Pre-diabetes and People Diagnosed With It Paper Example

Pre-diabetes is when your level of blood glucose is higher than normal and can lead one to develop type 2 diabetes. Often, pre-diabetes begins when one's body starts having trouble using the hormone insulin which is significant in transporting glucose through the bloodstream into the cells. Also, it takes place when the body doesn't make enough insulin or doesn't use it well thus the condition becomes insulin resistance. However, pre-diabetes can be managed before it reaches into serious health problems such as diabetes type2, stroke and other heart diseases (Chaitin, et al., 2018). The paper, therefore, explores a problem statement of pre-diabetes and information related to the PICOT approach to nursing research as well as provides a literature review that supports the problem together with its broad intervention approach.

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Health promotion of individuals with pre-diabetes focuses on enabling them to enhance control over their condition and to improve their health. This can be done through developing a lifestyle change program that will involve helping such patients with pre-diabetes work on their weight and get regular physical activity which as a result will put them away from the risk of developing type 2 diabetes. Quality improvement involves systematic and continuous acts that lead to measurable improvement in services of health care. A quality improvement for patients with type II diabetes will involve implementing a screening tool that will identify individuals with pre-diabetes hence allowing early intervention so as to slow onset of type II diabetes (Engelgau, Narayan & Vinicor, 2012). Prevention for type II diabetes will involve eating a healthy diet, losing weight by being physically active, avoiding and managing stress and even making regular checkups to detect the condition early. Education for individuals with pre-diabetes will involve educating them on their lifestyle changes through healthy eating and equipping them with skills of managing stress and weight loss. There is a need for managing pre-diabetes since the condition is critical and if not managed well, can risk a patient to developing type 2 diabetes which is fatal. Carrying out programs of managing pre-diabetes is important since it will give a warning to all people on the risk factors of pre-diabetes thus enabling them to work on their weight all time and to develop healthy physical activities.

The target population for carrying out the study is among persons above 19 years of age with no previous diagnosis of pre-diabetes. This is because patients already diagnosed with pre-diabetes in their medical record, they should be already receiving treatment for the diagnosis (Ovbiagele, 2010). Also, individuals who have had gestational diabetes in the past are eligible since such patients are more likely to get pre-diabetes in the future. The setting for the study is a rural primary care clinic and it is important to address the need in such a population since it is where one can get patients who are at risk of pre-diabetes and are not in a position to attend health facility for check-ups.

An intervention to address pre-diabetes among patients of aged 19 years and above within the rural primary care clinic is through screening. Screening fit this population since nearly three-quarter of them believed to be young for screening, completing less than a college degree and most saw themselves non-obese hence they believed that they were not likely to develop pre-diabetes. Although this is helpful, screening in rural areas can be costly especially if the population is small and only a few are volunteering.

A major potential inter-professional alternative to an initial intervention involves collaboration between nutritionist, physical therapist, pharmacist or other healthcare professionals. Often, they are consulted for dietary, exercises and medical-related education. This is important as it ensures that the target populations are reached through educational intervention program hence ensuring awareness and healthy lifestyle choices among the population. Although this is important, sometimes miscommunication can occur within hence interfering with the right information of each patient in the population.

A major outcome for a health promotion, quality improvement, prevention, education or management need is the quality enhancement of services. Quality enhancement services maximize the effectiveness, efficiency, and performances of services while it tries to minimize cost thus achieving equity and improving the health of the community (Cowie, et al., 2016). An improvement in the quality, safety or experience of care is measured using the satisfaction of patients. If there is an increase in the quality enhancement of services through thorough regular screening and checkups of patients in the population, the satisfaction of patient increases leading to better health. In the development and implementation of an intervention to address pre-diabetes, the rough time frame for the study would be within six months. This is because it will provide enough time for the study to take place effectively.

Literature Review

In the population, pre-diabetes is at increased rate with a study conducted showing that 15-30% of individuals with pre-diabetes are likely to develop type II diabetes within four years. If the condition is not treated, such patients have increased the risk of developing other multiple co-morbidities including hypertension, hyperlipidemia, heart attack, neuropathy etc. World widely, diabetes is the 7th leading cause of death with 1.4 millions of people every year being reported to be diagnosed with the illness. In 2012, statistics showed that 86 million young people within an age range of 19-25 had pre-diabetes in America only (Konchak, et al., 2016). Also, the estimated total cost spent in 2012 in diagnosing of diabetes was above $245 billion. If the trend continues, an estimation done by the Centers for Disease Control and Prevention showed that 1 in 3 adults living within America will have diabetes by the year 2050 (McLees, et al., 2015). Such statistics are significant as they help in establishing a foundation for understanding the epidemics of diabetes.

