The study found that the combination of blood glucose lowering and blood pressure medication slows the progression of microvascular complications. Similarly, the Turnbull (2009) meta-analysis study found that intensive glucose control leads to a reduced risk of major cardiovascular events, showing a reduction of 9% for major cardiovascular events. Advance Collaborative (2008) found that intensive blood glucose lowering with gliclazide and other drugs resulted in a reduced incidence of combined major macrovascular and microvascular events, as well as major microvascular events, because there also was a reduction of nephropathy. Still another study suggests that any kind of benefit attained by intensive lowering of blood glucose is lost after one year. The study conducted by Hollman et al. (2008) found that the patients who were assigned intensive glucose lowering were compared to patients who were assigned the standard treatment of dietary restriction. While the immediate results were that the intensive glucose lowering showed that the patients had a lower risk of microvascular complications then the patients with conventional dietary therapy, after one year, these advantages were lost. Introduction Patients with diabetes suffer from a variety of ailments. Among these ailments are microvascular and macrovascular diseases. Therefore, therapeutic intervention should be investigated to reduce the risks of a diabetic patient suffering from these ailments. One such intervention is aggressively lowering blood glucose levels through drugs such as glicazide. Therefore, this article will examine studies that are focused around the intervention of blood glucose lowering, and will examine whether this is an intervention that is positive for diabetic patients, with regards to lessening the risk of micro and macrovascular ailments. PICO Question In patients with Type II Diabetes Mellitus (P), what is the effect of intensively lowering the blood glucose (I) as compared with standard treatment (C) on the incidence of major macro- and microvascular outcomes (O)? Clinical Question Selection Criteria Inclusion Criteria 1. Journals and studies featuring patients who are who are subjected to either intensive glucose lowering or standard treatment. 2. The participants in these studies had either a microvascular or macrovascular cardiac event. 3. The journals were either randomized trials or meta-analyses. 4. Were published in peer reviewed journals. 5. Were reported in English. Exclusion Criteria 1. Journals that reported on either type I diabetes, juvenile diabetes or gestational diabetes. 2. Qualitative studies. 3. Studies that focused upon patients who were under the age of 18. Search Process The process began by looking for studies that had, as their focus, type II diabetes, intensive glucose lowering therapy verses traditional therapy and micro and macrovascular outcomes. These peer-reviewed journals were ones that were written in English. The data bases that were used were Pubmed, Psychosocial Instruments, British Nursing Index, Cumulative Index to Nursing and Allied Health Library, Psychosocial Instruments, Allied and Alternative Medicine and Sociofile. These databases were searched with the initial terms of type II diabetes, intensive glucose lowering therapy and micro and macrovascular cardiac. The articles were then narrowed down to studies that were randomized or studies which were
Effects of Lowering Blood Glucose v. Standard Treatment in Patients with Diabetes Mellitus Abstract Research shows mixed results for the anticipated therapeutic intervention of intensive glucose lowering in patients with Type 2 diabetes, and whether intensive glucose lowering leads to an impact on major macro and microvascular outcomes…
This paper explores the pros and cons of evidence-based practice in nursing. It analyzes the concepts of clinical expertise, patient preferences, and caring in the context of evidence-based nursing. It also examines the impact of these practices on the art of nursing as a practice.
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The hospital has many specialties but is nationally ranked in cancer, cardiology & heart surgery, diabetes & endocrinology, ear nose & throat, geriatrics, nephrology, orthopedics, pulmonology, urology, neurology & neurosurgery.
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ing its implications on care for respiratory patient and the impact it would have on my future practice together with critiquing the study in general.
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