Synthesis Paper

Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example

The purpose of this assignment is to develop a synthesis of evidence using three quantitative research study articles and three non-research evidence sources.

Diabetes Pandemic

Diabetes is a national problem in the USA. About one in every ten persons have diabetes, which translates into 37.3 million people or 13.8% of the total population (CDC, 2022). On the other hand, about 96 million adults have prediabetes. A CDC statistics ranks diabetes as position seven among the leading conditions/illnesses in the USA (CDC, 2021). Risk factors such as old age, overweight and obesity, sedentary lifestyle, glycated hemoglobin, smoking, high cholesterol, and blood pressure are high in the USA.(Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)

Diabetes affects the government and individuals in various ways. Individuals diagnosed with diabetes experience different social and health infirmities and high costs related to diagnosis and treatment (Arslanian et al., 2018). Similarly, the government loses revenue due to reduced productivity, direct and indirect healthcare costs, and increased welfare benefits for the affected population. Therefore, diabetes is a priority health issue that requires effective and deliberate interventions to minimize its impact on the affected people.(Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)

The identified studies provide interventions at different levels, including patient and federal. According to Elsaid et al. (2020), a platelet-rich plasma (PRP) gel produces a faster and increased reduction of chronic diabetic foot ulcers (DFU) compared to saline dressing. Conversely, Bels et al. (2019) assert that using a tailored smartphone-enabled digital self-management education and support effectively manages patients’ unmet needs, including insulin therapy and access to professional and peer advice. Lastly, Michiels et al. (2019) affirm that tailored diabetes information provided by the pharmacist to T2D patients contributes to a significant reduction in HbA1c and improves patients’ understanding of diabetes.(Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)

Analysis of the Practice Problem

Diabetes is a significant population health issue in the US. Diabetes has a complex etiology and results from irreversible risk factors such as aging, race, and ethnicity (CDC, 2021). Other factors contributing to the diabetes pandemic include old age, overweight and obesity, sedentary lifestyle, glycated haemoglobin, smoking, high cholesterol, and blood pressure (CDC, 2021). In the past two decades, the number of persons diagnosed with diabetes has doubled, further compounding the impact of the pandemic on the affected US population, yet one in every five individuals don not know they have diabetes. The prevalence of diabetes is has increased over the years. The Centre for Disease Control and Prevention reports that about 37.3 million people across all age groups have diabetes, and 37.1 million are aged above 18 (CDC, 2022). About 8.5 million diagnosed with diabetes reports not knowing they have diabetes. Equally, the number of individuals diagnosed with diabetes increases with age, with persons above 65 years accounting for 29.2% of diagnosed cases.(Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)

Diabetes is ranked position seven as the top killer condition in the USA. According to Michiels et al. (2019), diabetes is associated with various complications exacerbated with insufficient control. About 79535 people die from diabetes annually (Weatherspoon, 2019), while the American Diabetes Association reported 270702 diabetes deaths in 2017 (ADA, 2021). The ADA further reported that diabetes mortality could be underreported in death certificates. Diabetes subjects individuals and the government to high costs. The ADA reported that about 327 billion dollars were spent on diagnosed diabetes in 2017, with 237 billion dollars going directly to medical expenses and 90 billion dollars accounting for lost productivity (ADA, 2021; Weatherspoon, 2019). Significantly, the costs associated with diabetes increases with insufficient treatment and related complications.  (Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)

Evidence Synthesis

According to Elsaid et al. (2020), diabetic foot ulcers is a common diabetes complication associated with up to 10% prevalence among the elderly. About 20% of DFU cases are persistent, and about 24% result in limb amputation. Boels et al. (2019) point out that behavioural management through diabetes self-management education (DSME) provides a temporary reprieve to diabetes-related complications and glycemic management. However, only half of the diabetes patients are trained on DSME. Lastly, Michiels et al. (2019) argue that poor patient-personnel communication and limited diabetes knowledge contribute to poor glycemic control among T2D patients.(Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)

Elsaid et al. (2020), Boels et al. (2019), and Michiels et al. (2019) highlight and support different points regarding diabetes and associated complications. Elsaid et al. (2020) main argument is that PRP gel is a vital DFU dressing approach as opposed to the normal saline dressing. The study found that using PRP shortened recovery time compared to saline dressing. Notably, an individual’s response to therapy, treatment modality, and the nature of the wound limits the efficacy of DFU dressing.(Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)

