The introduction of PICOT-formulated questions to clinical research significantly improved its efficiency by facilitating the process of navigating the existing base of knowledge and finding relevant evidence. Diabetes mellitus (DM) is a disease characterized by a high blood sugar level caused by a deficiency of insulin production. The prevalence of diabetes has significantly increased in the past decades, making it one of the main concerns of modern public health systems (Lovic et al., 2020). It is expected that diabetes prevalence will continue to grow over the following years, and more than 9% of the global population will have DM in 2040 (Lovic et al., 2020). In addition to DM’s negative effects on an individual’s organ functioning, the disease significantly reduces the quality of life by causing physical impairments and injuries. Thus, older adults with DM face significantly higher risks of falls and physical disability.
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Physical exercises are often recommended to patients with diabetes to manage the disease effectively. According to Carbone et al. (2019), obesity and type 2 diabetes mellitus (T2DM) are caused by excess adiposity, which forms as a result of an unhealthy diet, lack of physical activity, and a sedentary lifestyle. Physical activity interventions such as exercise complexes can create a chronic negative energy balance, resulting in weight loss and reduction of adipose tissue (Carbone et al., 2019). Therefore, a significant portion of clinical research focuses on exploring the effects of physical activity in diabetes care and prevention. However, the question of the possible effect of physical activity on reducing the risks of falling in older adults with DM is explored less in the existing research. Therefore, this paper aims to use the PICOT question to define whether the integration of physical activity in diabetes care in older adults with T2DM will result in lower risks of falls. PICOT question: are older adults with T2DM (P) who regularly practice physical activity (I) for one year (T) at a lower risk of fall (O) than older adults without T2DM (C)?
Formulating a PICOT question eases the process of planning a search strategy. The majority of modern databases, journals, and websites support advanced search methods with the use of keywords. In the case of research with a PICOT question, each component of the question contains relevant keywords, which speeds up the process of relevant evidence filtration. Thus, the relevant keywords for the research include diabetes patients, older adults, physical activity, and fall risks. Furthermore, considering the sources of evidence, it was important for the research to use reliable and recent findings. Therefore, the research prioritized findings sourced from the PubMed database, which specialized in academic articles on medical research.
Next, the search in the PubMed database identified four articles that can be applied to the research. Firstly, the article written by Kraiwong et al. (2021) focuses on defining the effects of physical-cognitive training in older adults with T2DM who experience balance impairment. The research centered on the issue of fall risks in older adults and proposed a combined program of physical exercises and cognitive training to reduce the risks (Kraiwong et al., 2021). Furthermore, a study conducted by Drummond et al. (2022) focused on assessing fall risks among adults over 50 with type 1 and type 2 diabetes. The survey showed that most participants were not informed about the higher risks of falls and fractures in patients with diabetes, and only half of the respondents regularly engaged in physical activity (Drummond et al., 2022). Both articles can be used to draw important conclusions about the connection between physical activity and the risk of falls in adults with T2DM. However, their application in the research does not provide accurate information on fall risk reduction in T2DM patients who regularly practice physical activity over a period of one year.
On the other hand, the application of findings from the next two articles in the research provides more specific information about the reduction in the risk of falls in older adults with T2DM. Firstly, the study conducted by Huebschmann et al. (2022) explored the effects of physical activity coaching on adults with T2DM. The authors proposed a physical activity counseling program for diabetes care and assessed its efficiency in reducing the risk of falls (Huebschmann et al., 2022). Next, the article by Mesinovic et al. (2021) explored the risk of falls and fractures in populations of older men with T2DM and older men without T2DM. Therefore, combining the findings from the two articles can provide important information for the resea
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