Pre-diabetes is also accompanied by a lot of complications. Ovbiagele (2010) pointed out that individual with pre-diabetes has a 1.3 times higher rate of hospitalization compared to those without. Such people have also glycosylated hemoglobin level of above 6.5%. A comparison taken by Benjamin and his colleagues (2013) in the examination of diabetes to those without showed that individuals with pre-diabetes had a higher risk of coronary heart disease and stroke compared to those without. Other complications are disabilities, blindness, and disease of the kidney with death rates being 1.7 higher to patients above 45 years. A research showed that every year, around 282,000 of patients above 18 years get admitted in the emergency room due to complications of hypoglycemia. Despite diabetes being a debilitating disease, it is a costly disease. According to the American Diabetes Association, the total estimated cost of treatment of patients with pre-diabetes and diabetes every year is $245 billion (Tabak, et al., 2012. Due to this, it impacts the economic and social state of not only individuals but also the nation. Such information is appropriate for understanding the prevention, diagnoses and management measures to be taken in the treatment of patients that are at risk of pre-diabetes and diabetes. Also, it will provide a pivotal position for primary care providers to prevent pre-diabetes from progressing to type 2 diabetes by instituting the earliest possible preventive measures such as screening.

Health Policy

One of the major health policy that impacts the area of pre-diabetes is the Affordable Care Act (ACA) and is credited to expand access to health care providers and health insurance coverage to millions of people. Since lots of diabetes as a chronic condition disproportionally impacts certain subgroups including racial minorities and the less fortunate, ACA ensures that such people have equitable access to health insurance coverage that ensures they receive preventive services at low or no cost (Chatterjee, et al., 2010). Also, health insurance facilitates significant accessibility to health services thus leading to earlier detection and treatment of illness to a bigger population. Earlier diagnosis and treatment lead to a better outcome and low costs both individually and as a whole society. However, an analysis conducted showed that the rate of diagnoses of newly identified diabetes is increasing every year by 23% of patient expansion. This is because the condition is reaching epidemic proportions as a current research conducted showed that more than 29 million people have the disease with additional 86 million have pre-diabetes but unaware of it (Hossain, Kawar &El Nahas, 2011). Through ACA, it can help to identify patients with diabetes at an earlier stage thus making it easier to manage the condition before it progresses to a co-morbid condition such as diabetes type 2 and heart disease. ACA can also make it easy for all individuals to access health care and education programs that involve lifestyle changes and use of drug therapy that can cure the disease early before it progresses. Additionally, access to care offers a significant opportunity in identifying more illness at early and treatable stage thus it not only improves the health of individuals in the population but also save billions of dollars in healthcare cost.

ACA is also making various strides towards the strengthening of primary care and this is via its improved investment in federally qualified health centers (FQHCs) and health homes (Williamson, Vinicor & Bowman, 2014). They are also in an effort of expanding the primary care and workforces of community health. Such health homes provided by ACA are essential components for the successful population in that it combines innovational systems and technological interventions hence bringing better diabetes care quality and treatment services. Additionally, ACA promotes forms of innovation that improve care coordination thus encouraging proactive management of patient especially those at high risk of developing diabetes.

References

Benjamin, S. M., Valdez, R., Geiss, L. S., Rolka, D. B., & Narayan, K. V. (2013). Estimated number of adults with prediabetes in the US in 2000: opportunities for prevention. Diabetes Care, 26(3), 645-649.

Chaitin, C., Velasquez, J., Khanfar, N. M., Chassange, S., Perez Torres, R., Loan Pham, N., ... & Hale, G. M. (2018). Third-year pharmacy students propose an interprofessional prediabetes educational programme: PreDiaMe (Prediabetes+ Me). Journal of interprofessional care, 32(1), 118-122.

Chatterjee, R., Narayan, K. V., Lipscomb, J., & Phillips, L. S. (2010). Screening adults for pre-diabetes and diabetes may be cost-saving. Diabetes care, 33(7), 1484-1490.

Cowie, C. C., Rust, K. F., Ford, E. S., Eberhardt, M. S., Byrd-Holt, D. D., Li, C., ... & Geiss, L. S. (2016). Full accounting of diabetes and pre-diabetes in the US population in 1988-1994 and 2005-2006. Diabetes care, 32(2), 287-294.

Engelgau, M. M., Narayan, K. V., & Vinicor, F. (2012). Identifying the target population for primary prevention: the trade-offs.

Hossain, P., Kawar, B., & El Nahas, M. (2011). Obesity and diabetes in the developing world-a growing challenge.

Konchak, J. N., Moran, M. R., O'Brien, M. J., Kandula, N. R., & Ackermann, R. T. (2016). The state of diabetes prevention policy in the USA following the affordable care act. Current diabetes reports, 16(6), 55.

McLees, A. W., Nawaz, S., Thomas, C., & Young, A. (2015). Defining and assessin...