Minimum of 250 words with peer review reference.

Discuss how evidence-based practice is defined as translational research. Describe the framework that supports that definition. Identify a population health issue you are interested in researching and discuss the issue using that framework. As you select an issue, remember you will be building upon your research in this course for your evidence-based practice project in the next course. Think about how you can focus your research now to help you complete your EBP project. 

Note: While you will only be proposing a solution and implementation plan in your EBP project, keep in mind EBP projects lay a foundation for doctoral research, since doctoral candidates have the opportunity to actually implement their projects. If you are interested in pursuing doctoral education, it is a good idea to choose an issue you would be interested in pursuing in greater depth. The research and work you complete on your EBP project now can be used if you choose to move forward into doctoral education.

 Read a selection of your colleagues’ responses and respond  on two different days who selected a different type of diabetes than you did. Provide recommendations for alternative drug treatments and patient education strategies for treatment and management. 

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Diabetes is an all too common endocrine disorder. Creating an effective treatment plan is essential to delay long term effects of the disease. This post explores the differences between types of diabetes with a focus on details of type two diabetes, one drug used to treat it, dietary considerations, and short-term and long-term impact.

There are several types of diabetes include type two, gestational, juvenile, and type two. This list is not all-inclusive, but for purposes of simplicity, I will focus on these four. Type one diabetes is related to an autoimmune response that destroys the beta cells in the pancreas. The beta cells produce insulin for the body, and insulin is a hormone that draws glucose into the cells for fuel. When the beta cells no longer exist, no insulin production occurs, and the glucose remains in the bloodstream leading to hyperglycemia and cell starvation. Juvenile diabetes is the old name for type one diabetes and received the name because it often appeared during this time in the life span. Gestational diabetes appears in a pregnant patient and subsides quickly after delivery of the child. Type two diabetes is the most prevalent form as 90 to 95 percent of diabetics have this type (Rosenthal & Burchum, 2018). It is insidious and often appears after age 40. Type two is related to inappropriate production of insulin and insulin resistance. The cells become intolerant to insulin and do not uptake it, or the beta cells do not produce enough insulin, rendering it ineffective to control blood sugar. There is a familial association which suggests it is hereditary, but the etiology remains unknown. 

I chose Metformin as it is appropriate for the initial treatment of type two diabetes. It is a biguanide that works by decreasing glucose production in the liver and increasing tissue response to insulin. This mechanism of action is essential to understand because it prevents a sharp increase in blood sugar after a meal but does not actively control blood sugar. The provider should order Metformin at 500 mg twice a day with meals as the initial starting dose (Epocrates, 2019). There is no particular food to avoid with Metformin, and common side effects include gastrointestinal disturbances. The recommended diet should be low in carbohydrates, including sugar, low in fried foods, low in salt, and high in protein (National Insititute of Diabetes and Digestive and Kidney Diseases, 2016).

Lastly, the short-term effects of diabetes include medication, diet changes, adding exercise, and routine follow-up with the provider. The long-term effects include all of the above as well as retinopathy, nephropathy, peripheral neuropathy, and shorter life span related to these long-term effects of the disease. Metformin is relatively safe but can cause vitamin B12 and folic acid deficiencies and lactic acidosis, which is rare.  

References

Epocrates. (2019). Metformin Adult Dosing. Retrieved from https://online.epocrates.com/drugs/787/metformin

National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Diabetes Diet, Eating, & Physical Activity.

        Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/diet-eating-physical-activity

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO:

        Elsevier.