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Type 2 Diabetes is a global epidemic

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on 6 September 2013

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Transcript of Type 2 Diabetes is a global epidemic

Quantitative research shows the importance of identifying risk factors, self-care, education, and promotes the use of advanced technology with varying research designs
A cross-sectional study design was performed to assess the correlation between known protective factors, risk factors, and adaptive outcomes, within older adult type two diabetics.
Protective factors
: physical activity, coping strategy, and social support (Huang, Courtney, Edwards, & McDowell, 2010).

Risk factors
: age, duration of diabetes. body mass index, life events, diabetes distress, and diabetes symptoms (Huang et al., 2010).

Adaptive outcomes
: blood glucose control, quality of life, diabetes self management

Protective factors improved adaptive outcomes
Social support and coping strategies significantly reduced HbA1c levels and self-care behaviors
It is important for health care providers to take into account the protective factors in evaluating the disease development and planning diabetes intervention programs (Huang, Courtney, Edwards, & McDowell, 2010).
Patient education provided to patients with type two diabetes

A quasi-experimental study evaluated the effectiveness of using a technological based intervention to promote patient self-care while giving providers insight into how their patients were trending
Nursing interventions via internet could improve HbA1c in obese patients with type 2 diabetes mellitus.
Application into practice
Type 2 Diabetes is a global epidemic
Chronic disease with significant co-morbidities affecting millions of people (Chorzempa, 2006)

Affects 20.8 million Americans, and millions remained undiagnosed (Chorzempa, 2006).
Quantitative research methods give health care providers a vast amount of opportunities to implement effective interventions to gain a tighter control on their patients’ disease.
An experimental design was conducted to evaluate the effectiveness of patient education by primarily giving sole responsibility to nurses who instruct patients on the elements of disease management.
Future research should attempt to
Using a qualitative, quantitative, and systematic reviews will give health care providers the ability to provide care that is current, relevant, and evidence-based.
Older adults with type 2 diabetes left untreated are
more susceptible to developing complications (Chorzempa, 2006).
According to the Center of Disease Control and Prevention (CDC), diabetes is the leading cause serious complications.
Complications are dangerous and
costly to healthcare.
More than 60% of non-traumatic lower limb amputation occur in people with diabetes (ADA, 2013).
Summary of findings
Total cost of diagnosed diabetes
in the U.S. in 2012?
$ 245 billion
$176 billion for
direct medical costs
The prevalence of diabetes has led to the development of recommended guidelines.
Screening and Diagnosis
Emphasize self-centered management
Lifestyle modifcations
Healthy lifestyle

Glucose management
Adjust treatment to accomplish this goal
Heart Disease
Kidney Disease
Eye Disease
Nerve Damage
As new quantitative research emerges providers will need to appraise its value and applicability for promoting health within their patients.
Sent blood glucose levels and drug information through the web or cell phones
Sent recommendations to each patient through the cell phones and internet.
Future Practice & Research
American Diabetes Association. (2011). Diabetes statistics. Retrieved from http://www.diabetes.org/diabetes- basics/diabetes-statistics/

Abdoli, S., Ashtorab, T., Ahmadi, F., Parvizy, S., & Dunning, T. (2011). Religion, faith and the empowerment process: Stories of Iranian people with diabetes. International Journal of Nursing Practice, 17, 289-298.

Bai, Y., Chiou, C., & Chang, Y. (2009). Self-care behavior and related factors in older people with type 2 diabetes. Journal of Clinical Nursing, 18, 3308–3315.

Centers for Disease Control and Prevention. (2011). Diabetes fact sheet. Retrieved from http://www.cdc.gov/diabetes/pubs/factsheet11.htm

Chorzempa, A. (2006). Type 2 diabetes mellitus and its effect on vascular disease. The Journal of Cardiovascular Nursing, 21(6), 485-492.

Huang, M., Courtney, M., Edwards, H., & McDowell, J. (2010). Factors that affect health outcomes in adults with type 2 diabetes: A cross-sectional study. International Journal of Nursing Studies, 47(5), 542.

Karakurt, P., Kasikci, Magfiret K. (2012). The effect of education given to patients with type 2 diabetes mellitus on self-care. International Journal of Nursing Practice, 18(2), 170.

Kim, H., & Song, M. (2008). Technological intervention for obese patients with type 2 diabetes. Applied Nursing Research, 84-89.

Song, M., Ratcliffe, S. J., Tkacs, N. C., & Riegel, B. (2011). Self-care and health outcomes of diabetes mellitus. Clinical Nursing Research, 21(3), 309-326.

