Professional Documents
Culture Documents
Improving Glycemic Control And Quality Of Life In Adults With Type 2 Diabetes Mellitus
NURS693-F1WW (S18)
August 4, 2018
IMPROVING GLYCEMIC CONTROL 2
Improving Glycemic Control And Quality Of Life In Adults With Type 2 Diabetes Mellitus
mortality and health care resource utilization (Birdee, & Yeh, 2010). Diabetes is a
circulating insulin. This disease leads to abnormal lipid profiles, and increased free radical
production. With projected increases in the incidence of diabetes worldwide, health systems
behavior and improving efficiency of care (Birdee, & Yeh, 2010). Yet, providing high
quality care for diabetics still remains a challenge for healthcare systems and providers.
People with diabetes frequently use complementary and alternative medicine (CAM) and
other CAM therapies for a range of reasons. When counseling patients on CAM use,
evidence-based information about efficacy and safety or the lack thereof. Despite unclear
data, a large number of patients will continue using CAM in the future (Canaway, &
Manderson, 2013). As research grows in this field, physicians have an opportunity to help
patients make decisions about the most safe and effective CAM therapies to consider. It is
important that health professionals (HPs) do not assume that their patients use CAM to
In the United States, adults frequently use CAM, with 40% reporting use in the past
12 months. In addition, an estimated 34% of adults with diabetes mellitus use some type of
CAM therapy (Birdee, & Yeh, 2010). Although some CAM therapies have been shown to
affect glycemic control, the clinical efficacy and mechanism of many CAM therapies for
IMPROVING GLYCEMIC CONTROL 3
diabetes is controversial, and safety issues are a concern. Adverse effects of many CAM
therapies are not well documented (Naja, & Alameddine, 2014). Because patients with
diabetes often take multiple prescription medications, there exists the potential for herb-
drug and herb-dietary supplement interactions, leading to adverse events (Kennedy, &
Seely, 2010). At least 63% of the general population does not disclose use of CAM
The aim of the study is to investigate the effects of alternative medicine along with
regular therapy to improve glycemic control, and quality of life in patients with type 2
Diabetes within a 6-12 months’ period. The objective will be to improve glycemic control
and better quality of life in 45% of the population participating in the study. Strive to
Alternative Medicine use, and improve communization between patients and health care
providers.
project. They will make sure that quality patient care is delivered. For the project to have a
successful outcome is important that the lines of communication between providers remain
open. There should be mutual respect between all the parties involved and shared decision-
making needs to take place. The team will be composed of the Operational Manager,
Department. All of the member in charge of the proper conduction of the study will address
the patients’ double blindly to avoid biases. The patients will be divided into two groups, A
IMPROVING GLYCEMIC CONTROL 4
and B and will receive the same lifestyle modification and present medication with the only
The utilization of the electronic health record is a must for the selection of patients.
With this tool patients that qualify will be matched and screened for the demographics and
paraclinical variables. Also, a randomize algorithm will be created so that a table of random
numbers can be created and each patient will be assigned to one of the two groups. One of
the laboratories that the company uses will be utilized for the course of the research so that
During the study patients will have serologic measurements every 3 months. The
tests that will be performed are Cholesterol, Lipid levels and Hemoglobin A1c levels. The
evidence base in support of HbA1c as a diagnostic test for diabetes mellitus is focused on
cholesterol, and lipid values will determine if the results lead to the outcome of the study
(Sayeed, Mostofa, Ferdous, & Islam, 2013). Effective communization between patients and
health care providers is important to develop a trusting and pleasant environment leading to
a better outcome. For patients that do not adhere to the program changes in lifestyle, these
will be reflected in the serologic measure. In those cases, patients will be referred to a
Blood measurements will be taken monthly and compared to the baseline. The goal
is for more than 45% of the patients to have an HbA1c decrease by the end of the three-
month pilot study. The tests will be performed on patients with uncontrolled diabetes that
go to the office within 1 week and those patients will be followed through out the course of
a three months’ period. It is very important for the team to be aware of all the objectives of
IMPROVING GLYCEMIC CONTROL 5
the study, so communication here is a must. Training also will be provided as required as
well as detailed protocols of the project. All departments and the individuals who may be
During the implementation of the plan we need to observe how doctors nurses and
patient reacts. We will also need to know if everything goes as planned. Audit and feedback
must be obtained and all questions that emerge need to be addressed. It is important to
remember that each person contributes different by demonstrating a different set of skills
and opinions. Working with unity creates a more efficient project course.
After the implementation we will need to study the results to see if it made a
difference in the patient’s health, the provider components of care, and if it is cost effective.
We also need to evaluate if outcomes were achieved as expected. Data will be analyzed
with a table demonstrating the comparison between baseline and after results.
use supports chronic illness prevention and management. Herbal treatment is known to
decrease glycemic index and serologic measures (Sayeed, Mostofa, Ferdous, & Islam,
2013). One of the objectives is to increase the integration of herbal medicine for care
It is important to inform all the parties involved in the study. These include the
stakeholders, staff involved and the internal review board if the study is to be published
(Gallagher-Ford, Fineout-Overholt, Melnyk, & Stillwell, 2011). The purpose of the project
important to understand the advantages and disadvantages that can arise and have all
IMPROVING GLYCEMIC CONTROL 6
members of the research informed, including test subjects. The database and screening
should be clearly defined to minimize bias or conflicting measurements so that results are
valid and the study can be replicated. Lastly, the outcome of the study most be shown.
Meaning an outcome indicator should be created demonstrating what are the results
expected. In regards to the research proposed, a good indicator that the study was a success
is if the serological values demonstrate a decrease in the studied variables and that no
Safety and quality are the responsibility of all practitioners providing care. CAM
exemplifies person-centered care and some are evidence- based (Dunning, 2014). CAM
non-medicines options could be considered when appropriate and safe. The person’s
individual risk of adverse effects must be considered, and CAM use documented and
monitored as part of the overall care plan. People with diabetes are high CAM users;
therefore HPs must regularly ask about CAM use in a non-judgmental way.
IMPROVING GLYCEMIC CONTROL 7
Reference
Ali, B. (2014). Herbal Medicine Use among Patients with Type 2 Diabetes in North
arrb/2014/8015
Birdee, G.S., & Yeh, G. (2010). Complementary and Alternative Medicine Therapies for
diaclin.28.4.147
Canaway, R., & Manderson, L. (2013). Quality of Life, Perceptions of Health and
Illness, and Complementary Therapy Use Among People with Type 2 Diabetes
Chao, M., Handley, M., Quan, J., Sarkar, U., Ratanawongsa, N., & Schillinger, D.
and racially diverse safety net patients with diabetes. Patient Education and
Haffner SM: Coronary heart disease in patients with diabetes. N Engl J Med 2000,
342:1040–1042.
How to improve with the model for improvement. Boston, Massachusetts: Institute for
Kennedy DA, & Seely D. Clinically based evidence of drug-herb interactions: a systematic
5614(14)50469-4
Sayeed, M. S., Mostofa, A., Ferdous, F. T., & Islam, M. S. (2013). A Randomized,
doi:10.1089/acm.2012.0063
doi:10.18535/jmscr/v4i3.21