Literature Review Topic 6

Literature Review Topic 6

Type 2 diabetes poses a significant threat to the global healthcare systems by contributing to a high mortality rate, increased care costs, compromised quality of life, and prolonged hospitalization. According to Galicia-Garcia et al. (2020), type 2 diabetes mellitus (T2DM) emanates from the interplay between two primary factors: defective insulin secretion and the insulin-sensitive tissues’ inability to appropriately respond to insulin. The major risk factors for this disease are genetics and family history, overweight, obesity, unhealthy diets, and physical inactivity (Mohamed et al., 2018).

Literature Review Topic 6

The current scholarly literature supports pharmacologic and non-pharmacologic interventions for preventing and managing T2DM, including medication administration and adherence, physical exercise, and healthy diet plans. Therefore, this paper compares scientific studies that support the PICOT question which explores the effectiveness of physical activities in controlling blood glucose in people with type 2 diabetes.

A Comparison of Research Questions

The selected quantitative and qualitative studies are Nojom et al. (2020), Mikhael et al. (2018), Yao et al. (2021), and Conners et al. (2018). Although the researchers followed all the guidelines for quantitative and qualitative research methods, they did not vividly state research questions or hypotheses in all four articles. Therefore, it is essential to extract the probable guiding questions and hypotheses by reviewing each study’s scope and aim.

In a randomized controlled trial (RCT), Nojom et al. (2020) investigated the effectiveness of physical activity package (PAP) in the quality of life (QoL) in individuals with type 2 diabetes. Therefore, the overriding assumption was that PAP improves the quality of life of people with T2DM.

Secondly, Mikhael et al. (2020) conducted a qualitative study to understand the knowledge, behaviors, and barriers to diabetes self-management among Iraqi type 2 diabetes patients. The possible research questions for this study include (1) what is the role of knowledge and behaviors in self-management among Iraqi type 2 diabetes patients? (2) what barriers do they face?

Thirdly, Yao et al. (2021) conducted a secondary analysis of a randomized controlled trial to evaluate the independent effects of physical activity (PA) on hemoglobin (HbA1c) levels in Chinese patients with type 2 diabetes. Therefore, the hypothesis for this study was; physical activity can regulate hemoglobin levels in patients with type 2 diabetes.

Finally, Conners et al. (2018) conducted a randomized controlled trial (RCT) to determine the effects of an underwater treadmill walking program featuring a gradual and progressive increase in walking speed and duration on glycemic control. The hypotheses for this research were; (1) an underwater treadmill walking program has a positive effect on glycemic control and (2) gradual and a progressive increase in walking speed has positive effects on glycemic control.

A Comparison of Sample Populations

In a study by Nojom et al. (2020), the researchers included 100 participants and assigned even and odd digits for intervention and control groups respectively, meaning each group had 50 participants. On the other hand, Mikhael et al. (2018) involved 25 patients with T2DM recruited from the National Diabetes Center, Baghdad, Iraq.

Thirdly, 799 diabetes patients recruited from 35 selected clinic sites between February 2015 and March 2016 in China participated in a secondary analysis of a cluster RCT by Yao et al. (2021). Finally, 26 adults with physician-diagnosed type 2 diabetes volunteered to participate in the study Conners et al. (2018). The inclusion criteria included a diagnosis of T2DM for a minimum of 2 years, medical clearance to participate in exercise programs, and a sedentary lifestyle.

A Comparison of the Limitations of the Study

Three of the four selected studies revealed limitations that compromised their generalizability and validity. For instance, Nojom et al. (2020) identified a short follow-up period and the failure to measure HBA1C as the primary limitations of the randomized controlled trial. On the other hand, Mikhael et al. (2018) singled out a small sample size from only one diabetes center in Baghdad as the major limitation of this study.

Thirdly, Yao et al. (2021) mentioned various limitations, including the failure to compare the baseline levels of physical activity (PA) and HbA1c across the groups, the absence of detailed information on anti-diabetes agent uses and insulin shots, and the inability to avoid miscalculation bias. Finally, Conners et al. (2018) did not indicate any identified limitation (s) to the study.

Conclusion (with recommendations for further research)

Based on the findings and contentions from the selected quantitative and qualitative studies, it is valid to contend that physical activity (PA) effectively regulates blood glucose levels when applied at an appropriate speed and duration. In this sense, physical activity exercise represents an ideal non-pharmacologic intervention for tackling insulin resistance and moderating HBA1C levels.

Although these studies support the PICOT question, it is possible to comprehensively investigate the correction between physical activity and glycemic levels by conducting multisite randomized controlled trials (RCTs) with large sample sizes and long-term follow-up activities to obtain generalizable and reliable findings.


Conners, R. T., Caputo, J. L., Coons, J. M., Fuller, D. K., & Morgan, D. W. (2018). Impact of underwater treadmill training on glycemic control, blood lipids, and health-related fitness in adults with type 2 diabetes. Clinical Diabetes, 37(1), 36–43.

Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K. B., Ostolaza, H., & Martín, C. (2020). Pathophysiology of type 2 diabetes mellitus. International Journal of Molecular Sciences, 21(17).

Mikhael, E. M., Hassali, M. A., Hussain, S. A., & Shawky, N. (2018). Self-management knowledge and practice of type 2 diabetes mellitus patients in Baghdad, Iraq: a qualitative study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Volume 12, 1–17.

Mohamed, S. F., Mwangi, M., Mutua, M. K., Kibachio, J., Hussein, A., Ndegwa, Z., Owondo, S., Asiki, G., & Kyobutungi, C. (2018). Prevalence and factors associated with pre-diabetes and diabetes mellitus in Kenya: Results from a national survey. BMC Public Health, 18(S3).

Nojomi, M., Tapehsari, B., Alizadeh, M., Khamseh, M., & Seifouri, S. (2020). Physical activity and quality of life in people with type 2 diabetes mellitus: A randomized controlled trial. International Journal of Preventive Medicine, 11(1), 1–6.

Yao, W.-Y., Han, M.-G., De Vito, G., Fang, H., Xia, Q., Chen, Y., Liu, X., Wei, Y., Rothman, R. L., & Xu, W.-H. (2021). Physical activity and glycemic control status in Chinese patients with type 2 diabetes: A secondary analysis of a randomized controlled trial. International Journal of Environmental Research and Public Health, 18(8), 4292.

Literature Review Topic 6.

Assessment Description:

While the implementation plan prepares students to apply their research to the problem or issue, they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a review (750-1,000 words) that includes the following sections:

  1. Title page
  2. Introduction section
  3. A comparison of research questions
  4. A comparison of sample populations
  5. A comparison of the limitations of the study
  6. A conclusion section, incorporating recommendations for further research

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

PICOT question. (P) type two diabetes (I) physical activities (C) pharmacologic therapy (O) blood glucose levels (T) three months.

Refer to Literature Evaluation Table  order 115230