While, A. (2010). Improving compliance with diabetes clinical practice guidelines in military medical treatment facilities. British Journal of Community Nursing, 15(5), 66-74.
Current Guidelines
Create preventative guidelines to assist in reducing the prevalence of diabetes.
Reduce disease related complications as diabetes gains prevalence.
Subcutaneous insulin administration pumps
Continuous glucose monitoring systems
1. Promoted self-care activities
2. Positively affected HbA1c and lipid values

Please decrease the long acting insulin by two units.
2. Constant patient education to promote proper self-management of their disease.
3. Analysis of data to support the positive effect of education in patients with diabetes (Karakurt, Kasikci, & Magfiret, 2012).
1. Variety of treatment modalities to promote tighter control
4. Treatments tailored to how a patient is presenting gives an individualized approach to care (Kim & Song, 2008).

Statistically significant improvements to look for:

Total cholesterol,
Blood pressure,
BMI, and waist circumference (Karakurt, Kasikci, & Magfiret, 2012).
Identification of risk factors and protective factors have a significant effect on adaptive outcomes (Huang et al., 2009).
family hx

Develop effective disease management techniques derived from evidenced based research and implemented by both the provider and the self-care patient.
Encourage screening measures on a continual basis promotes for early diagnosis.
Type 2 diabetes accounts for 90%–95% of diabetes cases and is usually associated with older age, obesity and physical inactivity, family history of type 2 diabetes, or a personal history of gestational diabetes (ADA, 2012).
Identifying high risk individuals
Screen with accepted measures
Offer care to diagnosed individuals
Individualized plans

Multidisciplinary trained teams to provide group and individual care
Identifying factors that illicit positive experiences regarding the diagnosis and management of type 2 diabetes can help providers individualize a plan of care for better self-management.
Maintaining HbA1c below 7.0% to minimize risks
Qualitative exploratory research using phenomenology, grounded theory, ethnography show individualized, culturally competent care is essential.
Implications from qualitative studies
1. Identifying facilitators and barriers
2. Identifying factors that illicit positive and negative experiences in type 2 diabetes
3. Individualize care based on facilitators and barriers, considering cultural practices, and personal experiences to get the best results.
Empowerment and positive associations to promote self-management will improve outcomes and prevent complications associated with type 2 diabetes.
Identifying facilitators and barriers to promote empowerment is essential to improve self-care in patients with type 2 diabetes (Abdoli, et at., 2011).
Facilitators & Barriers
Positive Appraisal
1. Pursuing and individual way of life
Trying new activities to decrease stress and increase overall enjoyment. One participant joined a drawing class to combat stress.
1. Enjoying a new social network

Joined groups for support, weight loss, education.

Enjoyed the company of people with similar goals.
1. Opportunity for lifestyle change
Dx of diabetes gave individuals the opportunity to stop their bad eating and/or drinking habits.
2. Feeling Secure
Undergoing treatment for diabetes and improving self-management would overall improve health and prevent other diseases/complications.
3. Pleasant Surprise
Managing health and diabetes was easier than anticipated.

Ideas about quantity and quality of food intake, exercising, and impact on relationships from information obtained from the media turned from negative to positive.
2. Enjoying a healthy life
Although self-management was not considered easy, health improved, and participants felt more able to do activities they enjoy and be more active.
2. Improving family relationships
Once diagnosed, family support increased and relationships became stronger.

Felt more fullfilled
Individualized Care
Individualized care and support increases the likelihood of patient's ability to successfully self-manage their diabetes.
Helping patients integrate diabetes management into their daily lives and routines will improve outcomes and prevent complications.
Loss of Control
Feelings of anger, denial, and shock
Being and Staying in Control
The experience of accepting diabetes, feeling empowered enough to appropriately manage the disease, and continue to implement changes necessary to minimize complications.
Gaining Control
The process of patients slowly implementing lifestyle changes that helped begin to manage their disease.
Factors that affect self-management
Everyday life practices
The effects of the disease
Daily life before diagnosis
Family Support
Highlighting patients' experiences will help providers gain insight on how to navigate care for future diabetic patient, and improve support to current diabetics.
Fear of complications
Family support
Limited access to healthcare
Negative Associations
Many individuals experience stages from the time of initial diagnosis to self-management.
Experiences & Perception
Clinical Issue: Type 2 Diabetes
Rhoda Castelo, Jamie Potter, Brittney Schneider, Greg Smyth
Pat Shannon
A correlational design was conducted to evaluate if self-care behavior, social support, level of education, and extent of disease weighed heavily on the degree to which self-care could be managed.

Promoting self-care behaviors impacts positively management of diabetes, therefore it is important to determine any barriers in controlling the disease (Bai, Chiou, & Chang, 2009).

It is important to determine the educational level of the older adults to tailor the teaching methods appropriately for the individual.

Research methods included quantitative and qualitative research with varying study designs to gain a broad perspective.

University of Phoenix online library databases were accessed with search terms “adult type two diabetes,” paired with “quantitative,” and the term “qualitative” separately.

Quantitative studies varied in design, but successful diabetes management was the intended outcome for each research study.

Qualitative studies varied in design, but provide valuable insight into the experience of being a diabetic

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