Running head: MANAGEMENT OF DIABETES IN ELDERLY HISPANIC AMERICA MANAGEMENT OF DIABETIS IN ELDERLY HISPANIC AMERICA 8 Nidhi Sharma NRS433VN Linnette Nolte 03/12/2017 Abstract The study was conducted to analyze the management of diabetes within the Hispanic America ethnic group. The research was carried out in the different hospitals in the United States to determine the best management practices for the elderly Hispanic America suffering from diabetes. The research used interviews with the patients and the nurses who offer the services to the patients. The research focused on the population of 65years and above Hispanic America. The result indicates that the patients with good care from the family respond to treatment as the proper management results in glycemic control. The research also got that most of the diabetes has a biological origin. Management of diabetes in Hispanic America P)-Population: Adults aged 65 years and above from the ethnic group of Hispanic origin who are the leading majority with the diabetes cases across the country. The other adults aged over 65 years and above but not Hispanic America are excluded from the exercise. I)-Intervention: The research analysis the best management of Type 2 diabetes which is the most dominant type of the Hispanic America. The research compares the effectiveness of the Bariatric surgery in patients with body mass index, the healthy eating habit, and weight control measures. The best approach will be taught in every hospital holding the patients with diabetes in every two weeks seminar. C)-Comparison: The procedure will take approximately three months then the result will be compared in line the previous mortality related cases. The progress in the health status of the patients will be matched with prior data before the process started. O)-Outcome: The healthy eating habit and the weight management proved better in improving the conditions required to sustain the patients. The patients with the caretakers who help them in Glycemic control management improves even faster compared to patients without helpers. T) – Time: The procedure will be analyzed monthly after every two weeks collection of data in the different hospitals. Articles Foundation, C. H. (2003). Guidelines for improving the care of the older person with diabetes mellitus. Journal of the American Geriatrics Society, , 51(5s), 265-280. The article was written with the efforts of the California Health Foundation in collaboration with America Geriatrics Society concerned with improving the health of the elderly with diabetes on February 25, 2003. The T2D is highly increasing among the Hispanic America who is and 65 years and above. The estimates indicate that the total of approximately 20% adult aged 65 years and above are suffering from the T2D. The research is, therefore, provides the critical analysis of the guidelines required to improve the care of the elder people with T2D by giving a series of recommendatio ...

1. Running head: MANAGEMENT OF DIABETES IN ELDERLY
HISPANIC AMERICA
MANAGEMENT OF DIABETIS IN ELDERLY HISPANIC
AMERICA
8
Nidhi Sharma
NRS433VN
Linnette Nolte
03/12/2017
Abstract
The study was conducted to analyze the management of diabetes
within the Hispanic America ethnic group. The research was
carried out in the different hospitals in the United States to
determine the best management practices for the elderly
Hispanic America suffering from diabetes. The research used
interviews with the patients and the nurses who offer the
services to the patients. The research focused on the population
of 65years and above Hispanic America. The result indicates
that the patients with good care from the family respond to
treatment as the proper management results in glycemic control.
The research also got that most of the diabetes has a biological
origin.
Management of diabetes in Hispanic America
P)-Population: Adults aged 65 years and above from the ethnic
group of Hispanic origin who are the leading majority with the
diabetes cases across the country. The other adults aged over 65
years and above but not Hispanic America are excluded from
the exercise.

2. I)-Intervention: The research analysis the best management of
Type 2 diabetes which is the most dominant type of the
Hispanic America. The research compares the effectiveness of
the Bariatric surgery in patients with body mass index, the
healthy eating habit, and weight control measures. The best
approach will be taught in every hospital holding the patients
with diabetes in every two weeks seminar.
C)-Comparison: The procedure will take approximately three
months then the result will be compared in line the previous
mortality related cases. The progress in the health status of the
patients will be matched with prior data before the process
started.
O)-Outcome: The healthy eating habit and the weight
management proved better in improving the conditions required
to sustain the patients. The patients with the caretakers who
help them in Glycemic control management improves even
faster compared to patients without helpers.
T) – Time: The procedure will be analyzed monthly after every
two weeks collection of data in the different hospitals.
Articles
Foundation, C. H. (2003). Guidelines for improving the care of
the older person with diabetes mellitus. Journal of the American
Geriatrics Society, , 51(5s), 265-280.
The article was written with the efforts of the California Health
Foundation in collaboration with America Geriatrics Society
concerned with improving the health of the elderly with
diabetes on February 25, 2003. The T2D is highly increasing
among the Hispanic America who is and 65 years and above.

