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1. Diabetic nursing visits for better A1C control in patients Discussion
Diabetic nursing visits for better A1C control in patients Discussion ON Diabetic nursing
visits for better A1C control in patients DiscussionNow that you have completed a series of
assignments that have led you into the active project planning and development stage for
your project, briefly describe your proposed solution to address the problem, issue,
suggestion, initiative, or educational need and how it has changed since you first envisioned
it. What led to your current perspective and direction?tis is a 2-3paragraph answer no cover
page, no heading, no page numbbers, answer question and put refernceDiabetic nursing
visits for better A1C control in patients Discussionattachment_1attachment_2Unformatted
Attachment PreviewLiterature Evaluation Table Student Name: Gregory Catania RN Change
Topic (2-3 sentences): Better Diabetic A1C control in outpatient adult clinic with specialized
nursing visits that include education, lifestyle changes, medications and diet. Criteria
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article Article 1
Article 2 Islam, S.M.S. et al. Journal of Diabetes & Metabolic Syndrome, Clinical Research &
Reviews http://dx.doi.org/10.1016/j.ds x.2014.09.014 Marseglia, A. et al. Journal of
Alzheimer’s Disease Vol. 53, p.1069-1078 http://dx.doi.org/10 .3233/JAD-160266 Article 3
Kuo, Y. et al. Journal of American Geriatric Society (10), 1980-1988 https://doi.org/10.111
1/jgs.13662 Clinical Characteristics and Complications of Patients with Type 2 Diabetes
Attending an Urban Hospital in Bangladesh (2014) Early Cognitive Deficits in Type 2
Diabetes A Population Based Study (2016) Diabetes Mellitus Care Providers by Nurse
Practitioners versus Primary Care Physicians (2015) Research Questions
(Qualitative)/Hypo thesis (Quantitative), and Purposes/Aim of Study To find out the
relationship of social economic factors in T2D with complications of diabetes To explore
biochemical characteristics in T2D and diabetic related complications To find out diabetic
related complications among Pt taking oral medications and development of complications
To find out if uncontrolled diabetes has an effect on cognitive function- a predisposition to
dementia To explore differences in cost of care between Nursing practitioners compared
with primary care physicians Study explored eye examination, cholesterol, HbA1C,
neuropathy, referrals and costs between NP and Primary physicians. The study aim: to
investigate if there is a difference in cost and level of care between Nursing practitioners
and primary care Study aim: To investigate the clinical features of patients with type 2
diabetes on oral medications and determine the complications and risk factors in the
patients (515). Study Aim: Diabetic nursing visits for better A1C control in patients
DiscussionTo find out the effect of uncontrolled Almadhoun, M.R et al. Journal of Clinical

2. and Experimental pharmacology 8 (3), p.1-10 DOI:10.4172/21611459.1000250 Article
Title and Year Published Purpose of the study is to find out if diabetes contributes to risk of
dementia (196) Article 4 © 2015. Grand Canyon University. All Rights Reserved.
Assessment of Medication Adherence and its association with glycemic control among type
2 diabetes mellitus patient in Gaza (2018) To find out if medication adherence has any
effect on glycemic control among T2D patients Quantitative study diabetes on the risk of
dementia physicians The study was a cross-sectional quantitative study Sample size was
196 in a home for the elderly in Sweden Retrospective cohort study Cross-sectional study
Evaluating data provided by Medicaid from beneficiary of primary care N=64,354 The data
collected was coded and analyzed with regard to study variables T2D in Gaza attending
diabetic clinic Sample size 148 Design (Type of Quantitative, or Type of Qualitative)
Setting/Sample Study was a cross-sectional quantitative inquiry Methods:
Intervention/Instru ments Mixed method data collected through questionnaire, face to face
interview, laboratory investigations ECG, eGFR, Blood pressure machine, observation
during outpatient visit The collected data was analyzed using descriptive statistics, and
inferential statistics. The analysis deployed used t-test, logic analysis and simple logic
regression analysis Methods included observation, laboratory tests, cognitive functions
tests Analysis was done using multivariate linear regression to estimate differences and
multi-nominal logistic regression to examine association Statistical Logistic regression
model The study revealed that even in the best clinical setting the control of diabetes was
suboptimal. Average HBA1C was 8.3; hypertension 51%, 71% had uncontrolled T2D.
