Part I: Read the attached file

(Part II and Part III)

The Assignment:

Watch this Glucose, Insulin and Diabetes Video.

Then, research the general facts of diabetes to better address Elena’s concerns. Copy the questions below into a word processing document. Research Type 1 and Type 2 Diabetes to answer the questions. You can use quotes from your research that are copied and pasted into your submission file but you MUST include a hyperlink directly to the source. You will need to have access to your submission file during class!

1. Distinguish between Type 1 and Type 2 diabetes by comparing and contrasting their definitions, bodily effects, warning signs, target groups, and current treatments in a table.
2. Look up statistics to share concerning both types of diabetes.
3. Understand the function of insulin and its involvement with diabetes.
4. Answer the following question: Recent studies on mice have shown that fat cells produce a hormone called resistin that leads to insulin resistance. Researchers believe the gene that regulates the production of resistin is overactive in those suffering from obesity. How does this discovery correlate with Type 2 diabetes?

Pre-Class Research (Part III: Exploring Options)

Back home, Elena’s friends and family offered various pieces of advice:

• Her best friend, Julia, suggested the Keto Diet, a high-fat, low-carbohydrate regimen. “It’s all about cutting carbs and increasing fat intake. Many people have had success with it.”
• Her brother, Carlos, recommended regular exercise and a balanced diet. “You should focus on eating whole foods, reducing sugar intake, and incorporating exercise into your daily routine.”
• Her aunt, Maria, advocated for a traditional approach. “Why not try herbal supplements and remedies? They’ve been part of our culture for generations.”

Dr. Patel also referred Elena to a nutritionist, Dr. Rodriguez, who specialized in diabetes management. Dr. Rodriguez proposed a medically supervised weight loss program tailored to her needs.

Elena felt torn. Each option seemed viable, but which one was the best for her?

The Assignment: Copy the questions below into a word processing document. Research each of the weight loss strategies listed below and answer the questions. You can use quotes from your research that are copied and pasted into your submission file but you MUST include a hyperlink directly to the source. You will need to have access to your submission file during class!

Option 1: Medically Supervised Weight Loss Program

1. Find out what the components of a medical weight loss program are.
2. Compare the pros and cons of these programs to dieting and exercising on your own.
3. Research the pros and cons of using pre-packaged meals vs. meal replacement drinks/bars vs. meal plans that use grocery store foods.
4. Research the pros and cons of using prescription appetite suppressants.

Option 2: Keto Diet

1. Research the pros and cons of the Keto Diet, a high-fat, low-carbohydrate diet.
2. Find out what at least 2 major healthcare organizations say about the Keto Diet.

Option 3: Exercise and Healthy Diet

1. Research the pros and cons of using a balanced but calorie-restricted diet to lose weight.
2. Research the possible effects of exercise to control weight.
3. Find out what major healthcare organizations say about using diet and exercise for weight loss and/or diabetes control.

Option 4: Herbal Medications

1. Find out how the 3 main types of weight-loss drugs work (fat absorbers, appetite suppressants, and thermogenics/metabolic stimulants). Give an example of each.
2. Research the pros and cons of using health store supplements containing the herb ephedra (ephedrine) to lose weight.
3. Find out what major healthcare organizations say about herbal ephedra supplements.

Elena spent the next week researching her options. She considered her friends’ and family’s advice, as well as the information provided by Dr. Rodriguez. Each method had its advantages and disadvantages, and Elena needed to choose the one that best fit her lifestyle and health goals.

What should Elena do? Use your research on the four weight-loss methods mentioned in the case and scientific reasoning to advise Elena. Assemble evidence to support (or refute) the hypotheses of Dr. Rodriguez, Julia, Carlos, or Maria.

Hypotheses:

• Dr. Rodriguez: A medically supervised weight loss program that includes nutrition, calorie restriction, and the use of prescription medications will result in long-term weight loss and is appropriate for a woman with diabetes and obesity.
• Julia: The Keto Diet, which severely limits carbohydrates but does not restrict proteins or fats, will result in long-term weight loss and is appropriate for a woman with diabetes and obesity.
• Carlos: Lifestyle changes that include eating a nutritionally balanced diet, but calorie restricted in sugars and fats, and moderate exercise will result in long-term weight loss and is appropriate for a woman with diabetes and obesity.
• Maria: Eating a nutritionally balanced diet and using traditional herbal remedies, like ephedra or similar supplements from the diet shop, will result in long-term weight loss and is appropriate for a woman with diabetes and obesity.

The Assignment: Copy the 11 questions below into a word processing document. Answer the questions - each student must turn in answers in their own words. You may find chapters 11 and 12 in our textbook helpful, in addition to your research.

1. Identify potential biases: What personal or cultural biases are evident in each of the viewpoints presented? How might these biases influence the advice given to Elena?

2. Evaluate emotional influence: Do any of the advisors need to address their underlying emotions or beliefs about obesity and diabetes before advising Elena? Provide a rationale for your answer.

3. Assess practical challenges: What challenges might Elena face in following each of the recommended plans (e.g., financial costs, time commitment, access to resources)? Reflect on your own perspectives on obesity and diabetes while considering these challenges.

4. Long-term effectiveness: Each weight loss method has been effective for short-term weight loss. Which method do you believe would be most sustainable for long-term weight loss for Elena? Discuss any potential biases you may have regarding these methods.

5. Analyze internet resources: In your research, identify any biases in the provided internet resources. Which resources seemed to have a positive, negative, or neutral stance? What do you think contributed to these biases?

6. Evaluate evidence quality: What evidence did you find to support or refute the long-term weight loss success of your assigned method? Was the evidence scientific (e.g., clinical trials, data) or anecdotal (e.g., personal testimonials, claims without data)?

7. Assess safety for diabetics: What evidence did you find regarding the safety or suitability of your assigned method for a person with diabetes? Was this evidence based on scientific research or anecdotal reports?

8. Consider contraindications: Given that individuals with diabetes and obesity have a higher risk for heart disease and stroke, does your assigned method pose any contraindications for these conditions?

9. Summarize pros and cons: Summarize the advantages and disadvantages of your assigned weight loss method. Include any evidence that supports or contradicts the hypothesis you are examining.

10. Provide final advice: Based on your research and analysis, what is your final recommendation to Elena? Support your advice with evidence and reasoning.

11. Further Discussion:

In May 2019, a study by the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases compared ultra-processed and minimally processed diets in a controlled clinical trial. How could this study design be adapted to evaluate the effectiveness of weight loss plans for patients with diabetes and obesity? What additional data should be collected besides body weight? How should the use of diabetes medications be factored into the study?