3. The estimates indicate that the total of approximately 20% adult
aged 65 years and above are suffering from the T2D. The
research is, therefore, provides the critical analysis of the
guidelines required to improve the care of the elder people with
T2D by giving a series of recommendations that includes T2D-
specifics individualized to patients aged 65 and above.
Khattab, M. K.-K. (2010). Factors associated with poor
glycemic control among patients with type 2 diabetes. . Journal
of diabetes and its complications, 24(2), 84-89.
The study focused on the factors related to poor glycemic
management among the patients with T2D. The research used a
systematic random of 917 patients among the patients who have
type 2 diabetes for a duration of 6 months in the year 2008. The
research used questionnaires to collect the data on various
aspects of diabetes complications. The procedure used the prior
reading of hemoglobin A1c, fasting blood sugar levels and lipid
was deducted out of patients' records. Poor glycemic control
was explained as HbA1c ≥7%. The findings indicate that of the
entire 917 patients, 65.1% had HbA1c ≥7%. In the increased
duration analysis of diabetes, (>7 years vs. ≤7years) (OR=1.99,
P≤.0005), did not apply proper eating habit i.e. (OR=2.98,
P≤.0005), appears like having negative motives towards the
disease and this reduced scale score as it relates to odds of poor
glycemic control.
Tuomilehto, J. L.-P. (2001). Prevention of type 2 diabetes
mellitus by changes in lifestyle among subjects with impaired
glucose tolerance. New England Journal.
The research evaluates the impact of the rapidly increasing
type2 diabetes among the people and
how it can be prevented. The research used 522 overweight
patients with 65 years and above. The mean body weight index
determined by dividing by the square of the height meters and

4. the patients were given individualized counseling to help them
reduce weight as they practice to increase the fiber intake and
increased physical activities. The oral glucose tolerance was
tested yearly, and the analysis of diabetes was confirmed in the
second test with the mean duration of follow-up was at 3.2
years. The result indicated that mean (±SD) total weight
reduction at the end of year 1 was about 4.2±5.1 kg within the
intervention group and 0.8±3.7 kg in control group. The total
incidence of diabetes at the fourth year was 11% with 95%
confidence level.
Buchwald, H. E. (2009). Weight and type 2 diabetes after
bariatric surgery: systematic review and meta-analysis. . The
American journal of medicine,, 122(3), 248-256.
The study focused on the increasing obesity-induced T2D in the
recent years. The main focus was
to determine the impact of bariatric surgery on T2D in line to
the procedure carried out and the weight reduction achieved.
The research used a large dataset of 621 studies associated with
888 treatments departments with 135,246 patients. The second
set had 103 treatment arms linked 3188 patients with diabetes
cases. In 19 studies linked to 43 treatments with 11,175 patients
reported the reduction in weight and diabetes resolution
different among the 4070 diabetic patients. The baseline ranges
from 65years, and the body mass index was 48.9 kg/m2. The
general weight loss was at 38.5 or 55.9 excess body mass loss.
The research shows that 78.1% of the patients gained complete
resolution and were improved. The weight loss and resolution
was better among the patients attending biliopancreatic
diversion seconded by the gastric bypass and least in banding
process. The insulin rate reduced significantly postoperatively
just as hemoglobin A1C and the values for fasting glucose. The
disparity in weight and diabetes was very minimal within the
two years.

