A Research Critique on a Quantitative Study of Diabetes Ugommah Miller MRSHison 433V Emgi Lawson 07/20 A Research Critique on a Quantitative Study of Diabetes Diabetes is one of the world’s most emergent diseases that gains worldwide attention due to being linked to lifestyle choices, and is considered to be a growing epidemic among the global population (Barnett, Barnett, & Kumar, 2009). This gave him a 5-year diabetes risk of 5.6%. Therefore, there is a need for all the required resources to be integrated in order to achieve the benefits associated with selfmanagement. The majority of articles (75%) reported using substantive qualitative research, while mixed-methods research has remained underutilised. June 2013 ; Journal of Advanced Nursing 70(1) DOI: 10.1111/jan.12178. The design of the ongoing research project is qualitative explorative which focuses on patient autonomy as perceived by older adults with type 2 diabetes mellitus. Concept Ÿ. Diabetes self-care activities. 10.1016/S0277-9536(02)00064-3. Related Links. Results show low use of qualitative methods in diabetes research over the past 30 years. A Quantitative Research on Self-management of Type 2 Diabetes. The current study aimed to identify which natural products and which research directions are related to the major contributors to academic journals for diabetes therapy. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Patients in waiting: a qualitative study of type 2 diabetes patients' perceptions of diagnosis. 12,13 Qualitative research facilitated in-depth examination of knowledge and skills as well as perceived and … Rich, MD, Charles F. Shaefer, MD, FACP, Christopher G. Parkin, MS, and Steven V. Edelman, MD A n estimated 79 million American adults are at risk for developing type 2 dia - betes, based on a condition referred to as prediabetes. Strengths of our study include a large sample of young patients with type 1 diabetes, quantitative evaluation of fractal dimension, standardized assessment of diabetic retinopathy using stereoscopic seven-field retinal photographs, and detailed assessment of potential confounding variables (e.g., diabetes duration, A1C, and retinal vascular caliber). The self-management of type diabetes is an essential part of life for the patients with diabetes to have a better and a healthy lifestyle. A two-arm parallel-group randomized controlled trial with the blinded outcome assessors … Roberta Aguiar Sarmento 1, Bárbara Pelicioli Riboldi 2, Ticiana da Costa Rodrigues 1,3, Mirela Jobim de Azevedo 1,3 & Jussara Carnevale de Almeida 1,2,3 BMC Public Health volume 13, Article number: 740 (2013) Cite this article. Article PubMed Google Scholar Methods . Looking specifically at diabetes prevention interventions used in the Diabetes Prevention Program,2 it is noteworthy that these interventions required ~ 75% of staff time to treat the 25% of patients randomized to the intensive lifestyle intervention group. Although efforts have been made to address the significant and growing epidemic of diabetes, strategies to activate clinicians to aggressively screen for and treat individuals with prediabetes have been minimally successful. Studies were identified from multiple databases and screened according to an a priori defined protocol. and increased physical activity, and these programs should be covered by third-party payers.6 The ADA further recommends that treatment with metformin be considered for at-risk patients who have a BMI ≥ 35 kg/m2, are < 60 years of age, and/or are women with prior gestational diabetes.6, Criteria for Testing Adult Patients for Prediabetes or Diabetes6. Heather L. Voorhees and Michelle C. Howell Smith. The multimarker PreDx test is based on seven biomarkers (glucose, A1C, insulin, C-reactive protein, ferritin, interleukin-2 receptor α, and adiponectin) that are independently associated with diabetes risk.22 The test measures these markers in a fasting blood sample, and its results, along with patients' sex and age, are placed into an algorithm that generates an objective and quantitative score to distinguish among people at high, moderate, and low 5-year probability of developing type 2 diabetes.10–12 This information enables clinicians to focus interventions on the relatively few patients who are genuinely at a high 5-year risk of developing diabetes, thus avoiding unnecessary treatment and expenses for patients who are less likely to develop diabetes within the next 5 years. Objectives Self-management support aims to give people with chronic disease confidence to actively manage their disease, in partnership with their healthcare provider. We have identified two major obstacles to these diabetes prevention efforts: 1) limitations of current assessment tools and 2) constraints on clinicians' time and resources. Lifestyle interventions such as dietary modification, physical exercise, and modest weight loss have been shown to prevent or delay the progression from prediabetes to frank type 2 diabetes.2,23,24 Because these interventions often involve significant changes in eating habits and physical activity, patients need initial counseling to help them understand the changes they are being asked to make, as well as ongoing support and encouragement from their health care providers to sustain those new behaviors. the authors concluded that the cost-effectiveness of diabetes prevention may be improved by identification of high-risk individuals using the PreDx test. In type 2 diabetes, your body doesn’t make enough insulin or doesn’t use insulin well. Analysis of global research output on diabetes depression and suicide. provided a framework for integrating the resources and supports for self-management with key components of clinical care in a chronic care model. Patients meeting the criteria in Table 1 should have their glucoregulatory status assessed using FPG, A1C, or OGTT. Many clinicians have reported that use of the PreDx test has motivated their highest-risk patients to make significant lifestyle changes that could delay or prevent the progression to type 2 diabetes.22 Albeit anecdotal, these clinician-reported changes in patient motivation are supported by a recent study by Markowitz et al.32 that looked at how genetic testing for diabetes risk affects motivation. was counseled on the need to modify his diet, exercise regularly, and lose weight. Wagner et al. The diabetic epidemic shows no signs of slowing. OBJECTIVE— Evaluate type 2 diabetes susceptibility variants identified from genome-wide association studies in Hispanic Americans and African Americans from the Insulin Resistance Atherosclerosis Family Study (IRAS-FS) for association with quantitative measures of glucose homeostasis and determine their biological role in vivo. