Nursing Paper on Diabetes Management

Clinical Practice Guidelines as a Tool used to Manage Diabetes mellitus

Health is regarded as a key and essential aspect of any living human being. It is with this profound reason that clinical practical guidelines (CPG) are usually put in place for the medical practitioners to be able to offer quality medical services to its patients. Amid an alarming increase of chronic illnesses, the healthcare professionals need to be able to offer quality services that are in line with the patient’s needs.

Therefore, I write  this paper discuss on how Clinical Practice Guidelines can be used as a tool for provision of better healthcare services to the patients who suffer the condition of having Diabetes mellitus.

Scope and Purpose of Clinical Practice Guidelines

Clinical practice guideline (CPG) is evidence-based informed care management tools developed by medical experts with the intent of providing guidelines to healthcare professionals (In Chowdhury, 2014). One of the primary reasons as to why CPG is vital is due to the rapid increase of victims suffering from chronic illnesses. Diabetes mellitus is among the many chronic illnesses that has so far affected a vast of population all over the world. Diabetes mellitus is a heterogeneous group of metabolic disorders characterized by chronic hyperglycemia with disturbances of carbohydrate, fat and protein metabolism (Thomas, 2012).  This is usually the case due to the body’s defect in secretion of insulin, or inadequate insulin or both. A person suffering from Diabetes mellitus may usually end up suffering from long-term effects which include failure of dysfunction of body organs such as heart, kidney and eyes.  The purpose of the Clinical Practice Guidelines is to provide the medical and healthcare practitioners with the proper concept of managing Diabetes mellitus in adults. The main objective of the clinical practice guidelines is to provide evidence-based practice that is committed to providing the medical-care practitioners with the necessary knowledge that will help in them in examining, diagnosing and managing the patients suffering from Diabetes mellitus (In Chowdhury, 2014). These guidelines would also ensure that the healthcare professionals administer the best treatment and medications to their patients with an aim of enabling the patient reduce his or her medical cost. Thus, this paper is aimed to describe how CPGs have an impact on the quality of medical services that the healthcare professionals give to their patients.

Stakeholder involvement in the development of the document

The development and establishment of this document has come about as a result of collaboration by different parties who are the stakeholders. Some of the erudite medical practitioners who acted as part of the stakeholders were; the trained medical nurses, the doctors, nutritionists, pharmacists together with the trained medical educators. Aside from them, the Ministry of Health also played a big role by providing the necessary finances and facilities needed to come up with efficient and effective clinical practical guidelines for diagnosing and managing Diabetes mellitus. Medical research institutions such as USAMRU and CDC also played a vital role in carrying out medical research study with an aim of discovering new and better treatment techniques and medication. The Institute of Genetics and Molecular Biology in the University of Bath also contributed in the research on how genes are associated with the genetic inheritance of the disease from either of the parents to the child.

The target group for this clinical practice guideline are the; healthcare providers, Trained nurses, patients, Managed care organizations, health insurance companies and Advanced practice nurses. In addition, this document is also intended to reach the students, physicians, physician assistants and the Public Health Departments.

This guideline is also important for the target population who are all victims with Diabetes mellitus and those who are at a risk of having Diabetes. All Diabetic patients inclusive of children, adolescents and adults are among the target population as described by this guideline.

Rigor of Development

The development of this document was very rigorous as the systematic methods were developed in accordance with the medical protocols.  In addition, the criteria used for selecting the evidence were clearly and well structured. The guidelines were developed based on a systematic review of the literature using an approach based on the procedure outlined by the American Diabetes Association (Thomas, 2012). The systematic method used to develop the guideline for managing Diabetes mellitus was as follows; the description of the disease, Guideline for diagnosis, evaluation, management, prevention and treatment. Electronic database was used as the main method of selecting evidence that was used in creating the guideline structure. The clinical and research literature came about as a result of thorough research from different electronic databases such as Elsevier, Diabetes Prevention Program, Agency for Healthcare Research and Quality, Medical Expenditure Panel Survey and World Health Organization among other electronic databases . The criteria for selecting the evidence was determined by whether the researched literature had answered the questions that were addressed in the guideline. In addition, evidence was also recovered from the clinical trials that had been done by the CDC and USAMRU.