5. DeMaria, E. J. (2010). Baseline data from American society for
metabolic and bariatric surgery-designated bariatric surgery
centers of excellence using the bariatric outcomes longitudinal
database. Surgery for Obesity and Related Diseases, 347-355.
The
research was to analyze the baseline for patients who attended
BOLD. The data that were used by 800 surgeons in 450
facilities using the BOLD data before May 20, 2009, indicate
the following; a large data of 57,918 of patients who underwent
surgical procedure were considered, and 14% of this population
were aged 66years. The majority of the population was women
with 78% in total. Out of the total population of 57,918,
Hispanic America were 20% among other different ethnics from
different regions. The procedure involved the common system
such as gastric bypass (31,668, [54.68%) then gastric banding
(22,947, [39.63%), sleeve gastrectomy (1,328[2.29%) and lastly
biliopancreatic diversion (517 [.89%]). The rest majority
procedures were done using laparoscopic surgery techniques,
apart from biliopancreatic diversion which was majorly done by
the single open approach, during the period, 78 deaths were
reported after the index procedure all over the regions. The
mortality rate of 13% reduced to 11% in the duration of 90 days
with 09% mortality rate after one month.
Ford, E. S. (2002). Prevalence of the metabolic syndrome
among US adults: findings from the third National Health and
Nutrition Examination Survey. . Jama,, 287(3), 356-359.
The
research was the 3rd report of National Cholesterol Education
Program Expert Panel. It was meant to determine and evaluate
the best treatment of high blood cholesterol in adults. It was
aimed at treating the patients with metabolic syndrome to
control the cardiovascular disease. The data comprised of 8814
of aged 20 and older in Third National Health and Nutrition

6. Examination Survey (1988-1994), with the cross-sectional
presentation of none institutionalized civilian US population.
The commonness of the metabolic disorder as characterized by
ATP III (≥3 of the accompanying variations from the norm):
Waist periphery more noteworthy than 102 cm in men and 88
cm in ladies; serum triglycerides level of no less than 150
mg/dL (1.69 mmol/L). High-thickness lipoprotein cholesterol
level of under 40 mg/dL (1.04 mmol/L) in men and 50 mg/dL in
ladies; pulse of no less than 130/85 mm Hg; or serum glucose
level of no less than 110 mg/dL (6.1 mmol/L). The unadjusted
and age-balanced prevalent natures of the metabolic disorder
stayed 21.8% and 23.7%, individually. The commonness
ascended from 6.7% among members matured 20 through 29
years to 43.5% and 42.0% for members matured 60 into 69
years and matured no less than 70 years, separately. Mexican
Americans had the most astounding age-balanced commonness
of the metabolic disorder (31.9%). The age-balanced
commonness was practically identical for men (24.0%) and
ladies (23.4%). Be that as it may, among African Americans,
ladies had around a 57% more noteworthy predominance than
men, and among Mexican Americans, ladies had around a 26%
higher pervasiveness than men. Utilizing 2000 enumeration
information, around 47 million US occupants have the
metabolic disorder.
References
Buchwald, H. E. (2009). Weight and type 2 diabetes after
bariatric surgery: systematic review and meta-analysis. . The
American journal of medicine,, 122(3), 248-256.
DeMaria, E. J. (2010). Baseline data from American society for
metabolic and bariatric surgery-designated bariatric surgery
centers of excellence using the bariatric outcomes longitudinal
database. Surgery for Obesity and Related Diseases, 347-355.
Ford, E. S. (2002). Prevalence of the metabolic syndrome

7. among US adults: findings from the third National Health and
Nutrition Examination Survey. . Jama,, 287(3), 356-359.
Foundation, C. H. (2003). Guidelines for improving the care of
the older person with diabetes mellitus. Journal of the American
Geriatrics Society, , 51(5s), 265-280.
Khattab, M. K.-K. (2010). Factors associated with poor
glycemic control among patients with type 2 diabetes. . Journal
of diabetes and its complications, 24(2), 84-89.
Tuomilehto, J. L.-P. (2001). Prevention of type 2 diabetes
mellitu (Placeholder1)s by changes in lifestyle among subjects
with impaired glucose tolerance. New England Journal.
Nidhi, you have laid excellent groundwork for a solid PICOT. I
would recommend narrowing it down and creating a statement
(example provided in the margins.) You have also done a great
job of locating relevant research articles to support your topic.
Please review the guidelines for APA formatting, as several
authors have been left off of your references. Also, try to locate
relevant articles with more recent dates to give yourself the
most up-to-date data to work with. You have also done a good
job of summarizing the articles you’ve chosen, but only needed
to submit the pre-existing abstracts. You’ve made a good start.
Thanks for all your hard work.
-Dani
Nidhi, you did a good job but all your articles are outdated and
cannot be used. Please find a qualitative article for week 2.
Please revise your PICO question and relate it to nursing
practice. Linn
�Great job with the running head
�Not required