On the other hand, Boels et al.’s (2019) main argument is that using a tailored smartphone-enabled digital self-management and receiving professional support is crucial in managing patients’ unmet needs such as insulin therapy. Boels et al. (2019) examined the impact of DSME and personnel support on patients undergoing insulin therapy. Usually, patients do not get enough knowledge during periodical personnel visits, which justifies using a smartphone-enabled self-management kit to complement follow-up activities. Therefore, mHealth interventions should target individuals rather than general diabetes management instructions since diabetic conditions tend to vary.(Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)

Lastly, Michiels et al.’s (2019) main point is that a 30-minute patient interview following drug dispensation can help reduce HbA1c and improve patients’ understanding of diabetes management. Diabetes patients tend to interact with pharmacists more than other clinicians, justifying the importance of pharmacists-led diabetes education. Therefore, pharmacists can positively contribute to diabetes management, particularly glycemic control, patients’ understanding of diabetes, and perception of medication through a positive patient-pharmacist relationship.(Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)

Together, the selected articles addressees the significance of various methods of managing diabetes complications and self-management. Diabetes presents significant complications, including DFU, which are challenging to manage and requires consistent follow up with the patients. Therefore, it is vital to adopt smartphone-enabled self-management or pharmacists-led education to ensure patients are constantly educated on managing their condition (Boels et al., 2019; Michiels et al., 2019). Individuals with DFU, particularly the elderly, should go for PRP dressing to facilitate faster healing (Elsaid et al., 2020).  (Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)

Conclusion

In conclusion, this paper contributes to building up a synthesis on the diabetes pandemic in the USA. Using three quantitative and three non-research articles, this paper presents diabetes as a national problem, its significance, prevalence, mortality, and economic impacts. Diabetes affects individuals and the government differently as individuals suffer health and financial costs, while the government incurs the economic burden associated with lost productivity and medical expenses. Equally, the higher prevalence of diabetes and the related complications contribute to increased mortality as the disease is ranked position seven among other conditions and illnesses. Crucial interventions identified include PRP dressing of DFU, a tailored smartphone-enabled digital self-management, and pharmacists-led education. Therefore, the paper synthesizes research and non-research findings on diabetes, a national problem. (Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)

References

American Diabetes Association. (2021). (Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)Statistics About Diabetes. Available at: https://www.diabetes.org/resources/statistics/statistics-about-diabetes (Accessed 26 January 2022)

Boels, A. M., Vos, R. C., Dijkhorst-Oei, L. T., & Rutten, G. E. (2019). Effectiveness of diabetes self-management education and support via a smartphone application in insulin-treated patients with type 2 diabetes: Results of a randomized controlled trial (TRIGGER study). BMJ Open Diabetes Research and Care, 7(1), e000981(Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example).http://dx.doi.org/10.1136/bmjdrc-2019-000981

Centers for Disease Control and Prevention (December, 2021). (Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example)What is Diabetes? Available at: https://www.cdc.gov/diabetes/basics/diabetes.html. Accessed 26 January 2022

Centers for Disease Control and Prevention (January 2022). National Diabetes Statistics Report website. Available at: https://www.cdc.gov/diabetes/data/statistics-report/index.html. Accessed 26 January 2022.

Elsaid, A., El-Said, M., Emile, S., Youssef, M., Khafagy, W., & Elshobaky, A. (2020). A randomized controlled trial on autologous platelet-rich plasma versus saline dressing in the treatment of non-healing diabetic foot ulcers. World Journal of Surgery, 44(4), 1294-1301.(Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example) https://doi.org/10.1007/s00268-019-05316-0

Michiels, Y., Bugnon, O., Chicoye, A., Dejager, S., Moisan, C., Allaert, F. A., … & Vergès, B. (2019). Impact of a community pharmacist-delivered information program on the follow-up of type-2 diabetic patients: a cluster-randomized controlled study. Advances in therapy, 36(6), 1291-1303.(Developing a Synthesis of Evidence on Diabetes Comprehensive Nursing Paper Example) https://doi.org/10.1007/s12325-019-00957-y

Weatherspoon, D. (April 2019). Statistics and facts about type 2 diabetes. Medical News Today. Available at: https://www.medicalnewstoday.com/articles/318472