DNP Capstone Project Synthesis of the Evidence: Review of Literature

DNP Capstone Project Synthesis of the Evidence: Review of Literature

Pre-diabetes in African American Female Adults.

Diabetes is a disease that results in elevated blood glucose levels. The common signs and symptoms of the condition include increased thirst, increased urinary urgency, fatigue, unexplained unintentional weight loss and the constant feeling of extreme hunger (Sami et al., 2017 DNP Capstone Project Synthesis of the Evidence: Review of Literature). The adoption of sedentary lifestyles and unhealthy eating habits by majority of the population have resulted in an increase in the number of diabetes incidences recorded. Pre-diabetes is a condition where there is raised blood glucose but not to a level high enough to be qualified as type two diabetes.

DNP Capstone Project Synthesis of the Evidence: Review of Literature

 Pre-diabetes is a recently identified stage of type two diabetes where patients commonly present with impaired breakdown of glucose. Pre-diabetes predisposes one to cardiovascular complications including stroke and myocardial infarction (Standl et al., 2019 DNP Capstone Project Synthesis of the Evidence: Review of Literature). Pre-diabetes is indicated by an impaired fasting glucose ranging from one hundred to one hundred and twenty-five milligrams per decilitre or an oral glucose tolerance test ranging from one hundred and forty to one hundred and ninety-nine milligrams per decilitre measured after two hours. Both of these values indicate an impaired tolerance to glucose.

The value of the fasting glucose level was recently reduced to one hundred milligrams per decilitre from one hundred and ten. This was precipitated by the fact that there were more pre-diabetes cases using the old criteria following a research conducted by the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus (van Herpt et al., 2020). The lowering of the impaired fasting glucose levels to one hundred milligrams per decilitre will make it easier to diagnose pre-diabetes.

Improving awareness of pre-diabetes entails encouraging patients to find out if they are at risk. Many individuals are unaware if they are exposed to risk factors that pre-dispose them to diabetes. Formulating online health assessment surveys that are later circulated to the patients make it easier to analyse the risk of developing diabetes (Vluggen et al., 2018 DNP Capstone Project Synthesis of the Evidence: Review of Literature). These surveys enable the patients to analyse their current health status and determine any pre-disposing risk factors precipitating earlier diagnosis, better outcomes and efficient management.

Enlightening patients about the condition including the statistics, signs and symptoms to look out for and the importance of early screening and detection can go a long way in creating awareness. Handing out posters, using various platforms such as social media and other forms of print and broadcast media will go a long way in reaching wider audiences and creating awareness about pre-diabetes.

Having awareness months and programs such as walks and runs go a long way in promoting awareness about diabetes and pre-diabetes. Encouraging both staff and patients to participate in the events, including the walks, leads to donation of funds. These funds go a long way in enhancing awareness, advocacy and further research about the condition (Katangwe et al., 2020 DNP Capstone Project Synthesis of the Evidence: Review of Literature). Having awareness months and encouraging everyone including health care providers to share information concerning pre-diabetes also plays a part in boosting awareness concerning pre-diabetes within the general public.

Education of health care providers on the significance of early and frequent screening goes a long way in promoting early diagnosis and management. Highlighting the various signs and symptoms to look out for will also make it easier for health care providers to detect pre-diabetes early and consequently initiate early management. Identifying the risk factors that pre-dispose individuals to the condition and encouraging them to change any modifiable risks will play a huge part in reducing the occurrence of pre-diabetes.

 PubMed describes pre-diabetes as impairment in fasting plasma glucose, impaired tolerance to glucose or both. It further goes on to note that pre-diabetes is not considered a benign state as it is not only a predisposing factor for type two diabetes, but it is also a cause of micro and macrovascular complications (Thuesen & Vaag, 2018 DNP Capstone Project Synthesis of the Evidence: Review of Literature). Change in lifestyle habits such as adoption of healthier diets and exercise are the first line actions of management. Medications such as metformin, alpha-glucosidase inhibitors and inhibitors of pancreatic lipase have been proven beneficial in pre-diabetes.

