Article Critique: Childhood Type 2 Diabetes

Research Article Critique-Childhood Type II diabetes and Obesity

University of Phoenix

Research Article Critique Research critique enables nurses as a research consumer to evaluate the scientific merit of the study and decide how the results may be useful in practice. Critiquing involves intensive scrutiny of a study, including its strengths and weaknesses, statistical and clinical significance and the generalizability of the results. This paper will critique a medical quantitative study, which was conducted to “assess the prevalence of autoimmune thyroid disease (ATD) in insulin-treated youth with clinical features of type two diabetes mellitus (T2DM).” The study clearly states the increase concern among medical professionals
regarding the rising cases of T2DM among the pediatric population and the possibility for these type of patients to be at risk for developing ATD. Hypothyroidism was defined as the presence of increased thyroid-stimulating hormone (TSH) with or without decreased free T4 . Hyperthyroidism was defined as the presence of a decreased TSH and an elevated T3. Basal mass index (BMI) was calculated, and obesity was defined as a BMI >=85th percentile for age and sex. The objective of the study were to determent the prevalence of thyroid antibodies in Caucasian ( C ) and African-American (AA) children less than 19 years of age at onset of insulin treated diabetes; (ii) to compare their prevalence in three groups: the first group were lean children with or without B-cell autoimmunity, second group obese children with basal metabolic index (BMI)of >=85 percentile with evidence of B-cell autoimmunity, and with characteristics of diabetes type one and diabetes type two recognize as having double diabetes (DD) and the last group obese children with BMI of >=85 percentile with no evidence of b-cell autoimmunity.
The research shows that in patients with clinical features of T2DM who have evidence of B-cell autoimmunity (DD), the frequency of thyroid antibodies and ATD is similar to that in classical T1DM. This findings suggests that T1DM co-morbidities may be common in clinical T2DM patients who have B-cell autoimmunity. Despite their obesity, youth with insulin requiring diabetes should be screened for thyroid and possible other T1DM associated autoimmune
disease. The method of selecting the participants and the sample size was appropriate.
The researches evaluated 183 White and Black children for the prevalence of thyroid peroxidase (TPO) and thyroglobulin (TGA) antibodies at onset of insulin-treated diabetes. 136 BMI of = 85th percentile) with or without acanthosis nigricans with B-cell autoimmunity or DD (group II) and 22 were overweight with no conventional B-cell auto-antibodies (group III). The criteria for selection process was suited for the study. The participants were admitted to Children’s Hospital of Pittsburgh with new onset diabetes determined to be insulin requiring by physicians less than 19 years of age at diagnosis; and insulin therapy at the time of hospital discharge. All cases of secondary diabetes were
excluded. The general treatment philosophy was to start insulin therapy in all patients with clinically apparent insulin-requiring diabetes, based on the presence of ketosis and/or severe hyperglycemia and/or marked weight loss, irrespective of the presence of obesity. Patients that became euglycemic and were treated with diet and some with oral agents and these patients were excluded as well as those designated clinically as T2DM and treated without insulin at onset. Blood samples were obtain within 1 week of diagnosis for measurement of insulin auto-antibodies and within three months of diagnosis for testing of other B-cell auto-antibodies. Children who did not have available clinical data or blood for antibody measurements were excluded. Informed consent was obtained from all subjects. Moreover, demographic and clinical data were obtained from review of medical records, including sex, race, date and age at onset, height, weight, presence of acanthosis nigricans, and development of ATD. Demographic differences were not identify within the groups. The framework used was well-developed and clearly expressed; in addition; the concepts and the variables measured was appropriate for the study. The researcher used a variety of measurements and models to assess data; for example, student’s t-test and the one-way analysis of variance were used to compare continuous variables and chisquared test to compare proportions. In cases of having empty cell or cells with the expected values less than 5, fisher’s exact test was used. The p values