Uncontrolled diabetes led to eye complications (68.9%), chronic kidney disease (21.3%),
CVD (11.8%) and Neurological issues (2.5) from the study subjects. There is need to have
consistent screening using HBA1C goal, reduce BP and addition of statins to treatment
regimens to help lower high cholesterol. The study reported that uncontrolled diabetes
exposes patient to risk of dementia. There was no significant difference the two groups
regarding costs except Nursing practitioners rarely performed eye examinations, there is
risk of Nursing practitioners Rx wrong medications Control is diabetes is essential in
reducing risks associated with diabetic complication. Diabetic control will delay cognitive
problems in patient T2D Controlling diabetes help delay cognitive function impairment,
nurses can help patients There is need to have a treatment protocol that investigates eyes,
Hb AIC, CVD, Neurological complications to improve primary care Need to improve medical
adherence to improve T2D glycemic control Nurses have a significant role in helping patient
with T2D manage tighter glycemic control. Diabetic nursing visits for better A1C control in
patients DiscussionThe article is important because adherence to drugs leads to Analysis
Key Findings Recommendations Explanation of How the Article s EBP/Capstone Project
Sample size 515 patient at outpatient setting. The article recommends control of blood
sugar as a means of reducing diabetic complications. PICOT study seeks to enhance the use
of © 2017. Grand Canyon University. All Rights Reserved. Patients were followed through
face to face questionnaire, laboratory examination to monitor progress Descriptive
statistics and inferential statistics done. Regression analysis to determine influence of
independent variables The study found out that majority of the patients did not comply
with treatment instruction leading to 56.1% having poor control. HBA1C as measure of

3. controlling T2D through education, screening and patient management in diet & lifestyle
change because drugs alone are insufficient. Criteria Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article Article 5 gain proper control through
education, diet, exercise and medication Article 6 Nurses can help patient and doctors
achieve targeted Hb AIC < 6.4 Article 7 better glycemic control Article 8 Ruszkowska-
Giastek, B. et al. Vakili, S.T.T. et al. Wol, S.K. et al. Kostev, K. et al. Zhejiang UniversityScience
(Biomedical and Biotechnology) Neurogastoral Motil, 27 (10), 1389-1397 Journal of Korean
Academy of Nursing 48 92) 182-194 Journal of Diabetes, science and technology
https://doi.org/10.4 040/jkan.2018.48.2 .182 https://doi.org/10 .1177/193229681
7710477 Prescription Patterns in Disease control in T2D Mellitus in Nursing home and
Home care setting: Retrospective Analysis in Germany (2018) To determine the influence of
treatment setting on diabetes control https://link.springer.com/c
ontent/pdf/10.1631%2Fjz us.B1400218.pdf https://dx.doi.org/10. 1111%2Fnmo.12630
Article Title and Year Published Effect of Uncontrolled Hyperglycemia on levels of Adhesion
Molecules in Patient with Diabetic Mellitus Type 2 (2015) Association of High Dietary
Saturated Fat Intake and Uncontrolled Diabetes with Constipation: Evidence from the
National Health and Nutrition (2015). The effects of health mentoring program in
community dwelling vulnerable elderly individuals with diabetes (2018) Research
Questions (Qualitative)/Hyp othesis (Quantitative), and Purposes/Aim of Study To evaluate
the concentration of soluble forms of vascular adhesion in patient with controlled and
uncontrolled diabetes type 2 Cross-sectional Quantitative study Hypothesis there is no
relationship between diabetes and constipation. To determine the influence of mentoring in
the community on health treatment outcome in T2D Design (Type of Quantitative, or Type
of Qualitative) Setting/Sample The Study was a quantitative controlled randomized inquiry
Examination Survey Poland sample size 62 with 35 diabetic, 27 diabetic uncontrolled and
25 healthy subjects Diabetic patients non- Hispanic 6207 subjects Methods:
Intervention/Instr uments Laboratory analysis, urine, blood and kidney function tests
Physical and laboratory examination, BMI, Cross –sectional study, randomized, control,
quantitative design Korea setup with elderly at risk of dementia, diabetes complications 96
at the start and 70 at study end. Follow up, laboratory analysis © 2017. Grand Canyon
University. All Rights Reserved. Quantitative longitudinal comparative study Germany
comparing T2D in nursing homes and at home 9850 subjects /2 Analyzed, stored data
between 2011 and 2015 diet water intake Analysis Statistical analysis involved test for
normality, ANOVA for variance and Pearson correlation analysis to test relationship among
variables Control of diabetes delays vascular impairment Descriptive Statistics and
inferential statistical analysis was deployed Descriptive Statistical and inferential statistics
analysis Statistical analysis using Wilcoxon tests and Chi squared test to compare analyze
results There is a significant relationship between diabetic patients and constipation
compared to no diabetic subjects Mentoring is an effective strategy in monitoring the
diabetic patients in the community Recommendations Doctors need to ensure tight control
of diabetes to prevent vascular complications and neuropathy Diet is instrumental in
managing diabetes and ensuring Hb AIC targets are reached for tighter glucose control.
Mentoring need to be incorporated in management of T2D in the community Explanation of

4. How the Article s EBP/Capstone Control of Diabetes delays diabetic related complication
including vascular impairment, CVD and heart disease Diabetic nursing visits for better A1C
control in patients DiscussionThe article is important because diabetic control can help
reduce constipation in T2D pts The nurses are important as treatment facilitators in the
community with regard to education There was no significant different between the two
groups. The mean age at the nursing homes 80.7 years and those at home 74.8 years.
