Quantitative Research Critique: Relationship of Glucose Value to Sliding Scale Insulin

Plasma insulin concentration was at its lowest during the fasting time period. Concentration was about 68 during that time.

The purpose of this study is to minimize the risk of hypoglycemia among the elderly. As people with diabetis age, the physiological changes affect the diabetic. The purpose of this study is to consider whether HbA1 goals can be attained without undue treatment burden and decrease the risk of severe hypoglycemia. Though client teaching and minimizing the risk factors of hypoglycemia can prevent further exacerbation of catastrophic events that could have potential lethal outcomes to an older patient with diabetes. The one patient’s case, Mr. J., an 86 year old man who has had type 2 diabetes for 15 years is a quantitative study that focuses on prevention of hypoglycemia in older adults. Interventions include diet, meal planning, medication, glucose

All patients with type 1 diabetes (T1DM) and many patients with type 2 diabetes (T2DM) require insulin therapy at some point to adequately manage their disease state.5 Traditional treatment of DM therapy, which ultimately includes subcutaneous injection of insulin, is often met with apprehension among diabetic patients due to the inconvenience and discomfort of injecting oneself. Administration of insulin by methods other than injection has been investigated since the discovery of insulin in the 1920s.6One such

Insulin changed the plasma glucose levels by raising them from the fasting to 1 hour mark but reduced down at hour 3 to almost the same level

In a 52 week randomized clinical study, patients with either type 1 diabetes or type 2 diabetes were treated using insulin glargine or insulin degludec. The study focus was on the effectiveness, safety and how well the patients tolerated the insulin degludec. One area of the study that was of particular interest was the occurrence of hypoglycemic events and mainly nocturnal hypoglycemia. The results of this study were then analyzed and the findings interpreted to compare insulin glargine and insulin degludec.

In an implementation report by Roderman, Haire, and Hawley (2014), a study was initiated to determine if basal bolus insulin or other insulin regimens were more effective in achieving lower glucose and fewer hypoglycemia episodes. Patients who present with hyperglycemia and the inappropriate treatment of this state can prolong hospitalization, increase mortality rates, and put patients at risk for multi-organ complications. The use of subcutaneous sliding scale insulin is not an effective glycemic control tool because it is given without regards to carbohydrate intake and is contrary to normal pancreatic physiology (Roderman, Haire, & Hawley, 2014). In a few studies mentioned, overall mean blood glucose during hospitalization was lower in patients that had basal bolus insulin protocols versus sliding scale insulin protocols. Even with ADA and AACE recommendations of guidelines to use for optimal glycemic control, only 21% of hospitals in America had fully implemented non-critical care adult glycemic control protocols by 2008 (Roderman et al., 2014).

The rates of grade 2 or 3 hypoglycemia were low overall among the different groups; however, the prandial group experienced the most hypoglycemic episodes. Weight gain was more prominent in the biphasic and prandial groups, and the prandial group had the greatest reduction in the postprandial glucometer readings. While the percentage of patients in the biphasic group that replaced the sulfonylurea with a second type of insulin was 67.7%, the percentage in the prandial and basal group was 73.6% and 81.6%, respectively. The majority of patients from all three groups eventually required a basal-bolus (complex) regimen. The results of the trial support that the basal-bolus insulin regimen may be beneficial for better blood sugar control in type 2 diabetes.

According to the Canadian Diabetes Association (2013), low blood glucose is less than 4 mmol/L and high blood glucose is at or higher than 11 mmol/L. The official recommendations of the Canadian Diabetes Association is, “for most medical/surgical ICU patients with hyperglycemia, a continuous IV insulin infusion should be used to maintain glucose levels between 7.8 and 10 mmol/L.” (“In-Hospital Management of Diabetes”, 2013, p.1). It is essential starting the insulin infusion to avoid higher prevalence of infections and poor condition’s prognosis.

Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (2000). To Err is Human Building a Safer

A-Rapid-acting insulin: the onset of it is 5-15 min and it duration about 3-5 hours . It take immediately before eating the meal .An example : 1- Apidra (insulin glulisine) 2- Novolog (insulin aspart ) 3- Humalog 4- Afrezza (inhaled) . it commonly prescribed to people with type 1 diabetes and also for type 2 in some cases . - Due to rapid acting it can lead to increase the chance of hypoglycemia to occur. - Control high blood sugar , which

CGM is a debatable topic in the patients where tight glycemic control (TGC) regimens are required. There are few studies available supporting the use of CGM for glucose monitoring in case of inpatients. However data from these studies are not consistent. Nurses should also skilled

On November 15, 2017, I attended a professional meeting called “Think Like A Pancreas: A Practical Guide to Managing Diabetes with Insulin.” The sponsors for this meeting were SNDA and CVD. The speaker who presented at the meeting was Gary Scheiner Ms, CDE. He is an author of the book “Think Like A Pancreas: A Practical Guide to Managing Diabetes with Insulin.” The general objective for this meeting helped people gain more knowledge about diabetes, and learned more from author personal experiences with type I diabetes. After I attended this meeting, I become more knowledgeable about diabetes. I have a chance to learn more about diabetes nutrition, different type of medications, and many tools that are available for diabetes patients to keep track on the blood glucose.

Our whole project is surrounded around blood glucose level changes due exercise and serving size, so that brings about the question of what is blood glucose? Blood glucose is the sugar that is moved throughout the bloodstream to provide energy to all cells in the body. In simple terms, it is very important biological occurrence that drives the body by giving it the raw energy to power all the body’s functions. To test for this occurrence, there are two main methods to test for the levels of blood glucose in the bloodstream. One method is having the blood drawn intravenously, getting blood drawn using a needle, and sending it to a lab to conduct the action. The other method that is much more convenient and less costly is using

To examine the efficacy and safety of insulin and other pharmacological interventions for lowering glucose-lowering levels in patients with diabetics and Chronic Kidney Disease (CKD).

“Hyperglycemia (typically defined as a blood glucose of >200 mg/dL) is a well-known phenomenon in critically ill patients without a prior history of diabetes mellitus” (Langdon & Shriver, 2004, p. 163). While many studies have been completed with respect to management of hyperglycemia in diabetic surgical patients, there has been minimal research regarding the impact that tight glycemic control has on non-diabetic trauma and medical patients. With managed care requiring decreases in length of hospitalization and hospitals attempting to conserve cost expenditure, placing non-diabetic patients on insulin drips immediately upon entry into the health care system may adversely affect both of these areas. Trauma patients without a diagnosis of diabetes mellitus will require prolonged lengths of stay in the intensive care unit related to the fact that they must have closely monitored blood glucose levels. In addition to the increased duration of their intensive care unit admission, they are subjected to administration of medications they would not normally take at home. Furthermore, this patient population has