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I chose case study #3 of an 80 year old retired army officer living along with type 2 diabetes, who had episodes of hypoglycemia using insulin and OHA’s.  The patient was dependent on an attendant to administer injections and due to irregularity of insulin dose administration this would lead to episodes of hypoglycemia.  The patient was then put on Degludec insulin and over a period of time, the patient’s HgBA1C and fasting blood sugars showed improvement. The patient also had no further episodes of hypoglycemia (Kumar, 2015.  p. 877).

Formulating a clinical question in the PICO (T) format I questioned: Do elderly patients with Type 2 diabetes show improvement with episodes of hypoglycemia, FBS and HgBA1C with Degludec?

According to (Stillwell et al, 2010. p. 59), PICOT is an acronym used for elements of the clinical question.  They are helpful for summarizing research question that explore the effects of therapy (Riva et al, 2012. p. 168).

P- Patient population

I-Intervention or issue of interest

C- Comparison of intervention or interest

O- Outcome of intervention or interest

T- Time it takes for intervention to be effective

(Stillwell et al, 2010. p. 59), Also points out there are 2 types of clinical questions, background and foreground.  Foreground question appear to use questions asked using the PICOT format to determine which interventions are most successful for patient outcomes.

Nursing research strives to understand phenomena that impact health, seeks solutions to problems, tests approaches to improving nursing care, and generates new knowledge to further our profession (CCN, 2017)

My clinical question using the PICOT format:

P- Elderly patients with type 2 diabetes

I- On Degludec and OHA’s

C- On regular insulin and OHA’s

O-Improvement of FBS, HgBA1C and no further episodes of hypoglycemia

T- No time frame measured

In asking the question: Is Degludec effective in improving hypoglycemic episodes the focus of my question would be on the prognosis of treatment.  Are patients having less episodes of hypoglycemia, is disease control with treatment?  According to the case study once the patient had started on Degludec it was noted that there was improvement in FBS and HgBA1C and no further evidence of hypoglycemia.

References:

Chamberlain College of Nursing. (2017). Introduction to Evidence Based. Practice.  Week 1 [Online lesson].  Downers Grove, IL  DeVry. Retrieved from: https://chamberlain.instructure.com/courses/12226/pages/week-1-lesson?module_item_id=1191535

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