8. �Please revise the PICO to one sentence. I do not understand
your question or what you want to learn
�Great start to a PICOT, but needs to be narrowed down. For
example: “In Hispanic adults aged 65 years and above with
Type 2 diabetes, will bariatric surgery compared to standard
weight control measures improving health status after one
year?”
�Outdated an cannot be used
�No abstract available, but article reviewed and is a literature
review. Good!
�outdated
�Authors need to be cited in APA “Khattab, M., Khader, Y. S.,
Al-Khawaldeh, A., & Ajlouni, K.”
�Great research article!
�This is not the abstract. This is the abstract:
OBJECTIVES:

9. Determine factors associated with poor glycemic control among
Jordanian patients with Type 2 diabetes.
METHODS:
A systematic random sample of 917 patients was selected from
all patients with Type 2 diabetes over a period of 6 months in
2008. A prestructured questionnaire sought information about
sociodemographic, clinical characteristics, self-care
management behaviours, medication adherence, barriers to
adherence, and attitude towards diabetes. Weight, height, and
waist circumferences were measured. All available last readings
of hemoglobin A1c (HbA1c), fasting blood sugar measurements
and lipid were abstracted from patients' records. Poor glycemic
control was defined as HbA1c >or=7%.
RESULTS:
Of the total 917 patients, 65.1% had HbA1c >or=7%. In the
multivariate analysis, increased duration of diabetes (>7 years
vs. <or=7years) (OR=1.99, P<or=.0005), not following eating
plan as recommended by dietitians (OR=2.98, P<or=.0005),
negative attitude towards diabetes, and increased barriers to
adherence scale scores were significantly associated with
increased odds of poor glycemic control.
CONCLUSION:
The proportion of patients with poor glycemic control was high,
which was nearly comparable to that reported from many

10. countries. Longer duration of diabetes and not adherent to
diabetes self-care management behaviors were associated with
poor glycemic control. An educational program that emphasizes
lifestyle modification with importance of adherence to treatment
regimen would be of great benefit in glycemic control.
�outdated
�Good research! (but outdated)
�Not the abstract
�Outdated and is a lit review. Cannot be used for your
aassignments.
�Great literature review
�Not the abstract
�outdated
�All authors should be cited as appropriate with APA
�Good data analysis

11. �Not the abstract
�Good data analysis
�Not abstract
Research Critique Guidelines
To write a critical appraisal that demonstrates comprehension of
the research study conducted, address each component below
for qualitative study in the Topic 2 assignment and the
quantitative study in the Topic 3 assignment.
Successful completion of this assignment requires that you
provide a rationale, include examples, or reference content from
the study in your responses.
Qualitative Study
Background of Study:
· Identify the clinical problem and research problem that led to
the study. What was not known about the clinical problem that,
if understood, could be used to improve health care delivery or
patient outcomes? This gap in knowledge is the research
problem.
· How did the author establish the significance of the study? In
other words, why should the reader care about this study? Look
for statements about human suffering, costs of treatment, or the
number of people affected by the clinical problem.

