Evidence-Based Practice Project

Evidence-Based Practice Project: Paper on Diabetes
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Evidence-Based Practice Project: Paper on Diabetes
Diabetes is a health condition, which is characterized by a failure of the pancreas to produce insulin, which is important in bringing a balance in the blood glucose level. This can result in serious health issues, which include loss of consciousness, foot problems, eye problems, and the development of other diseases, which include hypertension (DeFronzo et al., 2015). The rate of development of type 1 diabetes has been on the rise for the last couple of years among the adults, which is attributed to the changing lifestyles, which has increased the risk factors associated with the development of this disease (DeFronzo et al., 2015). Due to this, it is important that effective diagnosis tests are implemented to enable healthcare practitioners to address the disease at an early stage as well as prevent any negative effects associated with the disease (DeFronzo et al., 2015). The article selected for the analysis is HbA1c as a Diagnostic Test for Diabetes Mellitus – Reviewing the Evidence by Chris Florkowski, which addresses the use HbA1c as a diagnostic tool for testing diabetes mellitus.
Summary
Research has indicated about 380 million people all over the world suffering from diabetes with diabetes mellitus being more common. This disease has also been indicated as the eighth cause of death across the globe (Guo, Moellering, & Garvey, 2014). Future projections have indicated the disease to spread to more individuals, which makes it important for the development of effective measures to help in addressing this disease. Some of the effective measures taken to address this disease is by prevention and managing the disease (Guo, Moellering, & Garvey, 2014). This involves early diagnosis, which enable healthcare practitioners to implement effective strategies to minimize and prevent the negative effects associated with the disease. The HbA1c test can be used to help clinicians in making effective healthcare decisions regarding patients with diabetes mellitus (Guo, Moellering, & Garvey, 2014).
With this test, the negative effects associated with diabetes mellitus can be addressed with the implementation of effective measures after a proper diagnosis. This diagnostic test was developed due to concerns that traditional diagnostic tests were not effective in identifying diabetes in an adult population (Florkowski, 2013). This test has enabled clients to receive effective healthcare to manage this condition with many countries adopting this test in the diagnosis process of diabetes mellitus in adults. However, there are some concerns on the use of this diagnostic test to diagnose diabetes mellitus with some countries resistant to adopt this test (Florkowski, 2013). These countries continue using the traditional blood glucose test to test for diabetes in adults. However, this test is unable to detect diabetes mellitus as it has been indicated effective for testing type 1 diabetes.
The main purpose of this intervention is to provide an effective strategy to detect this disease at an early stage, which is important in effectively managing type 2 diabetes (Florkowski, 2013). Type 1 diabetes has presenting symptoms, which include thirst, extreme hunger, and slow healing of wounds, which makes it easy to diagnose. This is also accompanied by a high blood glucose level (hyperglycemia) which can be easily detected by a blood glucose test (Florkowski, 2013). In type 2 diabetes, the glucose level rises slowly which makes it difficult to appropriately diagnose this disease using the traditional diagnosis tests. The glucose level in type 2 diabetes rises gradually over a long time, which makes the diagnosis process a complex process (Florkowski, 2013). The HbA1c does not test blood glucose based on one point rather it involves a continuous determination of glycaemia for a three-month period.
Comparisons done between the traditional diagnostic tests and the HbA1c on different aspects, which include the cost of using the diagnostic tests, biological impacts, as well as the accessibility revealed the HbA1c as the most effective diagnostic test (Florkowski, 2013). Early detection of diabetes is important as this helps healthcare providers to determine the expected health outcomes, which include long-term health benefits as well as improved outcomes in addressing patients suffering from type 2 diabetes (Florkowski, 2013). This diagnostic test is not aimed at opposing the traditional glucose based criteria for diagnosing diabetes, which is still recommended by the World Health Organization, rather provide a more effective diagnostic test to improve the health outcomes of individuals suffering from type 2 diabetes (Florkowski, 2013).
The HbA1c has also been identified as the most effective diagnostic test as this test gives an indication of chronic glycaemia over a long period compared to the commonly used diagnostic test (Florkowski, 2013). This test is also convenient to patients, as the traditional tests require the client to fast for 8 hours. However, this test requires only a single blood sample. The traditional diagnostic tests have also been criticized for some of the diabetes cases, which go undiagnosed (Florkowski, 2013). Another test, which includes an oral glucose tolerance test, is more expensive, complex, and inconvenient to the patients who are required to fast for over 8 hours. This test also requires a lot of time in performing the test with the test taking at least two hours (Florkowski, 2013).
Some of the individuals undertaking the test are also negatively affected by the glucose load, which may lead to nausea and vomiting which may affect the reliability of the results (Florkowski, 2013). This will require a repeat of the test to confirm the results with a number of patients being incompliant which gives the HbA1c an upper hand as this test can be undertaken at any time of the day (Florkowski, 2013). The HbA1c test was recommended in the mid 1980s with major concerns on its availability and poor standardization, which prevented its adoption in most of the countries. However, this was addressed by the recommendation of an international expert committee in 2009, which led to the American Diabetes Association and the World Health Organization adopting the diagnostic test for type 2 diabetes (Florkowski, 2013).
Conclusion
The HbA1c diagnostic test has more advantages compared to the negative effects associated with this test. This test is beneficial to the healthcare providers as well as the client, which makes it the most effective diagnostic test (Guo, Moellering, & Garvey, 2014). This diagnostic test is also available with samples also being delivered to medical agencies and research institutions for in-depth examinations to identify any concerns, which may be attributed to the test (Guo, Moellering, & Garvey, 2014). This diagnostic test is able to determine and predict clinical outcomes due to its effectiveness in diagnosing diabetes mellitus in adults. Other considerations are also taken into account, which include cost, and availability, which gives the HbA1c an advantage over the traditional diagnostic test (Guo, Moellering, & Garvey, 2014). However, dialogue and more research should continue to provide solutions in addressing some of the concerns affecting this test as well as implement improvement measures to increase the effectiveness of this test (Guo, Moellering, & Garvey, 2014).
References
DeFronzo, R. A., Ferrannini, E., Alberti, K. G. M. M., & Zimmet, P. (2015). International textbook of diabetes mellitus. Chichester, West Sussex; Hoboken, NJ: John Wiley & Sons Inc.

Florkowski, C. (2013). HbA1c as a Diagnostic Test for Diabetes Mellitus – Reviewing the Evidence. The Clinical biochemist. Reviews, 34(2), 75-83.

Guo, F., Moellering, D. R., & Garvey, W. T. (2014). Use of HbA1c for diagnoses of diabetes and prediabetes: comparison with diagnoses based on fasting and 2-hr glucose values and effects of gender, race, and age. Metabolic syndrome and related disorders, 12(5), 258-268.