults. When age, lifestyle, acculturation, employment status and waist circumference were held constant, Latina adults who are food insecure are 3.3 times more affected by type 2 diabetes than their food secure counterparts (Fitzgerald et al, 2011). The regression model also reveals that Latina adults with high waits circumference and low physical activity had 2.5 and 3.8 times more likely to have type-2 diabetes (Fitzgerald et al, 2011). However, less acculturated Latinas showed low risk of having type-2 diabetes. These findings also show that the association between type-2 diabetes and food insecurity in this population are due to certain mechanisms including physical activity, dietary intake, SES, obesity and cigarette smoking but negative association with meal skipping and alcohol drinking. This model also showed less significant association of Latina’s depressive symptoms, BMI, nutritional knowledge, interaction, education, Supplemental Nutrition Assistance Program participation, marital status, and access to car and cigarette smoking to likelihood of getting type-2 diabetes. Latinas with High depression levels and those with low nutritional knowledge also had high food insecurity and those who were food secure had good nutritional knowledge as well as low depressions and were not participating in SNAP. The findings also showed that depression scores increased with increasing severity of food security with scores of 14.7 for food security, 24.2 low food security and 28.2 for very low food security (Fitzgerald et al, 2011). CRITICAL ANALYSIS Fitzgerald et al’s “Food insecurity is related to increased risk of type 2 diabetes among Latinas focused on examining the relationship between food security and type-2 diabetes among Latino Americans. While the investigators clearly outline the aim of the study, they have not stated clearly what the problem is as well as the hypothesis. In this kind of study, it is important to outline the epidemiological problem that warrants the investigation. As stated by Melnyk & Fineout-Overholt (2011), a clear research question is important since it provides the researcher with direction so as to focus on specific answers to the research question. Gerrishet al (2011) also noted that a clear statement of the epidemiological problem should clearly state the condition, population of interest, the comparison or control, the population of interest, intervention and the outcome measure that is to be used to evaluate effectiveness, However in this study, the last aspect is lacking thus improvements could have been made to this study by incorporating reference measures such as food security index upon which were measure insecure or secure. Researchers in this study have conducted a literature review that outlines a research gap and justifies the need to conduct epidemiological research within this population. The research paper has also made a comparison between the target populations which is Latino households and other population which is non-Latino households. This has brought clearly how the problem of food insecurity among the Latinos and how it is a problem in the United States and how it is associated with type-2 diabetes. However, the investigators in this study have not provided enough statistical evidence to reinforce this claim. For instance, the investigators have provided that about 27% of Latino households experienced food insecurity compared to 11; however, they have not given statistics how food security is related to type-2 diabetes. Other aspects of the population such as prevalence rates among different age groups, gender etc within the focus population would have been done to improve the epidemiological rigour. As stated by Gerrish et al (2011), systematic review of literature that addresses the population of interest is important in identifying research gaps and finding evidences. This study could have therefore been improved by including more research statistics and exploring more studies on the topic. This is because the literature reviewed is not enough and do not present enough analysis to justify that a problem exist. Nonetheless this study has reviewed moderate number of literature on the epidemiological data as well as the existing pathways and how they are associated with type-2 diabetes within Latino population. This study outlines a comprehensive methodology that fits the epidemiological rigour necessary for this kind of study. Researchers in this study were also elaborate when it comes to study design and choosing off the participants, demographic and socioeconomic characteristics, diabetes status, anthropometric measures and classification of the different levels of food security. The organization of the methods such as application of questionnaires to participants was well organized because there was translation of language from English to Spanish and vice versa. This was very important for this study because of the language differences between the investigators and the participants. They also analyzed other factors such as depression, diet and lifestyle, alcohol, cigarette use, activity levels and nutritional status that are likely to affect the phenomena being tested in the population. In this respect, investigators were able to independently evaluate the effects of food security on incidences of diabetes among Latinos. However, one important improvement that can have improved this study further is to reorganize the sample of participants. It is important to note that the sample is not only small, but it has a wider age group (35-65) hence it is difficult to evaluate whether the observed higher rates of type-2 diabetes is resulting from food security or other age related complications that arises as people get older. Improving this study would therefore involve focusing on specific group within Latino population say adolescents, youth or adults. It is important to note that participants in this study were not homogenous. While the investigators do not give reasons for lack of homogeneity among the participants in this study, it would be inaccurate to make generalizations based on the findings of this study. With this heterogeneous population we cannot analyze how food security affects the various population demographics of the Latino. Investigators used regression model as statistical analysis tool to analyze the data and come up with findings. Data analysis is an important aspect of research since it helps in the synthesis and summary of the data collected to enable researcher make an inference (Melnyk & Fineout-Overholt, 2011). In this regard, the researchers were able to compare the treatment population with the control population and therefore make a conclusion on the effects of food security on type-2 diabetes. Investigators also used bivariate and multivariate analysis conducted by SPSS to detect group differences while other aspects that affect type-2 diabetes such as obesity, diet, lifestyle characteristics were entered in multivariate logistic regression with type-2 diabetes as the outcome (Fitzgerald et al, 2011). This was the best analytical tool for this study because of the different means that were to be compared. Analysis of variance (ANOVA) or the t-test was an alternative analytical tool for this data. However, linear regression chosen by researchers in this study was appropriate because o the different variables that we are analyzing to find out how they impacted on the (type-2 diabetes (outcome). However, presentation of results was not appropriate because the investigators only included tables but did not include the regression curves and presented results in graphs and charts to enhance evaluation and comparisons. CONCLUSION The findings of this study showed that Latina adults who are experiencing very low food security are 3.3 times more at risk of having type-2 diabetes than their counterparts who are food secured when all other factors are held constant. Food insecurity was also positively associated with SNAP, depression, smoking cigarette when other socioeconomic and other demographic factors are held constant. These results are very important since they provide leads to evidence based intervention that should focus on the provision of culturally based interventions for type-2 diabetes focusing on coping mechanisms to limit the effects food insecurity and depression among Latinas. However, this study showed certain limitations that should be considered in further studies within this population. One of the limitations is that up to 81% of the recruited Hispanic population were from Puerto Rico and the second is that the participants were older and young people without clear reference to gender. It is therefore important for future studies to focus on the various ethnic groups within Hispanic population and a stage of life whether adolescent, youth, adults or elderly people to make this study even more specific. This is because even without food insecurity age and other factors affect prevalence of type-2 diabetes. It is therefore important to note that generalizations of these findings are limited to the specific population of Hispanic community. Nonetheless these results are very important for policy makers and intervention strategies necessary to manage type-2 diabetes among Hispanic population since it is a step stone to further investigations. Further studies should therefore be done mainly with various intervention strategies to include food security as part of the strategies to mange type-2 diabetes. References Fitzgerald, N., Hromi-Fiedler, A., Segura-Pérez, S., & Pérez-Escamilla, R. (2011). Food insecurity is related to increased risk of type 2 diabetes among Latinas. Ethnicity & Disease, 21(3), 328-334 Melnyk, B.M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing &healthcare (2nd Edition.). Philadelphia, PA: Wolters Kluwer/Lippincott, Williams,& Wilkins Gerrish, K., McDonnell, A., Nolan, M., Guillaume, L., Kirshbaum, M., & Tod, A. (2011). The role of advanced practice nurses in knowledge brokering as a means of promoting evidence-based practice among clinical nurses. Journal Of Advanced Nursing, 67(9), 2004-2014 Read More