Patients in any set up provided adequate education is offered treatment goals will be
achieved. The article is vital because nurses attend to patient’s outpatient and inpatient
nurses facilitate glycemic control. Key Findings © 2017. Grand Canyon University. All Rights
Reserved. Running Head: PICOT 1 PICOT Statement on Diabetes Gregory Catania RN Grand
Canyon University NRS 490 11/25/18 2 PICOT PICOT Statement on Diabetes Over the past
few decades, diabetes has become a predominant health concern in the world. The
prevalence of prolonged, non-communicable illnesses is increasing at a rapid rate. It is
estimated that about 19 million individuals die annually due to cardiovascular illness, for
which diabetes is the major underlying cause (Vakili et al., 2015). At the moment, over 1.7
billion adults worldwide are overweight and 315 million of them being obese. The number
of adults with type 2 diabetes is approximated to be 250 million and it is projected to
increase to 400 million by 2025 (Marseglia et al., 2016). With these statistics, it implies that
a diabetes epidemic is underway. Diabetes occurs due to the impaired glucose sensitivity,
whereby the blood glucose is too high. The key risk factors for diabetes include obesity and
physical inactivity. Research has proved that the risk of developing diabetes can be
significantly reduced by lifestyle changes (RuszkowskaGiastek et al., 2015). That said, this
paper illustrates a PICOT statement on diabetes, especially on adults, and how it can be
controlled. PICOT Question: An increased glucose level is independently related to an
increased A1C level. Does reducing the A1C levels with specialized teaching from the nurse,
practitioners, and dieticians help to control diabetes on adult patients? Population: The
population for the study are American adult patients diagnosed for type 2 diabetes, aging 40
to 60 years old. This population is heterogeneous with respect to comorbidities and general
health status, which is important to establishing the appropriate intervention. 3 PICOT
Intervention: The intervention is quite essential as it explains on the way the researchers
addressed the problem and helped the population specified for the study. Implementation
of dietary and lifestyle changes would help control type 2 diabetes. Comparison: In order to
determine whether the intervention is successful, A1C levels would be measured before and
after the changes in lifestyle and diet. Outcome: At the end of the study, it is expected that
the A1C levels of adult diabetic patients would reduce. Timeframe: The research would be
conducted over a period of 12 weeks. PICOT Statement Control of type 2 diabetes for
American newly diagnosed adult patients has been problematic (P) due to the poor lifestyle
and diet, which leads to an increased glucose level. Specialized teaching from the nurse,
practitioners, and dieticians is an effective strategy to make the patients live appropriately
by eating the right food and doing exercises (I), which can enable them to control their A1C
levels (C) and live the normal life (O) within 12 weeks (T). Education as regards to lifestyle
modifications has been proved to be an effective intervention for controlling type 2
diabetes. Kuo et al. (2015) indicate that lifestyle interventions such as regular exercises and

5. diet changes reduce the incidence of diabetes by 53 percent compared 4 PICOT to the
control group. People assigned to these interventions reported reduced A1C levels than the
control group. Diabetic nursing visits for better A1C control in patients DiscussionIn a
similar study by Islam, et al. (2014), changing the lifestyle plays a key role in reducing in the
glucose levels, which further minimizes the cases of diabetes by 27 percent. Hence, there is
an important relationship between increased glucose level and increased A1C level as well
as the lifestyle change and reduced A1C levels, which leads to effective control of diabetes.
Among patients with pre-diabetes, it is worth to control their diet and do regular exercises
to help in a decrease of diabetes occurrence. Failure to prevent diabetes means increased
mortality. It is, therefore, the responsibility of each person to ensure they are living a
healthy life to lower the risk of diabetes. 5 PICOT References Islam, S.M.S., Alam, D.S., &
Wahiduzzaman, M., Nielsen, L.W, Fresch, G., Ferrari, U, Seisoler, J, Rouf, H, M.A & Lechner, A.
(2014). Clinical Characteristics and Complications of Patients with Type 2 Diabetes
Attending an Urban Hospital in Bangladesh. Diabetes and Metabolic Syndrome: Clinical
Research Reviews, 1-7 Kuo, Y., Goodwin, J.S. & Chen, N. Lwin, K.K., Baillargeon, J., & Raji, M.A.
(2015). Diabetes Mellitus Care Providers by Nurse Practitioners versus Primary Care
Physicians, Journal of American Geriatric Society. 63 (10), 1980-1988 Marseglia, A.,
Fratigioni, L., Laukka, E.J., Santoni, G., Pedersen, J., Backman, L. & Xu, W. (2016). Early
Cognitive Deficits in Type 2 Diabetes A Population Based Study. Journal of Alzheimer
Disease. 53, 1069-1078 Ruszkowska-Giastek, B., Sollup, A., Wernik, T., Rupiecht, Z.,
Golalczkyk, K., Gadomska, G. & Rosc, D. (2015). Effect of Uncontrolled Hyperglycemia on
levels of Adhesion Molecules in Patient with Diabetic Mellitus Type 2. Zhejiang University-
Science (Biomedical and Biotechnology) 16 (5), 355-361 Vakili, S.T.T., Nezami, B.G., Shetty,
A., Chetty, V.K. & Srinivasan, S. (2015). Association of High Dietary Saturated Fat Intake and
Uncontrolled Diabetes with Constipation: Evidence from the National Health and Nutrition
Examination Survey. Neurogastoral Motil, 27 (10), 1389-1397 …Diabetic nursing visits for
better A1C control in patients Discussion