This PICOT question is essential for research into the effects of lifestyle medication programs on glycemic control for older adults with Type 2 Diabetes. The reason for choosing the PICOT question is to gain more insights into controllable factors of diabetes type-2 among older patients above 65 years. It is also essential to understand the factors affecting diabetes to include them in health education. It aids in gaining a better understanding of how such programs could be beneficial to this group of patients. A study comparing the outcome of adults placed under a lifestyle modification program for 12 months compared to those who received standard care will help understand the effects of the intervention.

The integration of evidence entails each part of the PICOT question, the patient's needs, and the outcome of the diabetes condition. Exercises in patients diagnosed with diabetes are essential for improving general metabolic health (Moghetti et al., 2020). Glucose metabolism health improvement is due to good hormonal balance and increased glucose intake in the cell. Exercise also helps patients reduce body weight, preventing the development of obesity, which is the leading cause of insulin resistance among patients with diabetes. Exercises on daily episodes are essential in increasing the body's glucose needs, which is essential in stimulating the body's hormonal system to utilize insulin in increasing glucose uptake into the cells to provide energy (Meuffels et al., 2022). The main impact is the role of aerobic exercises, which consume a lot of body energy and strengthen the body's muscles, which in turn causes the need for more glucose, stimulating the role of insulin in the body. 

Another integration is the need to inform the patient of the risk factors of not exercising and the negative impact on the diabetes state. Lack of exercise among diabetic patients worsens the condition due to the loss of pancreatic and other glucose-regulatory hormonal mechanisms (Moghetti et al., 2020). Lack of exercise also leads to the retention of large amounts of glucose in the blood, increasing blood sugar levels and worsening diabetes and multisystem damage. The primary complications of diabetes are kidney damage, blindness due to damage to the blood vessels supplying the retina, poor wound healing due to the poor blood supply, and the development of peripheral neuropathy due to damage to the peripheral neurons (Garber et al., 2020). Physical inactivity and lack of exercise among diabetic patients also increase the risk of weight gain, which may lead to the deposition of excessive fat tissues, increasing insulin insensitivity. The chances of developing complications among diabetic patients are higher when the patient is obese than when a patient has an average body mass index. 

It is necessary to use randomized-clinical trials among the groups on exercise evaluation and those patients on regular diabetes management without exercise incentives. Data would be collected from the actual study group and the control group. In evaluating the effectiveness of the implementation, the blood sugar levels of the patients of the actual study group or the patients who received exercise incentives are measured and compared to the initial blood sugar levels during diagnosis. The blood glucose of the control group would also be measured against the initial diagnosis levels (Meuffels et al., 2022). Statistical tests will also highlight more information, the interventions' impact, and the comparisons. The results will also inform the healthcare practitioners of the program's short-term and long-term effectiveness. The results are also essential in improving the diabetic state of patients in the population and also inform all the support groups on collaborative management of diabetes.

References

Megahed, F. I. A., Hassan, S. A. A., Abdelwahid, H. A., & Farg, H. K. (2021). Effect of Lifestyle Modification on Glycemic Control of Type 2 Diabetic Patients at Suez Canal University Hospitals. Intechopen. https://doi.org/10.5772/intechopen.97738