1.Diabetes type 2 can be countered in different ways, either the use of drugs such as metformin or changing lifestyles. The study carried out placed a large group of people into three categories: receiving a placebo, a lifestyle change program and the administration of metformin (Umpierrez et al., 2014). Use of placebo is important as a control in determining the effects of the other two approaches. Upon a follow-up, this study concludes that use of lifestyle change and taking metformin are effective in the reduction of type 2 diabetes. According to Dunkley et al., (2014), the lifestyle change program may involve high physical activity and take note of the diet composition to avoid fat accumulation as well as excess blood sugars that might damage glucose receptors and result in type 2 diabetes. Use of metformin (an antidiabetic drug) although also reduces diabetes type 2 incidences, its efficiency is low as compared to lifestyle change program.
2.In the retrospective study conducted to determine the major adverse effects in noncardiac surgery, statistical analysis on odds ratio was carried out. This statistical analysis was aimed at determining the relative proportion of the study population who were at risk of developing major adverse cardiac effects (Hawn et al., 2013). It is evident that confounding variables are a barrier to a successful study. The numerous limitations associated with a clinical study may make it difficult to draw meaningful recommendations. Generally, randomized trials generate more meaningful conclusions as opposed to other studies which mostly generate the hypothesis (Pearse et al., 2014). Of great importance is the follow-up period whereby it is necessary to minimize the rate of loss in follow-up.
Dunkley, A. J., Bodicoat, D. H., Greaves, C. J., Russell, C., Yates, T., Davies, M. J., & Khunti, K. (2014). Diabetes prevention in the real world: effectiveness of pragmatic lifestyle interventions for the prevention of type 2 diabetes and of the impact of adherence to guideline recommendations. Diabetes care, 37(4), 922-933.
Umpierrez, G., Povedano, S. T., Manghi, F. P., Shurzinske, L., & Pechtner, V. (2014). Efficacy and safety of dulaglutide monotherapy versus metformin in type 2 diabetes in a randomized controlled trial (AWARD-3). Diabetes care, 37(8), 2168-2176.
Hawn, M.T., Graham, L.A., Richman, J.S., Itani, K.M., Henderson, W.G., & Maddox, T.M. (2013). Risk of major adverse cardiac events following noncardiac surgery in patients with coronary stents. JAMA, 310(14), 1462-1472. doi: 10.1001/jama.2013.278787.
Pearse, R. M., Harrison, D. A., MacDonald, N., Gillies, M. A., Blunt, M., Ackland, G., & Hinds, C. (2014). Effect of a perioperative, cardiac output–guided hemodynamic therapy algorithm on outcomes following major gastrointestinal surgery: A randomized clinical trial and systematic review. Jama, 311(21), 2181-2190.
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