PICOT/Research Question

In adults 65 years and older diagnosed with diabetes mellitus, how effective are the use of

dietary supplements, such as cinnamon, compared to medication alone, such as insulin

therapy/oral hypoglycemics, in the prevention of diabetic complications within a one-year

period?

PICOT TABLE

P Adults 65 years and older diagnosed with diabetes mellitus

Age is one of the most important risk factors for type 2 diabetes with

individuals in older age groups assuming a high burden of disease. Selvin

and Parrinello (2013) stated that in the US, adults aged 65 or older had 20%

prevalence of diabetes in 2011 versus the 2.4% disease prevalence found

among adults 18 to 44 years of age.

I Dietary supplements like cinnamon

It is believed that dietary supplements like cinnamon help patients to control

blood glucose. Hasanzade et al. (2013) stated that traditional herbs and

spices such as Ròu Guì and Cinnamomum cassia are commonly used for

control of glucose. They also stated that cinnamon was the most bioactive

among spices such as mint, green tea, and carnation.

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each section should be supported with a reference

C Insulin/Oral hypoglycemic medications

Insulin and/or oral glycemic medications are universally used to treat and

manage diabetes due to their ability to control blood sugar levels. Insulin

offers a unique ability to control hyperglycemia when used from the time of

diagnosis and when metabolic control is disturbed by medical illness,

procedures, or therapy, as well as in the longer term (Home et al., 2014).

O Prevention of diabetic complications

The ultimate goal of diabetes management is prevention of long-term

complications. Uncontrolled diabetes can lead to a number of short and

long-term health complications, including hypoglycemia, heart disease,

nerve damage, limb amputation, and vision problems. According to Vinik &

Vinik (2003), chronic complications can be devastating to patients with

diabetes mellitus. The major cause of morbidity and mortality among these

patients are complications such as cardiovascular illness, macrovascular

disease, and microvascular disease, with retinopathy, nephropathy, and

neuropathy.

T Within a one-year period

There is no set time frame for diabetic complications to occur. It all

depends on how uncontrolled the management has been. The duration of

diabetes and the degree of glycemic control achieved are noted to be risk

factors for complications (Nickerson & Dutta, 2012).

References

Hasanzade, F., Toliat, M., Emami, S. A., & Emamimoghaadam, Z. (2013). The effect of

cinnamon on glucose of Type II diabetes patients. Journal of Traditional and

Complementary Medicine, 3(3), 171–174. https://doi.org/10.4103/2225-4110.114900

Home, P., Riddle, M., Cefalu, W. T., Bailey, C. J., Bretzel, R. G., Del Prato, S., Leroith, D.,

Schernthaner, G., van Gaal, L., & Raz, I. (2014). Insulin therapy in people with type 2

diabetes: Opportunities and challenges? Diabetes Care, 37(6), 1499–1508.

https://doi.org/10.2337/dc13- 2743

Nickerson, H. D., & Dutta, S. (2012). Diabetic complications: Current challenges

and opportunities. Journal of Cardiovascular Translational Research, 5(4),

375–379. https://doi.org/10.1007/s12265-012-9388-1

Selvin, E., & Parrinello, C. M. (2013). Age-related differences in glycemic control in diabetes.

Diabetologia, 56(12), 2549–2551. https://doi.org/10.1007/s00125-013-3078-7

Vinik, A. I., & Vinik, E. (2003). Prevention of the complications of diabetes. The American

Journal of Managed Care, 9(3 Suppl), S63–S84.

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