Treatment and Advances in Diabetes

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Introduction

The study by Perkins et al. (2014) Sodium-glucose cotransporter 2 inhibition and glycemic control in type 1 diabetes: results of an 8-week open-label proof-of-concept trial is a peer-reviewed article that summarizes the results of the comprehensive research work and is published in a scholarly journal with a high reputation Diabetes Care.

Critiquing the Research Article

The title of the article describes it accurately and gives the general idea of what question the study aims to investigate. From the title, the reader can understand what kind of disease is the center of the articles attention, the kind of treatment that was used by the researchers, and the period over which the study has been performed.

The abstract of the study is represented in the form of featuring the key points of the article: its objective, research design and methods, results, and conclusions. Thus, it may be considered that the abstract is representative of the article since it gives a guide to what the paper is about and its most essential outcomes.

The articles introduction makes the purpose of the article clear. In the introduction, the authors describe what kind of studies they performed (animal and short-term human). Also, Perkins et al. (2014) mention what the results of the study demonstrate in a concise form.

The problem investigated by the authors is introduced properly though briefly. Perkins et al. (2014) mention that their research is dedicated to the study of one of the ways of performing glycemic control.

Although there is a subtitle objective of the study, it cannot be said that the purpose of the study is outlined by the authors clearly. Perkins et al. (2014) do not pay sufficient effort to explain why they initiated their study.

There is no separate paragraph defining the research questions. However, there is no need for this since the authors do their best to describe the study, and research questions can be deduced from this description.

In Perkins et al.s (2014) article, there is no description of the theoretical framework. However, it does not seem crucial in this particular type of study.

The article does not contain a literature review. However, the omission of this part of the study seems typical of such type of research. The studies by Chen et al. (2016), Ferrannini et al. (2014), and Vasilakou et al. (2013) are also dedicated to the investigation of sodium-glucose cotransporter 2 inhibitors for type 2 diabetes. These articles also do not contain a review of the literature.

The methods chosen for the study were published in another study by the authors, the publication information about which they provide. Thus, in their previous article, the authors measured inulin and paraaminohippurate clearances established on hyperfiltration (Cherney et al., 2013). Also, they measured circulating levels of renin-angiotensin-aldosterone system mediators and renal function under clamped hyperglycemic and euglycemic conditions (Cherney et al., 2013). The method design is appropriate for the study. Data were collected via patients documentation of their daily intake of medicines and the changes in health indicators. The validity and reliability of the data were not described. The sample size  40 patients  is sufficient to notice the divergences in glycemic control in people of nearly the same age. However, it would have been good if the authors had included patients of various ages in their study. Still, I understand that it would have required much more resources.

The analytical approach of the study is consistent with the research design. The results are presented clearly in the text as well as in figures (Perkins et al., 2014). The statistics are explained clearly.

There is no separate discussion section in the article. Perkins et al. (2014) do not explain the relationship of the results to the significance of nursing. The authors point out the single-arm design of the study as the major limitation of the study. However, Perkins et al. (2014) mention that this limitation does not take away from the beneficial outcomes of the research.

In their conclusion, the authors underline the advantages of the study. There are no recommendations for future research, nursing practice, or policymakers.

The Level and Quality of the Evidence

Since the study by Perkins et al. (2014) is based on the results of a controlled study without randomization, its level of evidence is IIA (Levels of evidence and grades of recommendations, 2017). This is not the highest possible level, but its quality is quite high and allows the researchers to make reliable conclusions.

Applicability of the Study to Practice

Research by Perkins et al. (2014) presents high clinical efficacy. The results and recommendations from the article can be used when applying treatment for patients who suffer from diabetes. The sodium-glucose cotransporter 2 inhibition is investigated in many articles. Many studies (Abdul-Ghani, Norton, & DeFronzo, 2015; Chen et al., 2016, Ferrannini et al., 2014, Vasilakou et al., 2013) also emphasize the benefits of such treatment.

Conclusion

Despite the omission of some crucial elements of a traditional research article, the study by Perkins et al. (2014) may be considered an important achievement in the fight against diabetes.

References

Abdul-Ghani, M. A., Norton, L., & DeFronzo, R. (2015). Renal sodium-glucose cotransporter inhibition in the management of type 2 diabetes mellitus. American Journal of Physiology  Renal Physiology, 309, F889F900.

Chen, M., Xie, C.-G., Gao, H., Zheng, H. Chen, Q., & Fang, J.-Q. (2016). Comparative effectiveness of sodiumglucose co-transporter 2 inhibitors for controlling hyperglycaemia in patients with type 2 diabetes: Protocol for a systematic review and network meta-analysis. BMJ Open, 6(1), e010252.

Cherney, D. Z., Perkins, B. A., Soleymanlou, N. Maione, M., Lai, V., Lee, A., & von Eynatten, M. (2013). Renal hemodynamic effect of sodium-glucose cotransporter 2 inhibition in patients with type 1 diabetes mellitus. Circulation, 129(5), 587-597.

Ferrannini, E., Muscelli, E., Frascerra, S., Baldi, S., Mari, A., Heise, T., & Woerle, H.-J. (2014). Metabolic response to sodium-glucose cotransporter 2 inhibition in type 2 diabetic patients. Journal of Clinical Investigation, 124(2), 499-508.

Levels of evidence and grades of recommendations. (2017).

Perkins, B. A., Cherney, D. Z. I., Partridge, H., Soleymanlou, N., Tschirhart, H., Zinman, B., & Johansen, O.-E. (2014). Sodium-glucose cotransporter 2 inhibition and glycemic control in type 1 diabetes: Results of an 8-week open-label proof-of-concept trial. Diabetes Care, 37(5), 1480-1483.

Vasilakou, D., Karagiannis, T., Athanasiadou, E., Mainou, M., Liakos, A., Bekiari, E., & Tsapas, A. (2013). Sodium-glucose cotransporter 2 inhibitors for type 2 diabetes: A systematic review and meta-analysis. Annals of Internal Medicine, 159(4), 262-274.

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