Chapter 7 Part 4 (1)在线视频

Part 4

Case Analysis

This article titled Multidisciplinary diabetes care with and without

bariatric surgery in overweight people

a randomised controlled trial is from the Lancet

Let’s first analyze this case’s structure

This introduction is composed of 4 paragraphs

It falls into the 3 moves

of the general structure of introduction

To understand the analysis better

please let’s look at the background of this article

Bariatric surgery improves

glycaemia in obese people with type 2 diabetes

but its effects

are uncertain in overweight people with this disease

The authors aimed to identify

whether laparoscopic adjustable gastric band surgery

can improve glucose control in people with type 2 diabetes

who were overweight but not obese

The first paragraph describes what is known

These two sentences present the general topic

excessive body weight with type 2 diabetes

and its difficult management

Thus

the authors provide evidence for their study

Claim importance

The next sentence

provides statement about the management approach

in weight loss

of obese people with type 2 diabetes

in randomised trial of lifestyle change

or bariatric surgery

The Intervention for obese people with type 2 diabetes

can reduce drug burden

and later achieves better results within 2 years

It is effective

Now it narrows down the topic

what is unknown

what is the gap

The second paragraph moves to What is unknown

That is there is no well-built evidence

for how big weight loss can affect the overweight people

with type 2 diabetes

The next two sentences further support this statement

One is the Look AHEAD trial result

The investigators found that

only one year later after lifestyle intervention

even a mild weight loss

like 10%of bodyweight

could affect a diabetes remission rate

about 10% of people with BMI less than 32.5%

The other is the results from bariatric surgery

in overweight people with type 2 diabetes

could only be found in observational studies of some surgeries

The last sentence of this paragraph

To date

no randomised trials of bariatric surgery

in overweight but not obese people have been reported

and its true benefit if any remains uncertain

this sentences describes the gap

in the present understanding of the effects of bariatric surgery

on overweight but not obese people

In this third paragraph

there are two sentences

The first sentence is the further explanation

to Laparoscopic adjustable gastric banding

showing that this intervention applied for obese people

is safe and effective

And the second sentence

is literature about previous randomised trial

These two sentences put together

reinforce the feasibility of the current study

on the overweight people

What is the aim

What is their hypothesis

You see

the aim and hypothesis are placed at the last paragraph

Now let’s analyse the language features of this article

First about the length

The total word count of this section is 375

spreading over four paragraphs

Second about the tenses

used in each move of the Introduction

To describe the current state of knowledge

of excess body weight

The present tense is used

in the first two sentences

To describe a process that began in the past

and is not yet finished

The present Perfect is used

The present tense

is used to show the fact of research results

In this paragraph

the first sentence uses present simple tense

to show the statement is a fact

You see is less established

The second sentence describes a past trial

so past simple tense is used

Showed

be associated with

was

When it comes to the current facts

the present simple tense is used

are limited

describe

have been reported

remains

Let’s come to the last paragraph of the introduction

We did this trial to establish whether

laparoscopic adjustable gastric banding had a similar effect

on glucose control in people with type 2 diabetes

who were overweight but not obese

We postulated that

laparoscopic adjustable gastric banding

in addition to multidisciplinary diabetes care

would improve glycaemic control

with acceptable comparative costs and safety

compared with multidisciplinary care alone

The first sentence is to formulate the author’s objectives

the past tense is used

did this trial, had, were

When it comes to the hypothesis

the first verb postulate

is past tense

and the tense would improve

is used for the verb in the clause

Next let’s look at the following sentences from this section

to appreciate the word choices

that are helpful in pushing the natural flow of the content

Sentence 1

Management of type 2 diabetes

is generally framed within a chronic disease model

with an expectation of progressive deterioration

in glucose control over time

Here the adverb generally is a good choice

It shows that the management of type 2 diabetes

is commonly or universally or popularly treated

as a chronic disease

and this kind of treatment has been well accepted

According to the article

this kind of treatment works well

among the obese people with type 2 diabetes

Thus this general treatment to type 2 diabetes

lays a solid foundation for the further research

among the overweight people with type 2 diabetes

Imagine the meaning of the sentence without this adverb

Sentence 2

The effect of substantial weight loss

on outcomes in overweight but not obese people

with type 2 diabetes is less well established

established means well-known or validated

this is from Collins Dictionary

When we say that something is well-established

we mean that

it has been in existence for quite a long time

and is successful

According to the article

evidences for how well substantial weight loss

could affect overweight with type 2 diabetes are insufficient

The word “less” indicates that

the authors are less than 100% certain

but confident enough

and signals how well they balance caution and confidence

Think if the sentence goes like this

The effect of substantial weight loss

on outcomes in overweight but not obese people

with type 2 diabetes is NOT well established

Not well established

makes the sentence sound more aggressive

In most academic writing

it is better to avoid too much assertive