7 million Australians have diabetes. It includes all types of diabetes diagnosed (1.2 million known and registered) as well as silent, undiagnosed type 2 diabetes (up to 500 million) (Diabetes in Australia, n.d.). A main factor in the progression of diabetes is cellular insulin resistance, which is exacerbated by obesity, lack of exercise, disease, treatment, and exacerbated age (Dalgard, 2017). These low blood glucose levels can lead to long-term and short-term health risks such as kidney failure, cardiac attacks, diabetic neuropathy, eye injury and hyperglycaemia (LeMone et al.,2017).
Why I have chosen this topic? Clinical Problem that I am Familiar with:
Diabetes is a complex medical condition which results when the body can’t maintain healthy levels of glucose in blood. It is one of the epidemics of 21st century and the greatest problem facing Australia’s health care system. 280 Australians grow diabetes every day which one person every five minutes is. About 1.
Throughout my clinical placement and my work experiences I have encountered a lot of peoples with diabetes. I have been checking their blood glucose levels, administering their injections (NoVo rapid) and more often found people being careless on their diet, having sedentary lifestyle along with different comorbidities which includes cardiovascular diseases. That’s why I choose to do a research on diabetes and its potential complications. My research will help to determine the effect of self-management practices such as physical exercise, healthy diet and daily self-monitoring glucose levels on the unnecessary use of prescription medications to minimise the risk of cardiovascular disease. This work also acts as a reflection for diabetics to develop their self-efficiency and self-confidence that keeps them from doing so.
PICO (Quantitative)
Population: Patient with diabetes
Intervention: techniques for self-management
Control: pharmaceuticals
Outcome: minimising risk of cardiovascular diseases
Research Question:
Is self-management practise more successful than overuse of prescription medications to reduce cardiovascular risk for patients with Diabetes Mellitus?
How my articles address the question?
In my first reference of (Cooper et al., 2014), which was well-designed randomised control trial a meta-analysis of quantitative studies, it was found that the participants who weren’t prescribed antihypertensive medications, glucose lowering medications or lipid lowering medications, improvements in dietary score were associated with significant reductions in systolic pressure. Among patients administered anti-hypertensive drugs, glucose-lowering drugs, or lipid-lowering drugs, respectively, dietary score changes were likewise correlated with substantial decreases in diastolic blood pressure. There is a significant difference between the reduction in HbA1c. between individuals who were and were not prescribed medication. Those who were not prescribed glucose-lowering medication experienced greater reductions in HbA1ccompared with those prescribed medication.
According to (standards of medical care, 2015), an American diabetes association’s position statement which is from evidence-based resources and recommendations for primary care, Diabetic patient has a higher risk of developing cardiovascular diseases. Some Diabetic Medications can have most severe and unresponsive side effects. Control of Lipids, with lifestyle changes and dietary modifications can reduce the progression and development of cardio vascular diseases. Control of glycaemic level can also benefit lipid rates, particularly in patients with high triglycerides and low glycaemic regulation. Hence, the early diabetes should be treated with lifestyle and dietary modification rather than the excessive use of medications.
References
Cooper, A, J, M., Schliemann D., Long, G, H., Griffin, S, J., & Simmon, R, K. (2014). Do improvements in dietary behaviour contribute to cardiovascular risk factor reduction over and above cardio-protective medication in newly diagnosed diabetes patients? European Journal of Clinical Nutrition, 68(10), 1113-1118
doi: 10.1038/ejcn.2014.79
Dalgaard, J. Z. (2017). What is the underlying cause of type II diabetes? – Are cells protecting themselves against the reactivity of glucose? Medical Hypotheses, 105, 22-24.
https://doi.org/10.1016/j.mehy.2017.06.011
Diabetes in Australia. (n.d.). Diabetes Australia.
https://www.diabetesaustralia.com.au/diabetes-in-australia
LeMone, P. (2017). Medical-Surgical Nursing: Critical thinking for person-centred care (Third ed.). Melbourne, VIC Pearson Australia
Standards of medical care in diabetes—2015 abridged for primary care providers. (2015). Clinical Diabetes, 33(2), 97-111.
https://doi.org/10.2337/diaclin.33.2.97
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