abstract: According to the ADA (American Diabetes Association), diabetes mellitus is one of the chronic diseases with the highest mortality rate. In the US, 25 million are known diabetics, which may double in the next decade, and another seven million are undiagnosed. Among these patients, older adults are a very special group with varying physical capabilities, cognitive functions and life expectancies. Because they run an increased risk for geriatric conditions, Type 2 diabetes treatments for them must be both realistic and systematic. In fact, some researchers have explored older adults’ experiences of diabetes, and how they manage their diabetes with new technological devices. However, little research has focused on their emotional experiences of medical treatment technology, such as mobile applications, tablets, and websites for geriatric diabetes. This study will address both elderly people's experiences and reactions to devices and their children's awareness of diabetes. It aims to find out how to improve the diabetes treatment and create a systematic diabetes mobile application that combines self-initiated and assisted care together. / Dissertation/Thesis / Masters Thesis Design 2017

Type 2 diabetes mellitus (DM) is a progressive disease characterised by hyperglycaemia caused by defects in insulin secretion and insulin action. In early stages of type 2 DM, dietary and lifestyle changes are often sufficient to control blood glucose levels. However, over time, many patients experience β cell dysfunction and require insulin therapy, either alone or in combination with oral agents. There are guidelines available to structure the management of this disease state, including both the use of oral hypoglycaemic agents and or insulin. Besides health complications, there are economic burdens associated with the management of type 2 diabetes mellitus. The aim of this study was to determine the management of type 2 DM in a South African sample group of patients drawn from a large medical aid database. The objectives of the study were: to establish the prevalence of type 2 DM relative to age, examine the nature of chronic comorbid disease states, establish trends in the prescribing of insulin relative to other oral hypoglycaemic agents, investigate cost implications, and determine trends in the use of blood and urine monitoring materials by patients. The study was quantitative and retrospective and descriptive statistics were used in the analysis. DM was found to be most prevalent amongst patients between 50 and 59 years old. Results also demonstrated that 83% of DM patients also suffered from other chronic comorbid diseases, with cardiovascular diseases, especially hypertension and hypercholesterolaemia being the most prominent. This study also revealed that DM is predominantly managed with oral hypoglycaemic agents. Changes in drug prescribing, for chronic disease states such as DM may have medical, social and economic implications both for individual patients and for society and it is envisaged that the results of this study can be used to influence future management of DM. Keywords: Pharmacoepidemiology, management, type 2 diabetes mellitus

No description available.

No description available.

Diabetes mellitus (DM) is one of the most common chronic diseases affecting children under the age of 20, and it often leads to serious complications. In recent decades, there has been an increase in incidence of both types of DM among U.S. children. Having this chronic condition not only negatively impacts the health of these children but also their academic achievements. School health nurses struggle to manage these children appropriately and safely. The purpose of this project was to develop an evidence- based guideline for a standardized process in which school nurses coordinate the school and student health care teams to ensure a safe school environment for diabetic children. The Stevens star model of knowledge transformation was used to frame the development of this guideline. A team of experts, consisting of 10 ten school nurses, was assembled to provide formative and summative evaluations of the guidelines. Nine nurses completed and returned the questionnaires within the allotted time. The formative group feedback resulted in the revision of the guideline prior to distribution for the summative evaluation. The experts then participated in a summative evaluation using the Appraisal of Guidelines for Research & Evaluation (AGREE) II instrument. The revised guideline was approved and recommended for use by all of the experts without additional modification. Implementation of the guideline will result in social change by improving outcomes in students' health and academic achievement and in strengthening the role and autonomy of the school nurse. Dissemination will occur first in the school district through presentation and then to a larger audience through publication in journals focused on school nursing.

The purpose of this study was to evaluate the health outcomes of diabetic patients in Puerto Rico, before, during, and after Hurricane Maria, in 2017. The Department of Health in Puerto Rico provided the secondary data for the variables low-density lipoproteins (LDL) cholesterol, hemoglobin A1C (HbA1c), mortality, and consumer price index (CPI). The inclusion criteria were participants for whom electronic data were available before, during, and after Hurricane Maria; the sample size was 450. The theoretical framework for this investigation was the health outcomes and impact assessment. The data were analyzed by univariate and analysis of variance (ANOVA) to compare means and normality test analysis. Results of this study revealed that before Hurricane Maria, diabetics in Puerto Rico did not have control of their health. The American Diabetes Association (ADA) guideline for Hgb AIC is < 7.0; prior to Hurricane Maria Hgb AIC was 7.30 and after it was 7.21. The ADA LDL goal is

Diabetes is a public health concern among older adults in the United States due to the increasing prevalence of diabetes among this age group and the associated long-term and financial impacts. Self-management is a key strategy in the control of diabetes. The purpose of this quantitative study was to examine the association between social support and glycohemoglobin level. The social cognitive theory was the conceptual framework for this study. The research questions were designed to determine whether social support played a role in diabetes management. Data were collected using a cross-sectional survey of secondary data from the 2007-2008 National Health and Nutrition Examination Survey. The participants represented a national sample of adults aged 65 years and older. The dependent variable was the glycohemoglobin level, and the independent variables were emotional and financial support, sources of social support, and sociodemographic factors. Statistical analyses, consisting of univariate analyses, were conducted to characterize the sample, and simple and multiple linear regression analysis were conducted for hypotheses testing. After controlling for the confounders, the multiple regression analyses revealed a statistically significant association between emotional and financial support, sources of social support, the frequency of religious activities, and the size of the social network and glycohemoglobin level. Spousal support, frequency of religious activities, and the size of the social network were positively associated with glycohemoglobin level. The study findings might contribute to positive social change through the integration of social support into clinical practices by using family-centered and church-based approaches to improve diabetes management among older adults.

Diabetes is the 7th leading cause of death in the United States and is the main cause of chronic kidney failure, nontraumatic limb amputations, blindness, myocardial infarction, and stroke. Many patients with diabetes do not meet goals for at least 1 control measure of blood sugar, blood pressure, or cholesterol. The purpose of the project was to implement a template for documentation--a toolkit for patient care management-to improve blood glucose and blood pressure levels in a rural health clinic in central Texas for 33 patients with diabetes during a 6- to 8-week timeframe. The practice-focused question asked whether management of patients with diabetes would be improved if documentation on a standard template were used by all providers at the site. Models used in this doctoral project included the chronic care model and the Institute for Healthcare Improvement breakthrough series collaborative model. Sources of evidence included published outcomes and research from a systematic review of the literature, archival and operational data collected from the rural health clinic, and evidence from the project. Glycosalated hemoglobin levels improved from a mean of 8.9 mg to 7.6 mg in 31 of 33 participants (t = 2.684, 30 df, p = .012). Systolic and diastolic blood pressures were reduced slightly, but changes were not statistically significant. Potential implications for positive change in nursing practice include improvements in clinical management, implementation of evidence-based practice, and improved outcomes for patients with diabetes. Incorporating evidence-based practice provides scientific justification for actions that will improve clinical outcomes for patients, which leads to healthier patients, families, and communities and contributes to positive social change.

No description available.

No description available.