12. · Identify the purpose of the study. An author may clearly state
the purpose of the study or may describe the purpose as the
study goals, objectives, or aims.
· List research questions that the study was designed to answer.
If the author does not explicitly provide the questions, attempt
to infer the questions from the answers.
· Were the purpose and research questions related to the
problem?
Method of Study:
· Were qualitative methods appropriate to answer the research
questions?
· Did the author identify a specific perspective from which the
study was developed? If so, what was it?
· Did the author cite quantitative and qualitative studies
relevant to the focus of the study? What other types of literature
did the author include?
· Are the references current? For qualitative studies, the author
may have included studies older than the 5-year limit typically
used for quantitative studies. Findings of older qualitative
studies may be relevant to a qualitative study.
· Did the author evaluate or indicate the weaknesses of the
available studies?
· Did the literature review include adequate information to build
a logical argument?
· When a researcher uses the grounded theory method of
qualitative inquiry, the researcher may develop a framework or
diagram as part of the findings of the study. Was a framework
developed from the study findings?
Results of Study
· What were the study findings?
· What are the implications to nursing?
· Explain how the findings contribute to nursing
knowledge/science. Would this impact practice, education,
administration, or all areas of nursing?
Ethical Considerations

13. · Was the study approved by an Institutional Review Board?
· Was patient privacy protected?
· Were there ethical considerations regarding the treatment or
lack of?
Conclusion
· Emphasize the importance and congruity of the thesis
statement.
· Provide a logical wrap-up to bring the appraisal to completion
and to leave a lasting impression and take-away points useful in
nursing practice.
· Incorporate a critical appraisal and a brief analysis of the
utility and applicability of the findings to nursing practice.
· Integrate a summary of the knowledge learned.
Quantitative Study
Background of Study:
· Identify the clinical problem and research problem that led to
the study. What was not known about the clinical problem that,
if understood, could be used to improve health care delivery or
patient outcomes? This gap in knowledge is the research
problem.
· How did the author establish the significance of the study? In
other words, why should the reader care about this study? Look
for statements about human suffering, costs of treatment, or the
number of people affected by the clinical problem.
· Identify the purpose of the study. An author may clearly state
the purpose of the study or may describe the purpose as the
study goals, objectives, or aims.
· List research questions that the study was designed to answer.
If the author does not explicitly provide the questions, attempt
to infer the questions from the answers.
· Were the purpose and research questions related to the
problem?
Methods of Study

14. · Identify the benefits and risks of participation addressed by
the authors. Were there benefits or risks the authors do not
identify?
· Was informed consent obtained from the subjects or
participants?
· Did it seem that the subjects participated voluntarily in the
study?
· Was institutional review board approval obtained from the
agency in which the study was conducted?
· Are the major variables (independent and dependent variables)
identified and defined? What were these variables?
· How were data collected in this study?
· What rationale did the author provide for using this data
collection method?
· Identify the time period for data collection of the study.
· Describe the sequence of data collection events for a
participant.
· Describe the data management and analysis methods used in
the study.
· Did the author discuss how the rigor of the process was
assured? For example, does the author describe maintaining a
paper trail of critical decisions that were made during the
analysis of the data? Was statistical software used to ensure
accuracy of the analysis?
· What measures were used to minimize the effects of researcher
bias (their experiences and perspectives)? For example, did two
researchers independently analyze the data and compare their
analyses?
Results of Study
· What is the researcher's interpretation of findings?
· Are the findings valid or an accurate reflection of reality? Do
you have confidence in the findings?
· What limitations of the study were identified by researchers?
· Was there a coherent logic to the presentation of findings?
· What implications do the findings have for nursing practice?
For example, can the findings of the study be applied to general

15. nursing practice, to a specific population, or to a specific area
of nursing?
· What suggestions are made for further studies?
Ethical Considerations
· Was the study approved by an Institutional Review Board?
· Was patient privacy protected?
· Were there ethical considerations regarding the treatment or
lack of?
Conclusion
· Emphasize the importance and congruity of the thesis
statement.
· Provide a logical wrap-up to bring the appraisal to completion
and to leave a lasting impression and take-away points useful in
nursing practice.
· Incorporate a critical appraisal and a brief analysis of the
utility and applicability of the findings to nursing practice.
· Integrate a summary of the knowledge learned.
Reference
Burns, N., & Grove, S. (2011). Understanding nursing research
(5th ed.). St. Louis, MO: Elsevier.
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