Research Proposal: Self-Monitoring Blood Glucose in Diabetes Mellitus

This research proposal examines the effectiveness of self-monitoring blood glucose (SMBG) in managing type 2 diabetes. The study aims to determine if SMBG significantly improves glycemic control by comparing individuals who use self-monitoring techniques with those who do not. The research employs a descriptive design with a positivism research paradigm and utilizes thematic analysis for data presentation. The proposal addresses potential limitations, including time and cost, and suggests strategies for mitigation. The background section highlights existing research on diabetes, obesity, and the impact of SMBG on blood sugar levels. The study will employ a primary research method based on the PICO framework, with the research question focusing on whether self-monitoring of blood glucose improves glycemic control in type 2 diabetes. The proposal also includes objectives to understand the role of SMBG, compare patient outcomes, and propose strategies to manage the disease. The proposal concludes by noting that there was no significant change in glycaemic levels even after using self-monitoring blood glucose techniques.

Diabetes mellitus
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ABSTRACT
Diabetes mellitus is defined as the increase in blood sugar level over a prolonged period of
time. The signs and symptoms of types 2 diabetes are characterized by frequent urination issues
increase in thirst and hunger level.
Aim:
The research proposal has mainly focussed on the self monitoring of blood glucose in order to
improve the glycaemic levels in blood. Further the proposal has proposed the comparison of
individuals who are using self-monitoring techniques with the people who are not using this
method. The research proposal has also proposed effective strategies to lower down the blood
glucose levels in people suffering from severe diabetes.
Methods and design
Descriptive research design has been proposed in the study because it will help in understanding the
research in effective manner. Positivism research paradigms has been projected in the design so that
aims and objectives of the research are appropriately framed. The overall research method be based
on primary research method as participants are selected for further analysis.
Data analysis
For data analysis the proposal has suggested thematic analysis so that presentation in the
form of themes, graphs and charts are easily able to interpret the given information and data. In
every study or research there are many limitation present which affect the quality of proposed study.
It can be time limitation, cost limitations and resources limitations.
Validity and reliability
Validity and reliability in overall research has also been maintained so that the study is performed in
an effective manner. In order to eliminate all the types of time and finance limitations the proposal
has proposed to develop various strategies which can effectively reduce the cost and allocate the
resource appropriately so that research is conducted successfully.
Conclusion
The conclusion to research proposal stated that there was no significant change in glycaemic levels
even after using self-monitoring blood glucose techniques.
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Table of Contents
INTRODUCTION................................................................................................................................3
BACKGROUND..................................................................................................................................4
RESEARCH QUESTION....................................................................................................................5
Research Aim and objectives ...............................................................................................................5
METHODOLOGY...............................................................................................................................6
Research design...........................................................................................................................6
Ethical consideration...................................................................................................................6
Research methods.......................................................................................................................7
Cost estimation............................................................................................................................8
Reliability of research.................................................................................................................9
Limitations..................................................................................................................................9
Timescale....................................................................................................................................9
CONCLUSION..................................................................................................................................10
REFERENCES...................................................................................................................................11
APPENDIX........................................................................................................................................13
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INTRODUCTION
Diabetes mellitus (DM) is a types of diabetes which is characterized by increased blood
sugar levels over a prolonged time period. Symptoms of diabetes mellitus are frequent urination
problems, increased hunger and thirst (Ginter and Simko, 2013). It is very necessary to treat this
type of diabetes because untreated diabetes mellitus may lead to develop acute and chronic
complications. Acute complications may include ketoacidosis which is characterized by ketone
secretion in in urine. Other consequence also include nonketonic hyperosmolar coma. Serious long
term or chromic complications involve myocardial infractions, strokes, nephrological failures,
peptic ulcers and ophthalmic inflammations (Chalishajar and Stanford, 2014).
What?
The research will focus on whether self-monitoring procedures of blood glucose
significantly improves glyceamic control in type 2 diabetes mellitus or not (Armstrong, Harskamp
and Armstrong, 2013). It will also include difference in sugar level during and after the monitoring
process.
How?
