Rasmussen College Type 2 Diabetes Discussion

The Determinants of Anti-diabetic Medication Adherence Based on the Experiences of Patients with type 2-Diabetes is a study that investigated the reasons 26 patients with diabetes do not adhere to anti-diabetic medication. There are several determinants that must be factored in. However, the overall result of this study is that there are multiple factors that patients mentioned that keep them from taking medications as they are prescribed.

Strength-This study identified common reasons patients do not take anti-diabetic medication. The information in this article will help tailor the proposed practice change. One thing that can be addressed before it becomes a problem, is to give the patient resources in the community. Looking for discounts and programs to help reduce the cost of anti-diabetic medications.

Weakness-The population studied was in Iran. Cultural beliefs and the cost of health care along with health insurance may be quite different in the United States. The study does not include a variety in population; therefore, the results cannot be generalized.

As mentioned above this study was done on a limited population. This may not be useful enough to provide scholarly information on diabetes education. Culture, health care access, resource access (Dehdari & Dehdari, 2019) and general knowledge of diabetes may or may not be different than the community of focus in the change proposal.

The effect of education given to type 2-diabetic individuals on diabetes self-management and self-efficacy. A randomized controlled trial. Primary Care Diabetes is a study that is based on the belief that education about diabetes improves self-management and self-efficacy in patients with type 2 diabetes (Eroglu & Sabuncu, 2021). The participants in this study had to have been diagnosed with Type 2 diabetes within 6 months of the study, had to be literate, Had to have an A1c greater than 6.5 to be included. The experimental group was given diabetes education face to face, given an education booklet, followed up with a phone call. In the experimental group there was a significant improvement in their metabolic screening (Egoglu & Sabuncu, 2021).

One strength of this study is that it focused on new diabetics. This is the patient population my proposed change project will address. A weakness of this is that there was only 78 patients in total. There was not a big enough population in the study, therefore there may not be enough representation for the diverse population that we serve.

I believe this study will be useful to my project because it lists what the topics of education was taught to patients.

Study number three is Predictors of Adherence Toward Specific Domains of Diabetic Self-Care Among Type-2 Diabetes Patients. This study was conducted on 207 patients with type 2 diabetes to observe how well patients adhered to self-care and anti-diabetic treatments. The participants had varying degrees of adhering to self-care management (Degefa et al., 2021). One weakness of this study would be the cost of healthcare. Some participants received free care while others had to pay out of pocket. That could have eliminated patients who could not afford care, but did not qualify for free care.

A strength of this study was the number of patients in the study. It gives us an idea of where we need to target education for diabetic patients. Medication had the highest adherence rate, whereas physical activity has the lowest. I can include some information from this study to identify areas of education that may need to be addressed.

The article entitled Hemoglobin A1c and diagnosis of diabetes in the next article. This study discussed the need to be cautious when using hemoglobin A1c alone for the diagnosis of diabetes. It goes on to say that A1c was lower in anemic patients, and higher after iron treatments (Ding et al., 2018) That does represent a large number of patients that have primary care providers in my field experience clinic. One strength of this article is that it does ultimately conclude that A1c levels detected diabetes more frequently when BMI, waist circumference and cholesterol were factored in. A weakness of the study is that it does not offer a better way to diagnose diabetes. It does list the American Diabetes Association and World Health Organization criteria for diabetes diagnosis. I can use this article in the section that teaches patients what diabetes is and how it was diagnosed.

The study entitled Effectiveness of simplified diabetes nutrition education on glycemic control and other diabetes-related outcomes in patients with type 2 diabetes mellitus is a study that took 208 participants and randomly placed them in a control group and study group. Over 22 weeks, with a combination of classes and follow-ups, patients that received simplified diabetic nutrition had improvement in A1c and diabetic control (Hashim et al.,2021). One weakness of this study is it did not combine both the plate method and the eating vegetables before carbohydrates method. Both have produced improvements in other studies, but one method or another was used. The strength of this study is that it does discuss two methods to help simplify diabetic nutrition methods. This can be used in the change proposal as options for diet and optimal nutrition.

Finally, A Comparison of Two Diabetes Self-Management Education Programs for the Reduction of Participant A1c levels is a study that concluded that group-based interactive diabetes self-management programs may be useful in reducing A1c levels of participants (Sharpless et al., 2021) The participants were followed for 1 year and those that participated in the group education had improved A1c for longer periods of time. The weakness of this study would be that participants were not randomly selected. They signed up for the study. This may alter results. One strength is that it identifies a method that proved to be successful in improving patient A1c levels. This information can be used by encouraging group-based interactive education modules. Letting patients know there are many options to help them self-manage diabetes will be an important aspect of the change proposal.

Dehdari, L., & Dehdari, T. (2019) The determinants of anti-diabetic medication adherence based on the experiences of patients with type 2 diabetes. Archives of Public Health 77(1), 1-9 https://doi-org.lopes.idm.oclc.org/10.1186/s13690-019-0347

Eroglu, N., & Sabuncu, N. (2021). The effect of education given to type 2-diabetic individuals on diabetes self-management and self-efficacy. A randomized controlled trial. Primary Care Diabetes, 15(3), 451-458. https://doi.org/10.1016/j.pcd.2021.02.011

Degefa, G., Wubshet, K., Tesfaye, S., & Hirigo, A. T., 2020) Predictors of adherence toward specific domains of self-care among type-2 diabetes patients. Clinical Medicine Insights: Endocrinology & Diabetes, 1-12 https://doi-org.lopes.idm.oclc.org/10.1177/1179551420981909

Ding, L., Xu, Y., Liu, S., Bi, Y., & Xu, Y. (2018). Hemoglobin a1c and diagnosis of diabetes. Journal of Diabetes. 10(5), 365 https://doi-org.lopes.idm.oclc.org/10.111/1753-407.12640

Hashim, S., Mohd Yusof, B, Abu Saad, H., Ismail, S., Hamdy, O., & Mansour, A. (2021). Effectiveness of simplified diabetes nutrition education on glycemic control and other diabetes-related outcomes in patients with type 2 diabetes mellitus. Clinical Nutrition ESPEN, 45, 141-149 https://doi.org.lopes.idm.oclc.org/10.1016/j.clnesp.2021.07.024

Sharpless, E., Borkowski, N., O’Connor, S.J., Herald, L., & Szychowski, J. (2021). A comparison of two diabetes self-management education programs for the reduction of participant A1c levels. American Journal of Health Promotion, 35 (7), 998-990 https://doi-org.lopes.idm.oclc.org/1-.1177/089011712111003829