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Evidence-Based Practice Project on Diabetics (Example)

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Name Instructor Course Date Diabetes Management Diabetes is a condition where the body either manufactures insufficient amount of insulin or the body is unable to utilize insulin produced. This metabolic disorder revolves the hormone insulin. The pancreas beta cells produce the hormone insulin and the key function is bringing high levels of blood glucose to normal. The most prevalent form of diabetes which constitutes about 95% of all the cases is diabetes mellitus type 2. It is simply referred to as type 2 diabetes and is caused by production of insufficient amounts of insulin or body’s insensitivity to the insulin produced. Type 1 diabetes on the other hand is mainly an autoimmune disorder which often destroys the pancreas beta cells. Thus little or no insulin is produced and the patient has to inject insulin. It is less prevalent and accounts for only about 5% of the total cases of 2 diabetes (BEGIN Basal-Bolus Type 2): a phase 3 randomised open-label treat-to-target non-inferiority trial." The Lancet 379.9825 (2012): 1498-1507. Philis‐Tsimikas A. et al. "Effect of insulin degludec versus sitagliptin in patients with type 2 diabetes uncontrolled on oral antidiabetic agents." Diabetes Obesity and Metabolism 15.8 (2013): 760-766. Mathieu Chantal et al. "Efficacy and safety of insulin degludec in a flexible dosing regimen vs insulin glargine in patients with type 1 diabetes (BEGIN: Flex T1): a 26-week randomized treat-to-target trial with a 26-week extension." The Journal of Clinical Endocrinology & Metabolism 98.3 (2013): 1154-1162. Zinman Bernard et al. "Insulin degludec versus insulin glargine in insulin-naive patients with type 2 diabetes." Diabetes care 35.12 (2012): 2464-2471. Ratner R. E. et al. "Hypoglycaemia risk with insulin degludec compared with insulin glargine in type 2 and type 1 diabetes: a pre‐planned meta‐analysis of phase 3 trials." Diabetes Obesity and Metabolism 15.2 (2013): 175-184. [...]

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Evidence-Based Practice on Treatment of Diabetes Per CDC and the American Diabetes society, there has been tremendous growth in the number of people that are diagnosed and at risk of diabetes every year. To attain guidelines and standard proposal of diabetes societies remains a big problem in the healthcare sector, despite the fact of having a best glycemic control to avoid persistent complication related to diabetes (Philis-Tsimikas, Del Prato, Satman el al., 2013). This paper will discuss recent treatments which will assist in lowering blood glucose levels with the least risk of hypoglycemia. Management of Diabetes The reduced ability of the body to utilize insulin manufactured in the body of the insufficient production of insulin which normally leads to higher levels of sugar in the blood results 2 diabetes. 95% of patients or people that have been diagnosed with diabetes disease have the type 2 diabetes. This type 2 diabetes result because the body tissue resistance to insulin and only 5% of people are diagnosed with type 1. This type results from an autoimmune condition where the insulin that are manufactured by pancreatic cells are destroyed. Diabetes that are not properly managed these to the risk of other diseases like kidney failure, Strokes, heart disease, peripheral nerve damage etc. (Zinman, Philis-Tsimikas, Cariou et al., 2012). Modern investigation has given efficient methods of treating diabetes. Some of these ways comprises of antidiabetic agents like insulin, medication, diets in the management of one's weight. Although current research shows this method to be efficient but they are linked up with episodes such as low blood sugar levels after treatment contributing to comas, fatigue, seizures or death. Treatment of Diabetes There are lots of clinical management obstacles encountered in bringing diabetes under control. They are a lot of factors that has hindered the proper control and management of diabetes and these includes, people non-compliant to their treatment therapy, cost of the treatments, progression of the disease, lack of awareness of the disease and poor self-management. In the event of addressing all these challenges mentioned above as well as improve upon to avoid the episodes of hypoglycemic, the FDA has in current endorsed a long-acting insulin agent. Type 1 and 2 diabetes can be well controlled or managed by using an insulin agent called degludec (Tresiba). This insulin agents have been tested and proven to be very efficient and effective of lowering HbAlc as compared to other agents of insulin flooding the marketplace (Zinman, Philis-Tsimikas, Cariou et al, 2012). The success in Tresiba’s clinical study trials is from a prove of targeted 721 participate which is of both sexes group on a SWITCH 2 who were of age 18 years randomized diabetes type 1 and 2 patients. The objective of this clinical trial was to detect the outcome of HbAlc levels and then to measure the incidence of hypoglycemia in within a 16-week trial period and then compare with similar long acting insulins like Levemir and Lantus (Javeria Fayyaz, 2016). By the close of a 16-week trial, the Tresiba insulin proved to have lower incidences of hypoglycemia incidents as well as lesson in HbAlc as compared with different long acting insulin. It is again proven that, Tresiba has an action of longer duration of 42 hours as compared to other insulin duration acting of only 24 hours (Javeria Fayyaz, 2016). It is also a proven fact, Tresiba gives similar glycemic control with other insulin when it is given on distinct schedules times during the different days of the week, and the damag effects that could be encountered in using Tresiba are headaches, sweating and upper respiratory infections” (Javeria Fayyaz, 2016). “Through clinical trials, it has become a proven fact that Tresiba is only needed in a small dose of short-acting insulin, and it is also needed for one time a day administration and such will be as effective just like other insulin that needs two times administration” Garber, King, Del Prato el al., 2012). Conclusion Research shows that, Tresiba is very efficient in the lowering of HbAlc levels in patients with diabetes as well as lessen the dangers of hypoglycemic patients. Although this insulin is very new on the market, there is continuing clinical trials on this insulin to determine the safety of cardiovascular (Javeria Fayyaz, 2016). References Garber AJ, King AB, Del Prato S et al. (2012) Insulin degludec, an ultra-long acting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin as part in type 2 diabetes (BEGIN Basal-Bolus Type 2): a phase 3, randomized, open-label, treat-to-target non-inferiority trial. The Lancet 379: 1498–507 doi: 10.1016/S0140-6736(12)60205-0 Philis-Tsimikas A, Del Prato S, Satman I et al. (2013) Effect of insulin degludec versus sitagliptin in patients with type 2 diabetes uncontrolled on oral antidiabetic agents. Diabetes, Obesity and Metabolism 15: 760–6 doi: 10.1111/dom.12115 Javeria Fayyaz, (2016); Doctor of Pharmacy Candidate LECOM, reviewed by Dave Joffe, BSPharm, CDE “A Trial Comparing the Safety and Efficacy of Insulin Degludec and Insulin Glargine, With or Without OADs in Subjects with Type 2 Diabetes (SWITCH 2).” Novo Nordisk A/S, Dec. 2015. Web. 2 Feb. 2016. Zinman B, Philis-Tsimikas A, Cariou B et al. (2012) Insulin degludec versus insulin glargine in insulin-naive patients with type 2 diabetes: a 1-year, randomized, treat-to-target trial (BEGIN Once Long). Diabetes Care 35: 2464–71 doi: 10.2337/dc12-1205

Subject Area: Nursing

Document Type: Thesis/Dissertation Chapter

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