To analyse whether self-monitoring of glucose levels significantly improves the glyceamic
control in type 2 or not a study will be conducted a which will focus on detailed investigation on the
issue in a systematic manner. In this research the examiner will perform a background study after
reviewing the different studies related to the topic (Hayes and et.al, 2013). The literature review
based on the current issues will provide a deep understanding about the research topic. Further the
research will conduct a cross sectional study to examine the effectiveness of self-monitoring blood
glucose. It will be conducted by selecting different individuals who have encountered diabetes type
2. it will try to gather more accurate and precise results so that the study is completed successfully
(Armstrong, Harskamp and Armstrong, 2013). To avoid inconsistency and reduce the limitation in
the research it will also propose estimated cost and time of the overall study so that it is completed
in due period.
Why?
Diabetes mellitus is one of the major problem of recent times which is affecting large
percentage of population in recent times. Numerous studies have been conducted on diabetes type 1
and other issues related to it but no appropriate research has been conducted for reviewing the use
and effectiveness of self-control blood glucose levels (Evans and et.al, 2013). This study will
overall lay an emphasis on how effective it is to self-monitor the increased blood sugar levels in
patients who are suffering from diabetes mellitus. Although, major symptoms and signs of type 2
diabetes are identified at earlier stage but due to lack of proper knowledge many patients are not
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able to monitor the blood sugar levels which develops severe acute and chronic complications in
later stages of life (Chary, Greiner, Bowers and Rohloff, 2012). Further this study will also help all
the endocrinology health professionals to guide patients in self-monitoring process.
BACKGROUND
Polonsky and Fisher, 2013 have stated that “self-monitoring of blood glucose in insulin
dependant patient is very useful because it helps in improving and controlling the blood sugar levels
in all patients” (Polonsky and Fisher, 2013). Different studies suggest that the major cause of
increasing type 2 diabetes is obesity among children and adults. 90% of patients who suffer from
type 2 diabetes are due to being obese and remaining 10% of patients who develop diabetes mellitus
is due to already encountered diabetes insipidus. A major difference in signs and symptoms of type
1 and 2 diabetes has been noticed. But studies suggest that as compared to type 2 diabetes, self-
monitoring blood glucose is more effective in controlling the blood sugar levels in diabetes type 1.
The process of self-monitoring of blood glucose level is effective to a great extent. According to
Schaupp and et.al, 2015 “the self-monitoring technique is much easy and reliable when measuring
the blood sugar levels is concerned” (Schaup and et.al, 2015). The glucose levels in blood can be
lowered by implementing a proper diet and exercise in patients who suffers from type 2 diabetes.
Although results drawn from various studies have concluded that use of self-monitoring blood
glucose can significantly lower the blood glucose levels but majority of service users are not found
to comply with the SMBG techniques. This apparently leads to poor levels of glyceamic controls
reported in type 2 diabetes patients (Armstrong, Harskamp and Armstrong, 2013).
In yet another study Ginter and Simko, 2013 have stated that “apart from self-monitoring
blood glucose it is very important to bring about a significant changes in lifestyles of patients who
are suffering from diabetes mellitus” ( Ginter and Simko, 2013). It is also very necessary to
maintain a proper control on fasting blood glucose and postprandial glucose levels. SMBG also
helps in developing awareness so that individual encountered with type 2 diabetes is able to
understand the role and levels of sugar in improving the glyceamic control system. Even after
successful arrangements and methods used for SMBG no significant changes in results were notices
in patients who implemented SMBG and who did not use the same techniques (Morino and et.al,
2012). Research also revealed that only particular control on diet plans in types 2 diabetes patients
will not likely improve the glyceamic levels. This need proper exercise medication regime and self-
monitoring so that the issue can be solved effectively (Armstrong, Harskamp and Armstrong, 2013).
Further the studies also suggested that the self-monitoring blood glucose can only be effective when
patients are well aware about this. More efficiency is noticed when the patient is capable of self-
adjusting the drug treatment provided to them due to type 2 diabetes.