After the evidence had been graded, the results were recorded on Evidence and Recommendation Grading Sheet by the Ministry of Health (In Chowdhury, 2014). This was later followed by a two face-to-face meetings where all documents having the graded evidence were voted on by the Guideline Development Reading Group.

Recommendations

Expert consensus is the primary method that was used in formulating the recommendations that are currently stipulated in the guideline. The major recommendations are categorized as those which have the highest grade with regard to the strength of evidence.

Diabetes mellitus examination

It is recommended for medical practitioners to conduct thorough examination on a patient by measuring the ACI, measuring the height, weight and blood pressure, calculating the BMI, carrying out retinal screening and measuring the person’s cholesterol and microalbuminuria levels (Kramer-Kile & Osuji, 2014).

Lifestyle modification

After the examination process, the patient should be taken to the nutritionists who will advise him or her on the importance of adapting to a healthy lifestyle. This includes to food choices, exercise and stopping bad habits such as smoking tobacco and drinking too much alcohol (In Chowdhury, 2014).

The diabetic patient should ensure that his or her meal and snack carbohydrate are consistently distributed throughout the day on a daily basis. This is due to the fact that consistency in carbohydrate intake results to an improved glyacemic control (Thomas, 2012). In addition, every person is recommended to take meals that are rich in fibre. A total of 25-35g of dietary fibre is highly recommended for both the healthy and the diabetic patients.

On the other hand, the diabetic patients who are obese or overweight need to ensure that they practice and do exercise on a regular basis. However, patients who have been diagnosed with type 2 diabetes should not do rigorous exercises. Instead, they are advised to do vigorous exercise for approximately 3 hours for one week.

Controlling the sugar levels

Patients suffering from type 1 or type 2 diabetes mellitus are advised to be in charge of their sugar levels. If one is able to monitor his or her blood sugar levels, then he or she is also able to administer insulin to himself whenever it is necessary. Patients with diabetes type 1 are recommended to monitor their blood sugar levels for three or more times per day (Kramer-Kile & Osuji, 2014). It is thus the responsibility of the health-care professionals to educate the patients on how to they can monitor their blood glucose levels and the interpretations of the blood glucose levels.

Application

This clinical practice guideline is applicable to the population of interest who are mostly the Diabetic patients. This guideline targets all diabetic patients irrespective of age or gender. The target population is also inclusive of the diabetic patients who have developed complications such as organ failure or dysfunction. This guideline is also inclusive of victims who are at a higher risk of developing Diabetes mellitus especially due to probability of genetic inheritance or due to poor lifestyle.

The average cost of treatment for Diabetes mellitus is approximated to be $20,000 per patient. This is according to a research study finding that had been performed in the year 2015. However, with this new clinical practice guideline, the cost of treatment is expected to reduce significantly as patients and medical practitioners would be made more aware on how they can better manage the condition. On the other hand, the cost of medication for Diabetes mellitus will be subsidized by the government through the Ministry of health together with other stakeholders.

 

Editorial independence

A designation for applicability was provided to all the Country’s newspapers in a bid to reach and inform the target population on the causes, treatment and prevention of Diabetes mellitus. This guideline was also published in all the scientific magazines and websites for the public to access either through mobile phones or a computer.

Summary

In conclusion, this guideline is an essential tool that could better improve the current state of medical care services to patients. This guideline also enables a diabetic patient to be in charge of monitoring his or her own blood-glucose levels and thus enabling the whole nation to be able to effectively manage the condition.

 

https://www.guideline.gov/summaries/summary/47865

http://www.bcbsil.com/pdf/clinical/diabetes_cpg.pdf

 

References

In Chowdhury, T. (2014). Diabetes management in clinical practice.

Kramer-Kile, M. L., & Osuji, J. C. (2014). Chronic illness in Canada: Impact and intervention. Burlington, Mass: Jones & Bartlett Learning.

Thomas, N. (2012). A practical guide to diabetes mellitus. New Delhi: Jaypee Brothers Medical Pub.