Metabolic Control of Adults With Type 2 Diabetes

Research Question: Can Metabolic Control of Adults With Type 2 Diabetes Mellitus Be Controlled by Education and Counseling? This is a common question that is answered with research from journals and academic studies when you order a paper on controlling type 2 diabetes.

Known to man since about 2000-3000 B.C., the Greeks and Romans gave diabetes its name: diabetes, Latin for siphon (frequent urination) and mellitus, Greek for honey (sugar in the urine). Until 1921 when Drs. Banting and Best discovered insulin, the only outlook for patients diagnosed with diabetes was starvation and eventual death. Today with the advent of modern science and medicine, diabetes, although still incurable, has become a treatable disease. Despite this, however, statistics on diabetes estimate that for every one case of diabetes diagnosed and treated there is one that goes untreated.This is because the symptoms of diabetes can have a slow onset and are sometimes associated with other problems.

Typical Proposal Outline for Research on Type 2 Diabetes

• Introduction:
  A short summary describing all aspects of the study on controling type 2 diabetes metabolically.
• Purpose - Significance to nursing and health care
  • Specific question to be asked:
    • Hypothesis statement
      
    • This study will explore the differences between (groups)
    • This study will determine the relationship between (Variables).
    • This investigation will survey/explore.
• Significance:

Describe the importance of the study in relation to health care, health policy, nursing practice, etc. You must substantiate with references from the academic literature.

• Review of the literature:

Framework for the past and present information about the study problem. Cite the publication of others. Utilize a conceptual and/or theoretical framework, when appropriate before summarizing current research.

• Methods:

1. Sample - describe the sample include any delimitations.
2. Procedures - describe when and how you will approach subjects so that the consent form and instruments will be completed.
   
3. Instruments - with each instrument used, describe the construct and report measures of reliability and validity.
   
4. Design and Data Analyses - (e.g. Blood pressure measurements, before, during and after the procedure will be measured by a one way repeated measure analysis of variance). Relationship between variables will be measured by a Pearson Product Moment Correlation.

• Human Subject:
  1. Describe the number of subjects in the samples and the name of the institution (e.g., 140 patients with Swan Gantz catheter admitted to the Intensive Care Unit of the University of Omaha Hospital).
     
  2. Report how informed consent will be obtained.
     
  3. State when and how the interview will be conducted in addition to the order in which instruments will be administered. State the length of time it will take to gather data.
  4. (e.g., you may want to indicate that the subject group of 140 utility workers followed by case management for Metabolic Control of Adults With Type 2 Diabetes Mellitus will be meet Through Education and Counseling on a weekly basis for 1 year). To Test the proposed hypotheses you may want to use a quasi-experimental design with repeated measures in two groups (experimental and comparison groups) can be randomly assigned or non-randomly.
• References:

Number each reference cited as presented in text. The correct APA format must be followed.

• Budget:

A. Possible categories, if necessary

• Personal salary and employee benefits: Please indicate the the program will be headed by the Nurse Case Manager, who has a master's degree as a Family Nurse Practitioner. She will have the nursing staff at Occupational Health assist in the management of the employees, therefore cost should be at minimum because the staff will be paid through the salary. The cost should only be from materials ordered, e.g., pamphlets, video, educational tools, stationary.
  
• Equipment and supplies.
  
• Patient care costs.
  
• Computer analyses costs.
  
• Consultation costs.
  
• Other expenses.
  ** Record the TOTAL cost for the specific time period (e.g., $2,524 for 1 year).

• Appendix:

1. The consent form, demographic data, and each instrument should be labeled with separate letters of the alphabet, e.g., A,B,C,D.
   
2. The consent form for patients should be written with great clarity and reflect:
   
   1. Purpose and participation requirements of the study.
      
   2. Length of time fore subject participation.
      
   3. Place for investigators signature.
      

   ** Above should include about 3 separate paragraphs.

• State (in the first person) that the subject agrees to participate in the study, without prejudice subjects.
• Date and place for signature (e.g., I understand what questions are and agree to participate in the study, etc.).

Introduction to Type 2 Diabetes

The complications that arise from the onset of diabetes are perhaps the most devastating aspect of this disease. One of the most acute complications to arise from diabetes is diabetic ketoacidosis. In some instances, it is actually the first sign of diabetes in undiagnosed patients. Ketoacidosis is caused by a lack of insulin that in turn causes the glucose in the bloodstream to be unutilized. Since the glucose cannot be used, the body rapidly searches for another source of energy. In this condition, the diabetic breaks down body fat (lipolysis) to use for energy. During lipolysis, waste products called ketones are produced and are normal eliminated through the urine and lungs. Under normal conditions, the body can eliminate ketones, but in ketoacidosis, fats are being broken down at such a high rate that the body cannot eliminate the ketones fast enough.

Clinical pathogenesis is as follows: acute insulin deficiency results in rapid mobilization of energy from stores in muscle and fats deposits leading to an increased flux of amino acids to the liver for conversion to glucose and of fatty acids for conversion to ketones (acetoacetate, beta-hydroxybutyrate and acetone). In addition to this increased availability of precursor, there is a direct effect of the low insulin: glucagon ratio the liver that promotes increased production of ketones.

When you write a paper on the stated research question, you will want to make the subjects accessable by you in order to do an appropriate study. Any subject you use should be approved by Administration of the Occupational Health Clinic, e.g., A Physician specialized in Occupational Health.