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Background research has interpreted that there is no significant difference in the HbA1c
level was observed between the individuals who used the criteria of self-monitoring blood glucose
and the one who did not follow the same criteria (Chalishajar and Stanford, 2014). The overall
percentage of blood glucose in the users were recorded to be 6.9% whereas the percentage of
glucose in non-users were reported to be 6.8% (Yu and et.al, 2015). Further the patients who were
treated with only diet supplements were reported to be containing more than 6% of blood glucose
whereas the person who were not only on diet measured and overall percentage of 5.6%
(Chalishajar and Stanford, 2014). When both the results were compared after the completion of
studies it was noticed that medical history or records generated in users and non-users of self-
monitoring blood glucose did not show any significant change or complication in the clinical
intervention of diabetes mellitus. However randomized controlled trials research system also
showed that appropriate self-monitoring of blood glucose has significantly lowered the glycated
haemoglobin by considerable percentage (Sindhur and Sanjay, 2013). Along with self-monitoring
the use of diabetes management regime can also effectively reduce the HbA1c level by 0.42%.
However no significant change was observed when the self-monitoring of blood glucose was
implemented alone.
Along with this, background research has reflect de that the level of creatinine was also
recorded in the users who adopted the self-monitoring of blood glucose. The creatinine level was
reduced as compared to non-users of this method. The difference in users and non-users of
glycaemic control was not remarkable. Hence it was concluded that if self-monitoring method is
used alone without the diabetes management regime then this will not reduce or improve the
glycaemic control in type 2 diabetes patients (Armstrong, Harskamp and Armstrong, 2013).
RESEARCH QUESTION
The overall study will be based on Primary research which will be conducted in order to
provide the appropriate results for the study .The research will be performed with the help of
information gathered through PICO framework (Evans and et.al, 2013).
 P-patient with diabetes mellitus
 I- Self-monitoring of blood glucose levels
 C-N/A (Chalishajar and Stanford, 2014)
 O- improves glycaemic control in type 2 diabetes mellitus
1. “Does self-monitoring of blood glucose significantly improves glyceamic control in type 2
diabetes mellitus?”
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RESEARCH AIM AND OBJECTIVES
Aim
“Does self-monitoring of blood glucose significantly improves glycaemic control in type 2
diabetes mellitus?”
Objectives:
 To understand the role of self-monitoring blood glucose in improving the glycaemic levels
in patients with type 2 diabetes
 To compare the results of patients who have been using self-monitoring blood glucose with
the individuals who do not use SMBG.
 To propose appropriate and effective strategies which can prevent the rate of increased
number diabetes 2 patients in recent times
METHODOLOGY
Research design
There are two types of philosophical and epistemological positions which help in
determining the research problem in efficacious way. For the current research subject it will use
epistemological positions because it helps in acquiring knowledge and making difference between
truth and falsehood. Therefore, it will play very important role in analysing research problem
properly (Chary, Greiner, Bowers and Rohloff, 2012). It needs to use appropriate philosophy for
conducting research investigation and resolving research problem. There are two types of the
research paradigm positivism and interpretivism. For the current research it will use positivism
research paradigms which will help in attaining aim and objectives in appropriate way. Along with
this, it will play important role in resolving research issue by conducting in-depth study on current
subjects.
For the current study it will use descriptive research design because it will help in
understanding subjective research subject in effective manner. It will play important role in
analysing blood glucose significantly improves glycaemic control in type 2 diabetes mellitus
because it is a subjective concept. Along with this, it will also help in understanding the research
problem in efficacious way (Sindhur and Sanjay, 2013). Along with this it will play important role
in gathering large amount of data about the self-monitoring of blood glucose which will help in
conducting detailed study on the current subject. It has been chosen because it is less expensive and
less time consuming as compare to the other research designs (Armstrong, Harskamp and
Armstrong, 2013). Therefore, study will be used positivism research philosophy for analysing
research subject in effective way (Chalishajar and Stanford, 2014). Interpretivism is not used as the
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research paradigm in the proposal because it is used when the study is subjective based. Here the
overall study is objective based hence, it is more preferable to use positivism research paradigm.
Research Methods
Participants
Participants in research will be selected through random sampling so that all the individuals
can get equal chances of participating in the study (Buijsse and et.al, 2011). The overall research
will be done by categorising the sample into two different groups. One group will include
participants who use self-monitoring of blood glucose to control the glycaemic index in diabetes
mellitus 2. The other group of study will include all the individuals who do not use the criteria of
self-monitoring (Travers and et.al, 2013). In this study an overall of 50 participants will be selected.
