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MANAGEMENT OF DIABETIS IN ELDERLY HISPANIC AMERICA 11

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 recommendations that includes T2D-specifics individualized to patients aged 65 and above.

K hattab , 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 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.

D eMaria , 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 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.

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 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