Running head: LITERATURE REVIEW 1

Literature Review

Kailey Koons

Grand Canyon University: NSG 324

November 11, 2018

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Introduction

“Type 1 diabetes mellitus (T1DM) of children is a congenital and chronical metabolic

disease, which is caused by the absolute shortage of insulin secretion” (Bayat, Uslu, Erdem, Efe,

Variyenli, Arican, & Kurtoglu, 2017, p. 1). Because there is no insulin being made or there is not

enough insulin in the body most of these children will on insulin injection treatments for the rest

of their life. This means checking blood glucose multiple times a day, counting calories to know

how much insulin to give, and getting insulin injections multiple times a day. There are some

parents who have tried to use complementary and alternative therapies instead of the insulin

injections. This author is trying to figure out if there is a definite difference in the blood glucose

levels in one type of therapy or the other. The author’s PICOT question is wondering whether the

use of insulin treatment or complementary and alternative therapies are better at maintaining an

appropriate blood glucose level over two years’ time. This author will be using three articles to

pick apart and use to help further the research into the PICOT. This will include methods, a

synthesis of the literature, and areas of further study.

Methods

Since every research study is different, each of study is going to have different methods

to conduct that study. The articles this author chose were picked specifically to support one type

of therapy over the other. For this particular assignment, two out of the three articles support

insulin treatment as better at maintaining an appropriate blood glucose level. The other article

does not necessarily support complementary and alternative therapies instead of insulin, but it

supports the use of those with insulin treatment. This was one criterion for this author in

choosing articles. Another criterion was that the article had to be published within the last five

years. All of the articles fit within this criterion. The last criterion this author had for choosing
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articles was that they had to be specifically about either insulin treatment or complementary and

alternative therapies and the maintenance of blood glucose levels.

Synthesis of Literature

With a topic like type one diabetes in children, articles can go in many different

directions. The subject of the three articles this author has chosen are similar. They all examine

which type of treatment or therapy would be better at maintaining an appropriate blood glucose

level. This is where the similarities ended for the most part. Dong, Liu, Chen, Sun, Xiao, & Wu,

(2017) were studying nutrition in combination with insulin treatment and did a comparison of a

group of children with type one diabetes and healthy children. In the article written by Korkmaz,

Demir, Cetin, Mecidov, Altinok, Ozen, Darcan, Goksen, (2018), they used methods similar to

the previous article. This particular article studied all children with type one diabetes, but they

were trying to see if “continuous subcutaneous insulin infusion” or multiple daily insulin

injections were better at maintaining an appropriate blood glucose (Korkmaz, Demir, Cetin,

Mecidov, Altinok, Ozen, Darcan, Goksen, 2018, p. 147). Lastly, in the article written by Bayat,

Uslu, Erdem, Efe, Variyenli, Arican, & Kurtoglu (2017), they used a method that was completely

different from the other two articles. This study was qualitative in design. The researchers asked

the parents and children questions about the complementary and alternative methods they were

using to help maintain an appropriate blood glucose level. The participants in this study were

also asked to fill out a questionnaire with similar information. The key findings for each article

are different. In the article written by Dong, Liu, Chen, Sun, Xiao, & Wu, (2017), it was found

that the children with diabetes that had correct nutrition along with insulin were at the same

levels as the children who were healthy. This article supports the authors PICOT because it is

showing that insulin along with proper nutrition is a good way to maintain an appropriate blood
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glucose level. The article written by Korkmaz, Demir, Cetin, Mecidov, Altinok, Ozen, Darcan,

Goksen, (2018) found that continuous subcutaneous insulin infusion is better at maintaining an

appropriate blood glucose level than multiple daily insulin injections. This article supports the

author’s PICOT because it is showing that insulin is a better way of maintaining an appropriate

blood glucose level even if it is just one form of giving insulin over another. The findings in the

article written by Bayat, Uslu, Erdem, Efe, Variyenli, Arican, & Kurtoglu (2017) were that a

high percentage of parents are using complementary and alternative therapies in conjunction with

insulin treatments to help maintain an appropriate blood glucose level. This article supports the

author’s PICOT because it is showing that one therapy over the other is not necessarily better,

but a combination of the two therapies may be better at maintaining an appropriate blood glucose

level than just one over the other.

Areas of further study

Using information from these articles there are many things that are known. It is known

that insulin is a universal treatment for diabetes. There are different types of insulin treatment

and a continuous infusion is better than the multiple daily shots. It is also known that

complementary and alternative therapies are on the rise and being used in addition to insulin

treatments. An unknown is if there are any studies done that focus solely on the use of

complementary and alternative therapies instead of insulin as a way to better maintain

appropriate blood glucose levels. This would need further study because this author cannot use

articles that are exclusively supporting one side of the PICOT question. This would lead to a

bias. Another element that needs further study is how insulin by itself is at maintaining an

appropriate blood glucose level.

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References

Bayat, M., Uslu, N., Erdem, E., Efe, Y. S., Variyenli, N., Arican, F., & Kurtoglu, S. (2017).

Complementary and Alternative Medicine Used for Children with Type 1 Diabetes

Mellitus. Iranian Journal of Pediatrics, 27(4), 1–6.

Dong, Y.-J., Liu, L.-J., Chen, H.-M., Sun, J., Xiao, M.-H., & Wu, J.-H. (2017). Influence of

nutritional intervention on children with type 1 diabetes mellitus and DPP-4 in

serum. Experimental and Therapeutic Medicine, (2), 913.

Korkmaz, O., Demir, G., Cetin, H., Mecidov, I., Altinok, Y. A., Ozen, S., Darcan, S., Goksen, D.

(2018). Effectiveness of Continuous Subcutaneous Insulin Infusion Pump Therapy

During Five Years of Treatment on Metabolic Control in Children and Adolescents with

Type 1 Diabetes Mellitus. Journal of Clinical Research in Pediatric Endocrinology, (2),

147.