Study will follow inclusion and exclusion criteria which will not allow many individuals for the
current investigation. All those participants who will not have complete follow up or medical
history records will not be eligible for the research (Polonsky and Fisher, 2013). Only 50 patients
who will be followed for self-monitoring criteria for blood glucose will be selected based on the
inclusion criteria.
Regarding this study needs to select sample from patients of type 2 diabetes mellitus. This
sample will be collected by using probability sampling method such as random number sampling. It
provides an equal chance to each and every participant to select in a sample for whole investigation.
It will be appropriate for the current investigation because it reduces sampling error which help in
improving the reliability and validity of the research findings. Sample size for the current
investigation will be 50 because it will be appropriate for presenting characteristics of whole
research universe (Singh, 2015).
Data collection
There are different data collection methods for collecting facts and figures such as primary
and secondary methods. But the overall data in the research will be collected through primary
method in which primary sources will be the participants taking part in glycaemic control research.
Regarding this, research will conduct an online survey of different participants. It will develop an
appropriate questionnaire on the basis of current subject which will comprise open and close ended
questions about the type 2 diabetes. It will play important role in getting most appropriate answers
to resolve research question in effectively (Schaupp and et.al, 2015). The overall data for the
research will be collected through different nursing homes, hospitals,
Data analysis
As per the above discussion it has been chosen primary data collection for collecting facts
and figures. So, for analysing all these information study will use qualitative data analysis method.
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It includes thematic data analysis method which will include different themes, graphs, charts and
diagrams. It will help in analysing all information in effective way. It will resolve research issues
and help in getting appropriate findings for attaining aim and objective in appropriate way.
Thematic analysis will play important role in analysing qualitative information in effective manner
(Chalishajar and Stanford, 2014).SPSS is a software package that is used for statistical analysis of
data. It is widely used in analysing data in medical and healthcare researches so that data can be
analysed appropriately. The base software that is included in the statistical analysis is cross
tabulation, descriptive statistics, frequencies ANOVA and correlations. Cluster analysis can also be
done with the help of SPSS tool
Cost estimation
As per the cost estimation whole investigation will be completed in £150. It will be allocated
to different resources such as internet, system, transport, etc. It needs to use different transportation
services for conducting survey, interview and self-monitoring in different institutions. Along with
this, It will conduct online survey so, expenses of the internet will also include in the cost of the
current investigation. Next expenses of the current research will be two hard binding of the report.
So, printing and binding of two copies will be included in the major expenses of the current
investigation.
Reliability and Validity
Validity and reliability of the data can be maintained by the appropriate use and application
of all research methods. There is need to develop appropriate questionnaire for collecting primary
information. It must be based on current research subject which will help in increasing reliability
and validity of the data. Along with this, for testing the validity and reliability it can also apply
different statistical tests also (Sindhur and Sanjay, 2013). Validity can be defined as the extent or
which a result or concept derived from certain evaluation is accurate and precise. one of the most
important parameter that should be considered by performing any secondary or primary research in
healthcare or any other field. It is different from reliability because it is the degree to which the
results are measured.
Ethical consideration
It is very important to consider ethics in ongoing research so that ethical dilemmas are
reduced to minimal. Ethical requirements prior to the research should be conducted so that
participants who are involved in the research are aware about different concepts of ongoing studies.
All the individuals in research should be treated autonomously (Polonsky and Fisher, 2013). The
author who is conducting the research should ensure that all the participants are aware of risk and
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benefits associated with the study. Persons who have diminished autonomy should be provided with
extra care and protection (Albiero and et.al, 2014). They should not be forced to participate without
their consent and will. Before conducting the research it is necessary for investigator to provide a
patient consent form which describes rules, regulations, risks and benefits mentioned in the form.
Approval from research committee and other higher authority is very necessary (Boström and et.al,
2014).
Along with this, study will use primary data collection methods for collecting facts and
figures. So, study needs to focus on safety and security of the personal information of all
participants. Regarding this, it will assure about not to disclose any personal information of
participants. Along with this, it will use only those information which will \be required for
completing research in efficacious way. Overall, research study will follow all ethics in effective
manner which will help in conducting investigation in ethical way (Carnethon and et.al. 2012).