            Healthy People 2020 note that people from minority groups are at a higher risk of developing diabetes. African Americans, Hispanic Americans and American Indians form a cohort population that are at a greater risk of developing diabetes (Mitchell et al., 2020). Diabetes has been shown to be associated with other complications including cognitive impairment, incontinence, increased risk of fractures and added risk of developing cancer. Lifestyle adjustments have been proven effective in the prevention and delaying of development of type two diabetes in individuals who are at high risk of developing the condition.

            The social determinants of health related to pre-diabetes comprise of conditions where individuals are born, where they spend their time either studying, working or living and their age. These encompass aspects of the social environment including education level and marital status, physical environments such as housing situations and healthcare services including access to and quality of health care (Hill-Briggs et al., 2021 DNP Capstone Project Synthesis of the Evidence: Review of Literature). Social determinants of health are associated with reduced opportunity to access resources vital in the protection, improvement and maintenance of health. These factors are mainly responsible for the health disparities witnessed in the society. Poor social determinants increase the risk of pre-diabetes and consequently, type two diabetes.

            In conclusion, diabetes has been the cause of increased mortalities in society today. Early screening and diagnosis of pre-diabetes during the initial stages is key to promoting better management and better outcomes. Lifestyle changes including healthier diets and exercise can go a long way in reducing the incidences of pre-diabetes, thereby alleviating the development of type 2 diabetes.

DNP Capstone Project Synthesis of the Evidence: Review of Literature References.

  • Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., & Haire-Joshu, D. (2021). Social determinants of health and diabetes: a scientific review. Diabetes Care, 44(1), 258-279. https://doi.org/10.2337/dci20-0053
  • Katangwe, T., Family, H., Sokhi, J., Kirkdale, C. L., & Twigg, M. J. (2020). The community pharmacy setting for diabetes prevention: A mixed methods study in people with ‘pre-diabetes’. Research in Social and Administrative Pharmacy, 16(8), 1067-1080. https://doi.org/10.1016/j.sapharm.2019.11.001
  • Mitchell, F. M., Sangalang, C., Lechuga-Pena, S., Lopez, K., & Beccera, D. (2020). Health Inequities in Historical Context: A Critical Race Theory Analysis of Diabetes among African Americans and American Indians. Race and Social Problems, 12(4), 289-299. https://doi.org/10.1007/s12552-020-09301-4
  • Sami, W., Ansari, T., Butt, N. S., & Ab Hamid, M. R. (2017). Effect of diet on type 2 diabetes mellitus: A review. International Journal Of Health Sciences, 11(2), 65.
  • Standl, E., Khunti, K., Hansen, T. B., & Schnell, O. (2019). The global epidemics of diabetes in the 21st century: Current situation and perspectives. European Journal Of Preventive Cardiology, 26(2_suppl), 7-14. https://doi.org/10.1177/2047487319881021
  • Thuesen, A. C. B., & Vaag, A. (2018). Perspectives on diabetes mortality as the result of residual confounding and reverse causality by common disease. Diabetes, Obesity and Metabolism, 20(6), 1342-1349. https://doi.org/10.1111/dom.13238
  • van Herpt, T. T., Ligthart, S., Leening, M. J., van Hoek, M., Lieverse, A. G., Ikram, M. A., Sijbrands, E. J. G., Dehghan, A. & Kavousi, M. (2020). Lifetime risk to progress from pre-diabetes to type 2 diabetes among women and men: comparison between American Diabetes Association and World Health Organization diagnostic criteria. BMJ Open Diabetes Research and Care, 8(2), e001529. http://dx.doi.org/10.1136/bmjdrc-2020-001529
  • Vluggen, S., Hoving, C., Schaper, N. C., & De Vries, H. (2018). A web-based program to improve treatment adherence in patients with type 2 diabetes: Development and study protocol. Contemporary Clinical Trials, 74, 38-45. https://doi.org/10.1016/j.cct.2018.10.002

DNP Capstone Project Synthesis of the Evidence: Review of Literature Instructions

Synthesis of the Evidence: Review of Literature
Evidence-Based Practice Search (how completed)
Topics by Headings of Evidence Related to your Topic-Explore the Scope of this Topic: Prediabetes in African American Females adult. Diagnosis and screening for prediabetes in primary care, Improving awareness of prediabetes and education among Healthcare provider in primary care. Compare and Contrast Authors’ viewpoints; Include Tools, Healthy People 2020, Social Determinants of Health, Other
Comments / Note