Approximately 38 million Americans are living with type 2 diabetes, a chronic condition characterized by elevated blood glucose levels. Among these, 90–95% are affected by type 2 diabetes (CDC, 2023). To manage this prevalent condition effectively, a strategy that incorporates leadership, collaboration, communication, and systematic change management is essential. Healthcare providers must allocate resources, train staff, and prioritize evidence-based diabetes care. Improving outcomes for the millions of Americans with type 2 diabetes requires medical facilities to evaluate and optimize these aspects. A holistic approach, including clear communication between providers and patients, interdisciplinary teamwork, pragmatic change management, and supportive policies, is crucial for successful management.
Definition of Patient Health Problem
Karev, a 52-year-old man, has had poorly managed type 2 diabetes for five years. He has experienced fatigue, poor vision, and slow-healing wounds, and he consulted his primary care physician. His family history is significant, with his father having died of cardiovascular disease at 65 and his mother also having type 2 diabetes. Despite being on metformin and glipizide, Karev’s hemoglobin A1C levels average 8.9%, indicating poor control of his diabetes. With a BMI of 32, he is overweight and struggles to reduce intake of salt, refined sugars, and saturated fats. Although he has not had severe complications, he was hospitalized once for diabetic ketoacidosis. Without better management, Karev is at increased risk for peripheral neuropathy, kidney failure, and heart attack. He needs a comprehensive treatment plan, including medication adjustments, dietary changes, physical activity, weight loss, and continuous monitoring. After observing Karev’s interactions with healthcare professionals, it is evident he requires more education and support for lifestyle changes and adherence to medication and glucose monitoring. Continuous support and resources will be necessary for him to manage his chronic condition effectively and improve long-term health outcomes (Tri Rima Setyawati et al., 2023).
Relevance of Problem
Type 2 diabetes is a common and complex health issue, especially relevant to my role as a baccalaureate-prepared nurse. Managing this condition involves diligent clinical monitoring, patient education on lifestyle changes, adherence to medications, and a comprehensive therapeutic approach due to its numerous complications and potential outcomes. With my expertise in patient advocacy, health promotion, clinical research, and teamwork, I am well-equipped to assist individuals like Karev in effectively managing their diabetes. Given that type 2 diabetes accounts for about 90% of cases, I will encounter many patients with this condition. My nursing education enables me to handle this intricate disease, coordinate care, make evidence-based decisions, and provide well-informed guidance to patients with type 2 diabetes.
Analysis of Evidence
Academic literature strongly indicates that uncontrolled blood glucose levels pose severe risks associated with type 2 diabetes. Experts recommend a multimodal treatment approach to maintain an A1C below seven percent (Oh et al., 2022). Research suggests that medications alone may not suffice for patients like Karev, who have a history of poor glucose control and hospitalization due to hyperglycemia. A randomized controlled trial showed that combining metformin with a weight loss and aerobic exercise program significantly improved A1C levels compared to metformin alone.
Additionally, a comprehensive review highlighted the crucial role of nurses in managing type 2 diabetes by providing education, counseling, and integrated care across various settings to improve outcomes (Juanamasta et al., 2021). For Karev, this evidence underscores the need for a tailored treatment plan involving medication optimization, dietary support from a nutritionist, a structured exercise program, close follow-up to ensure medication and glucose monitoring adherence, and regular nursing counseling on lifestyle modifications (Dankoly et al., 2020). By leveraging current research, nurses like myself can deliver holistic, evidence-based treatments tailored to patients’ needs, aiming to reduce risks associated with poorly managed type 2 diabetes and prevent severe complications.
Evaluation of Evidence
I will assess the type 2 diabetes treatment evidence using reliable and valid criteria, including the quality of documentation, consistency of findings across studies, and the relevance of evidence to the patient population and clinical context. Evaluating potential risks or adverse effects and their impact on patient care contributes to both effectiveness and quality of life (Salanova et al., 2021). Findings that are consistently
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