Limitations
Each and every research associates with some basic limitations which may affect the findings
of the current research in negative manner. For managing different limitations study has used most
appropriate strategies. For example, lack of time, cost and experience are major limitation for the
current investigation. For resolving these limitation there is need to develop appropriate plan for
managing time and cost. It will help in allocating these resources successfully on different activities
of the investigation. Along with this, lack of experience of the field study is also major limitation
for the current research. For managing this, limitation it has analysed the theoretical information of
the different research methods. It has improved the overall understanding about the different tools
and techniques which also played important role in selecting appropriate tool as per the research
subject and issue (Aschner, Horton and Skyler, 2010).
Timescale
It will develop appropriate plan for conducting whole investigation in effective manner which
will comprise different activit6ies and duration that is required to complete each task. It can be
presented by Gantt chart which is as follows:
Table 1: Gantt chart for the current investigation
Key activity / Weeks 1 2 3 4 5 6 7 8 9 1
0
1
1 12 13
Review of background
and rational of the
current subject
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Research methodology
Data collection using
primary data collection
methods
Sampling technique
Data analysis using
most appropriate
methods
Interpretation of
findings and results
Submission of Draft
and making necessary
changes
Final submission of
report
CONCLUSION
The overall research will be based on whether the use of self-monitoring of blood glucose
level can improve the glycaemic control. Further it may be concluded that there is no significant
change noticed in the results of both the groups. However some continued to use self-monitoring
method so that they can relatively reduce the extent of type 2 diabetes in them (Asija, 2014). The
research will also found that there will no considerable amount of change or alteration measured in
the patients who use the self-monitoring methods with the individuals who do not use this
procedure. The study will mention that if the method of self-monitoring is used alone with the
adoption of any diabetes management regime then it will not show any remarkable improvement in
HbA1c levels. For getting appropriate findings of the current investigation It will be use most
appropriate methods of research such as positivism research paradigm, inductive approach, primary
data collection method, random number sampling etc. It will play important role in attaining aim
and objectives in effective manner.
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REFERENCES
Books and Journals
Armstrong, A.W., Harskamp, C.T. and Armstrong, E.J., 2013. Psoriasis and the risk of diabetes
mellitus: a systematic review and meta-analysis. JAMA dermatology. 149(1). pp.84-91.
Aschner, P., Horton, E., and Skyler, J. S., 2010. Practical steps to improving the management of
type 1 diabetes: recommendations from the Global Partnership for Effective Diabetes
Management. International Journal of Clinical Practice. 64(3). Pp. 305- 315.
Asija, R., 2014. Herbal plants used in treatment of diabeties mellitus: an updated review. Journal of
drug discovery and therapeutics. 2(24).
Boström, E. and et.al., 2014. Interaction between diabetes specialist nurses and patients during
group sessions about self-management in type 2 diabetes. Patient Education and Counseling.
94(2). Pp.187-192.
Buijsse, B. and et.al., 2011. Risk assessment tools for identifying individuals at risk of developing
type 2 diabetes. Am J Epidemiol. 33. Pp.46–62.
Carnethon, M. R. and et.al. 2012. Association of weight status with mortality in adults with incident
diabetes. JAMA. 308. Pp.581–90.
Chalishajar, D.D. and Stanford, C.A.C., 2014. Mathematical Analysis of Insulin-Glucose Feedback
System of Diabeties. International Journal of Engineering. 5(02). p.8269.
Chary, C. and et.al., 2012. Determining adult type 2 diabetes-related health care needs in an
indigenous population from rural Guatemala: a mixed-methods preliminary study. BMC
Health Services Research. 12(476).
Evans, J.M. and et.al., 2013. Self-monitoring among non-insulin treated patients with type 2
diabetes mellitus: patients’ behavioural responses to readings and associations with glycaemic
control. Diabetes research and clinical practice. 100(2). pp.235-242.
Ginter, E. and Simko, V., 2013. Type 2 diabetes mellitus, pandemic in 21st century. Springer New
York.
Hayes, A.J. and et.al., 2013. UKPDS outcomes model 2: a new version of a model to simulate
lifetime health outcomes of patients with type 2 diabetes mellitus using data from the 30 year
United Kingdom Prospective Diabetes Study: UKPDS 82. Diabetologia. 56(9). pp.1925-1933.
Polonsky, W.H. and Fisher, L., 2013. Self-Monitoring of Blood Glucose in Noninsulin-Using Type
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