Evidence Based Nursing Report on Type 2 Diabetes Mellitus Management

Running head: NURSING
Evidence Based Nursing Report
Name of the Student
Name of the University
Author Note

NURSING
Table of Contents
Part 1..........................................................................................................................................3
Identification of the Clinical Issue.........................................................................................3
Summarising the evidence based...........................................................................................3
Justification for the choice of topic........................................................................................4
Research Question..................................................................................................................4
Search Strategy.......................................................................................................................4
List of Articles........................................................................................................................4
Rationale for the choice of the paper.....................................................................................5
Part 2..........................................................................................................................................6
Synthesis of Findings.............................................................................................................6
Identification of highest level of evidence.............................................................................8
Critical appraisal tool.................................................................................................................8
Critical appraisal....................................................................................................................8
Answer 1............................................................................................................................8
Answer 2............................................................................................................................9
Answer 3............................................................................................................................9
Answer 4..........................................................................................................................10
Answer 5..........................................................................................................................10
Answer 6..........................................................................................................................10
Answer 7..........................................................................................................................10
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Answer 8..........................................................................................................................11
Answer 9..........................................................................................................................11
Answer 10........................................................................................................................11
Answer 11........................................................................................................................11
Appendix 1...............................................................................................................................12
Search Strategy.....................................................................................................................12
Appendix 2...............................................................................................................................16
The final list of articles........................................................................................................16
Appendix 3...............................................................................................................................17
PRISMA Chart.....................................................................................................................17
Appendix 4.............................................................................................................................0
References..................................................................................................................................8
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Part 1
Identification of the Clinical Issue
One of the local health need in Australia is increase in the rate of incidence and
prevalence of Type 2 Diabetes Mellitus (T2DM). According to Australian Institute of Health
and Welfare [AIHW] (2019), 1.2 million (6%) of the Australian adults who are above 18
years of age (2017-18) suffers from diabetes. T2DM is more common than T1DM and is the
principle causes of hospitalizations. People residing under poor socioeconomic disadvantage
group are principle victims of T2DM. The rate of incidence of T2DM has increased among
the adult Australian population by 3.3% since 2001. The percentage is higher in men than
women. The development of T2DM is associated with several co-morbidities like cardio-
vascular disease, renal complications, peripheral neuropathy and retinopathy. Nearly 2/3rds
of the Australian adults who are suffering from diabetes experiences heart attack every year
and it is estimated that in the upcoming year nearly 1100 and 3300 Australians will suffer
from diabetes-associated heart attack (Diabetes Australia, 2019). The medication
management doe for the diabetes management include injection of subcutaneous insulin in
order to lower the blood glucose concentration in the blood. Moreover, in addition to this, the
affected individuals might also require proper pharmacological interventions in order to
reduce the high blood pressure and high level of blood cholesterol for managing the co-
morbidities of diabetes.
Summarising the evidence based
However, in T2DM, the glucose in the blood is insulin resistant and insulin
administration fails to extract the desired results. The escalating rate of diabetes in Australia
is also indicating the need for change of the insulin therapy in Australia (Diabetes Australia,
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2019). According to the reports published by Diabetes Australia (2019), investigation of the
evidence-based care for the Australian suffering from the diabetic-foot ulcers might help in
saving of nearly $2.7 billion investment in the healthcare during the last five years.
Justification for the choice of topic
The non-modifiable risk factors for the development of diabetes include genetic pre-
disposition, age of the individual and family history. The modifiable risk factors behind the
development of diabetes include unhealthy lifestyle habits like obesity, sedentary life,
smoking and alcohol consumption (Australian Government Department of Health, 2016).
National Institute of Diabetes and Digestives, and Kidney Diseases (2019) stated that
modifications of the lifestyle factors could be helpful in reducing the severity and
vulnerability of developing T2DM.
Research Question
Thus the main clinical Questions include: What is the effectiveness of the lifestyle
interventions in reducing the blood glucose level of the individuals suffering from T2DM in
comparison to insulin injection
Population (P) Adults with T2DM and having high blood glucose level
Interventions (I) Healthy lifestyle interventions
Comparison © Insulin injection
Outcome (O) Reduced blood glucose level in blood
Search Strategy
Given in the appendix section (Appendix 1) for the CINHAL databases that was selected for
search of the articles
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List of Articles
Given in the appendix (Appendix 2)
Rationale for the choice of the paper
All the five selected articles focused on the effective management of the Type 2
Diabetes Mellitus. Out of the five articles, 3 articles focused in the relevance of the lifestyle
interventions on the diabetes management and two articles focused in the effectiveness of
insulin in T2DM. One of the selected articles is a meta-analysis, while one is systematic
review and meta-analysis; one is only meta-analysis. The remaining two articles include
cohort study and one is randomised control trial. The systematic review and meta-analysis are
more reliable than the single study because it helps in getting a retrospective overview of
more than one study and then framing of the final results based on the summative over-view.
LoBiondo-Wood and Haber (2017) are of the opinion that systematic review and meta-
analysis are helpful in framing evidence-based nursing practice. Randomised control trail are
selected because it they study is associated with low level of bias. Cohort study is a type of
longitudinal study that helps in the establishment of the risk factors and the health related
outcomes of the study.
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