Article/ Diabetes

This is a Collaborative Learning Community (CLC) assignment. This assignment is to be completed in a group, which will be assigned by your instructor.

As a group, identify two research or evidence-based articles published within the last 5 years that focus on the identification of a specific intervention or treatment tool addressing pathophysiological processes associated with diabetes affecting the aging/elderly population or children. These articles must be relevant to nursing practice and utilize the PICO(T) question format.

Reminder: PICO(T) stands for population, intervention, comparison, outcome, and timeframe.

Submit references and working hyperlinks to the articles, along with a summary of the PICO(T) question (if relevant), as a Word document for your instructor to approve. Your first article should be your first choice, while the second article is to be used as a backup in the event the first article is not approved.

use this article to answer this assignment

https://eds-p-ebscohost-com.lopes.idm.oclc.org/eds/viewarticle/render?data=dGJyMPPp44rp2%2fdV0%2bnjisfk5Ie46bZLsamvUbSk63nn5Kx94umvWLKlr0qtqK5KspavUrKruEyxls5lpOrweezp33vy3%2b2G59q7Ra%2botE2xprZPtamki%2bfau1Gvq7N749y2Ra7btEirqq9PsKPfSN%2btq0mv2uN8sKrfT%2bGt4Vjw2%2bKB8Zzqeezdu33snOJ6u9vii%2bjp8j7y1%2bVVv8Skeeyz43zx4PGMrODrgqyss0a0pLRNrMDLYq%2bvrGqvraR%2b7ejrefKz5I3q4vJ99uoA&vid=6&sid=9155cef8-0e60-4172-a0a7-11ded24a7c7c@redis

References

Hiroaki Satoh. (2019). Glycemic Control in Elderly Patients with Type 2 Diabetes Mellitus: The Importance of Preventing Hypoglycemia Especially in Patients with Chronic Kidney Disease. Juntendo Medical Journal, 65(6), 517. https://doi-org.lopes.idm.oclc.org/10.14789/jmj.2019.65.JMJ19-R17

Glycemic Control in Elderly Patients with Type 2 Diabetes Mellitus: The Importance of Preventing Hypoglycemia Especially in Patients with Chronic Kidney Disease

Appropriate selection of glucose-lowering drugs based on the condition of the individual patient is necessary for better control of the onset and the progression of complications and to achieve better glycemic control without causing hypoglycemia.

 

Over the last several decades, the treatment strategies for T2DM have changed with the improved understanding of the underlying pathophysiology and the development of many glucose-lowering drugs. Sulfonylureas and glinides promote the secretion of insulin, -glucosidase inhibitors suppress the absorption of glucose from the intestinal tract, biguanides suppress the hepatic production of glucose, and thiazolidinediones improve the action of insulin in the liver and muscles. Additionally, dipeptidyl peptidase-4 inhibitors and glucagon like peptide-1 receptor agonists promote the secretion of insulin in a glucose-dependent manner, whereas sodium glucose cotransporter 2 inhibitors reduce glucose reabsorption in the proximal renal tubules and urinary glucose excretion. Sulfonylureas are prone to precipitate hypoglycemia in patients with renal dysfunction. It is important for patients to understand the symptoms of hypoglycemia for appropriate resolution.

 

The prevalence of patients with type 2 diabetes mellitus (T2DM) continues to increase. One primary concern in the patients with T2DM is the development of various complications, including retinopathy, nephropathy, neuropathy, myocardial infarction, and stroke; their prevention is the main treatment goal in T2DM. Furthermore, the frequencies of dementia, sarcopenia, and cancer are also higher in elderly patients with T2DM. Numerous clinical trials reveal that improving glycemic control can mitigate complications. In addition, hypoglycemia is associated with increased rates of dementia and cardiovascular death.
article 2

Effect of massage, passive neural mobilization and transcutaneous electrical nerve stimulation on magnetic resonance diffusion tensor imaging (MR-DTI) of the tibial nerve in a patient with type 2 diabetes mellitus induced neuropathy: a case report


we need one PICOT question for the 2 article

article 1

Background 

MR-DTI parameters namely fractional anisotropy (FA) and apparent diffusion coefficient values (ADC) of diffusion imaging demonstrate the directional preference and speed of diffusion of water molecules. The purpose of this case report is to explore the effect of massage, passive neural mobilization and transcutaneous electrical nerve stimulation on MR-DTI of the tibial nerve in a patient with type 2 diabetes mellitus having chronic distal symmetrical sensorimotor neuropathy.

Case Description 

A 63-year-old male with type 2 diabetes mellitus diagnosed with chronic symmetrical sensorimotor diabetic peripheral neuropathy on the basis of medical examination and electrophysiological testing. Altered mechanosensitivity of the tibial nerve was confirmed through neurodynamic testing. MR-DTI revealed severe damage of the tibial nerve as shown by chaotic diffusion of water molecules and damaged microstructural integrity.

Intervention 

A total six sessions over 3 weeks including nerve massage in a longitudinal and transverse direction; passive neural mobilization consisting of sliders and tensioners of the tibial nerve; and followed by 15 minutes of continuous transcutaneous electrical nerve stimulation directed along the nerve course.

Outcome 

FA and ADC values, pain, neuropathy quality of life and range of motion data were collected pre and post intervention. Analysis revealed clinical improvement in all the outcome measures.

Conclusion 

This case report identified improvement in radiological MR-DTI outcomes following rehabilitation in a patient with diabetic peripheral neuropathy.