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and a qualitative measure of the journal’s impact. Moreover, there is growing evidence questioning the reliability of the A1C test. 2018; 17: 44. Your Research Data. Type 1 Diabetes Research At-a-Glance. Older adults valued an effective physician-patient treatment relationship and quality of life in their diabetes care. Despite his elevated FPG of 110 mg/dl, which placed him in the prediabetes glucoregulatory category, his PreDx score was 6.3. Criteria for Diagnosis of Prediabetes or Diabetes6. Lua Wilkinson , Roles Conceptualization, Formal analysis, Validation, Writing – original draft, Writing – review & editing * E-mail: [email protected]. number of patients with prediabetes, accurate tools are needed to identify prediabetic individuals who are most likely to progress to type 2 diabetes. Use the screening criteria presented in Table 1 to identify and screen all patients who may be at risk for diabetes or prediabetes. The guide can be downloaded free of charge from the NDEP Web site (http://ndep.nih.gov/publications/PublicationDetail.aspx?PubId=71). A meta-review can inform policy-makers and healthcare managers about the effectiveness of self-management support strategies for people with type 2 diabetes … A study by Kolberg et al.10 demonstrated that the performance characteristics of the PreDx test were similar to those of the OGTT but superior to all other methodologies, including FPG, A1C, fasting insulin, and the HOMA-IR (homeostasis model of assessment—insulin resistance) for predicting the 5-year likelihood of type 2 diabetes. This should allow for more efficient and effective use of health care resources and optimize health care outcomes. The knowledge gained from this combined research will be used to further improve GDM related detection, counselling, treatment and postpartum follow-up. Unfortunately, many patients do not receive the level of care they need to make and sustain these changes; barely half of patients receive the preventive, chronic disease, and acute care services recommended by national health care organizations and agencies.25. Although each method has advantages and disadvantages, all are adequate for assessing the presence of diabetes or prediabetes as defined by the ADA.6 Table 2 presents the glycemic thresholds for diabetes and prediabetes. As discussed above, the PreDx test classifies patients as low, moderate, or high risk and provides an estimate of the 5-year likelihood of progressing to type 2 diabetes. Soc Sci Med. 2003, 56 (4): 671-84. The PreDx test is a relatively new prognostic blood test that may help clinicians address these issues. The OGTT is a specific indicator of diabetes risk and is considered to be the gold standard for detection of prediabetes.13 However, its complexity, poor reproducibility, associated costs, time requirements, and patient inconvenience often inhibit routine use in clinical practice.6,14,15 The OGTT is rarely performed for purposes other than clinical research and to assess glycemia status in women during pregnancy. These tools and approaches are either difficult to implement in clinical practice or lack the specificity required for accurate detection of high-risk individuals. KEYWORDS: Type 2 diabetes, quantitative method, middle-aged population, self-management. The three patient cases presented in this article illustrate how the PreDx test can both motivate patients to make necessary lifestyle changes and guide treatment decisions regarding referral to formal diabetes prevention programs and/or pharmacological interventions. However, this method of screening for prediabetes casts a very wide net, identifying ~ 26% of the adult population as at risk (prediabetes),16 with minimal stratification for level of risk of progressing to type 2 diabetes. In the first case, the PreDx test prompted the patient to initiate intensive dietary modification and a regular exercise program to reduce his diabetes risk. Design Three year follow-up of a multicentre cluster randomised controlled trial in primary care, with randomisation at practice level. In addition, diabetes self-management is related to enhanced knowledge of diabetes, improved overall behaviour and discipline to adhere to diet and physical activity recommendations resulting in a better outcome. Patients with normal glucose regulation or prediabetes should be re-screened for diabetes with one of the above-mentioned tests (Step 1) annually, or sooner if they develop symptoms of diabetes. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes. Although it is clear that diabetes prevention should remain a high priority for patients, clinicians, and payers, it is also crucial that new technologies such as the PreDx test be used to accurately diagnose individuals who have the highest likelihood of developing diabetes in the near term to enhance the clinical efficacy of prevention efforts and ensure the viability of the national health care system. Clinical Diabetes Print ISSN: 0891-8929, Online ISSN: 1945-4953. The University of Tennessee, Knoxville's institutional review board approved the study before data collection began. Only original research and systematic reviews are accepted. Semi‐structured interviews were conducted among 23 people living with type 2 diabetes and 14 HCPs recruited from the diabetes clinics of three hospitals in Tamale, Ghana. 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