Prompt: Write a 2 page discussion section to include the implications of your study for nursing practice and the implication for nursing research, what you intend to find and what other research could potentially result from your study
Results And Discussion
The study involved synthesizing data from 60 patients to determine the effectiveness of tight glycemic intervention in elderly patients (above 65 years) with diabetes. Nurses gathered data from accurate documentation of patients in the tight glucose intervention group and the intermediate glycemic control category (Zimmerman, 2016). Registered nurses documented the complications like hypotension and hypoglycemia in the tight glycemic management intervention group. Microvascular complications indicate the relation between the treatment methods on the two selected groups. Results show discordance between the group with tight glycemic control and the intermediate glycemic control group. Tight glycemic control minimizes the risk of vascular complications in elderly diabetic patients. According to Sinclair and Abdelhafiz (2020), the cardiovascular benefits of tight glycemic control have long-lasting effects of at least ten years after intervention. However, this treatment method increases the risk of hypoglycemia by 1.5 to 3 fold among elderly patients. The intervention intensity varies depending on the level of the elderly diabetic patient; independent, partially dependent, and dependent. Dependent patients with multiple comorbidities should receive an A1C target of 8.0-9.0% to prevent the risk of hypoglycemia and the side effects of medications.
The number of comorbidities increases as one gets older, resulting in vascular complications among older diabetic patients. Diabetes interventions avert or delay the onset of vascular complications and sustain the quality of life among elderly patients (Valensi et al., 2019). Diabetes guidelines mandate early and consistent glycaemic control to reduce the health impacts of prolonged hyperglycemia on the patients. This study sought to determine the effectiveness of tight glycemic control intervention in older diabetic patients with vascular complications. Establishing tight glycemic control intervention among elderly patients should be routinely integrated into diabetes care practices. This aspect requires hospitals and nurses to conduct regular screening to identify vascular diseases as part of the protocol for diabetes management. Nurses need to familiarize themselves with up-to-date, evidence-based practice to better understand the identification and classification of the intervention methods for maximizing the health benefits. It is also critical for clinicians to identify the patients who will benefit more from a combination of intervention measures aside from tight glycemic control.
Research shows that pioglitazone reduces a patient’s risk of developing major cardiovascular events (Sinclair & Abdelhafiz (2020). Moreover, the medication prevents recurring stroke in patients with ischemic stroke history. The use of pioglitazone in patients with heart failure should be moderated since it increases these patients’ susceptibility to weight gain, heart failure, and peripheral edema. The use of metformin medication in diabetic patients without multiple morbidities contributes to reduced long-term cardiovascular mortality compared to the use of sulfonylureas in the same patients. Supplementary interventions like α-Glucosidase inhibitors effectively reduced the risk of myocardial infarction.
The complexity of the phenotype of diabetes among the elderly increases their risk of vascular complications. Therefore, regular assessment among this key population should be comprehensive to facilitate timely intervention. Intervention should be individualized depending on the patient’s independent, partially dependent, and dependent levels. The implication of this study to nursing practice is the provision of a comprehensive analysis of the impacts of tight glycemic interventions on elderly diabetic patients across multiple levels. Moreover, the study contributes to nursing research by providing evidence-based practice to manage vascular complications among elderly patients. Researchers could use this study to expand their knowledge on the management of vascular complications in elderly diabetic patients.
Sinclair, A. J., & Abdelhafiz, A. H. (2020). Challenges and Strategies for Diabetes Management in Community‐Living Older Adults. Diabetes Spectrum, 33(3), 217-227.
Valensi, P., Prévost, G., Schnell, O., Standl, E., & Ceriello, A. (2019). Targets for blood glucose: what have the trials told us. European Journal of Preventive Cardiology, 26(2_suppl), 64-72.
Zimmerman, R. S. (2016). Diabetes mellitus: management of microvascular and macrovascular complications. J Cleveland Clinic: Centers for Continuing Education.
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