Saur et al. (2013) conducted a level II prospective study to determine whether glycemic derangements are more effectively controlled using software-guided insulin dosing compared with paper-based protocols. The study evaluated 197 critically ill patients, by consecutive sampling, treated in a tertiary hospital surgical ICU between January 1-June 30, 2008 and January 1-September 30, 2009 (Saur et al., 2013). Patients who required continuous insulin infusions for hyperglycemia and had a minimum of a three-day stay in the ICU were included in the study. The population’s demographics did not statistically vary. The intervention group received the software-guided insulin dosing while the control group received the standard care. The standard …show more content…
The nursing staff should activate insulin-dosing strategies with the goal of decreasing hyperglycemia, hypoglycemia, and glycemic variability (Saur et al., 2013).
Joshi et al. (2013) conducted a level II retrospective observational study to measure the efficacy and possible adverse consequences of tight blood glucose control when compared to relaxed control. The study took place at a community-based teaching hospital for hospitalized adults admitted to the ICU. The study population was divided into 3 groups: average BG value between 80 and 110 mg/dL, average BG value between 111 and 140 mg/dL, and average BG value between 141 and 180 mg/dL (Joshi et al., 2013). In order to be considered for the study, patients had to have greater than four blood glucose readings in the ICU. The researchers included both patients with and without diabetes mellitus in the study. This study was fairly large, with 12,857 patients meeting the inclusion criteria. The patient demographic of age did not vary significantly throughout the study. However, only females were included and the Caucasian population was nearly four times more than the African-American population and nearly 1,500 more patients than the Hispanic population. Data was collected through the Charlson Index score to calculate 10-year mortality rate for patients with multiple
The purpose of this study is to minimize the risk of hypoglycemia among the elderly. As people with diabetis age, the physiological changes affect the diabetic. The purpose of this study is to consider whether HbA1 goals can be attained without undue treatment burden and decrease the risk of severe hypoglycemia. Though client teaching and minimizing the risk factors of hypoglycemia can prevent further exacerbation of catastrophic events that could have potential lethal outcomes to an older patient with diabetes. The one patient’s case, Mr. J., an 86 year old man who has had type 2 diabetes for 15 years is a quantitative study that focuses on prevention of hypoglycemia in older adults. Interventions include diet, meal planning, medication, glucose
Living with diabetes poses many challenges for patients in areas like nutrition, glycemic monitoring and medication adherence. In fact, patients with diabetes
The American Diabetes Association (2004) defines diabetes as a subset of metabolic diseases associated with hyperglycemia secondary to insulin failing to release, act, or both. Complications related to chronic diabetes can be detrimental to one’s health including but not limited to: heart disease, stroke, kidney disease, amputations, blindness, and other optical diseases. Furthermore, the prevalence of diabetes is rising at an astronomical rate within the United States as well as internationally. According to the Center for Disease Control and Prevention (CDC) (2016) an estimated 29 million people suffer with diabetes and 86 million are prediabetic within the United States (US). Without major interventions from the healthcare community,
Kramer, Roberts, and Zygun (2012) conducted a level I systematic review and meta-analysis of randomized controlled trials (RCTs) to assess whether tight glycemic control reduces mortality and improves outcomes in neurocritical care patients. A thorough search was conducted through Ovid interface, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Cochrane Database of Systematic Reviews. The search terms used were: “intensive glycemic control”, “neurocritical care”, and “clinical trials”. After the initial search, 3,040 references were identified. However, only sixteen studies were included. These sixteen studies involved 1,248 patients total, 654 patients treated with intensive glycemic control vs. 594
Diabetes can be treated in three basic ways: by diet, by diet in conjunction with tablets, or diet in conjunction with insulin. Diet serves as an initial control for non-urgent patients. If a person’s diet will have a major effect on glycaemic control, it does so reasonably quickly, within a few weeks of changing
Learning objective #2: (Affective) patient will be able to verbalize the benefits of maintaining acceptable blood glucose levels and the importance of taking insulin exactly as prescribed.
I reviewed various articles in regards to these aspects. The first article was about improving diabetes care in nursing homes. To summarize this study, it was discovered that information was needed about sliding scales, non-insulin agents, and signs and symptoms (Boyle, O’Neil, Berry, Stowell, & Miller, 2013).
Having diabetes means thinking differently about food and nutrition. This can seem challenging sometimes, but it becomes a bit more manageable once you learn the facts. There are several forms of diabetes. Diabetes can occur at any age. Insulin is a hormone produced by special cells, called beta cells, in the pancreas, an organ located in the area behind your stomach. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy. In pt. with diabetes, these cells produce little or no insulin. Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. The body is unable to use this glucose for energy. This leads to an increase in Blood
Diabetes is a chronic illness that requires continuous medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications[ ].
There are proposals to enlighten people with diabetes and healthcare providers realize the benefits of nutritional intervention. The strategies to attain such goals, and changes individuals with diabetes. Achieving nutrition-related goals requires a team effort that is in sync with people who have diabetes and also involve them in the decision making process. By engaging with team members who play a key role in providing care for a healthy diet. Usually for people who have diabetes their therapeutic nutrien is determined or have been recommended by doctors to helps improving their health. This practice can be done with several different approaches for creating a diabetic diet that able to maintain the level of glucose in the blood within normal
Our clinical group elected to do this semester’s teaching project on correct insulin administration. This topic is relevant because millions of Americans are currently affected with diabetes. Correct administration of the insulin injection is necessary for proper absorption, and also to prevent a condition where fat accumulates under the skin from injections called lipohypertrophy. This information is fundamental in the nursing process, due to nurses frequently administer insulin to patients, as well as play a vital role in patient education. Research has indicated that many patients do not recall receiving any education on how to administer insulin correctly. For our teaching, we created a poster to hang in the staff restroom on the ICU West floor at Redmond Medical
Diabetes is a chronic condition in which the body produces too little insulin (Type One Diabetes) or can’t use available insulin efficiently ( Type Two Diabetes). Insulin is a hormone vital to helping the body use digested food for growth and energy.
To examine the efficacy and safety of insulin and other pharmacological interventions for lowering glucose-lowering levels in patients with diabetics and Chronic Kidney Disease (CKD).
Glucose fluctuations has been suggested as a main contributor to both micro and macrovascular complications, therefore tight glycaemic control was fought to benefit in patients with type diabetes mellitus. However, individual results from tree recent clinical trials—the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE trial), and the Veterans Affairs Diabetes Trial (VADT) failed to support a significant reduction in CVD events in the intensive glycaemic groups (Buse et al., 2007; Patel et al., 2008; Duckworth et al., 2009). In fact, in those studies intensive glucose control may increase risk in older patients with pre-existing CHD or longer duration of diabetes.
On November 15, 2017, I attended a professional meeting called “Think Like A Pancreas: A Practical Guide to Managing Diabetes with Insulin.” The sponsors for this meeting were SNDA and CVD. The speaker who presented at the meeting was Gary Scheiner Ms, CDE. He is an author of the book “Think Like A Pancreas: A Practical Guide to Managing Diabetes with Insulin.” The general objective for this meeting helped people gain more knowledge about diabetes, and learned more from author personal experiences with type I diabetes. After I attended this meeting, I become more knowledgeable about diabetes. I have a chance to learn more about diabetes nutrition, different type of medications, and many tools that are available for diabetes patients to keep track on the blood glucose.