Comparison of Diabetes Modifiable Risk Factors versus Taking Medication Techniques
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Comparison of Diabetes Modifiable Risk Factors versus Taking Medication Techniques
Diabetes is one of the common conditions among people globally, with a high prevalence
in African Americans. There are medications for this disease, but recently according to (CDC,
2021), diabetes can be successfully managed by people when they are keen on the risk factors
associated with diabetes. Mottalib et al. (2018) state that managing these risk factors is effective
as it reduces the HbA1c of patients with diabetes type 2. These ways do not involve any use of
medications, and they help a lot, especially for people who cannot afford diabetes drugs.
Managing these risk factors is also a healthy lifestyle. Most of these risk factors are always
associated with other diseases; for instance, if one quits smoking to avoid diabetes or further
damage of diabetes, they will also save their hearts from any heart disease related to smoking.
Background
African Americans are the most affected with diabetes, according to CDC (2021). As an
African American, my sister was diagnosed with high blood pressure, and after some months,
her A1C was seven, and her doctor advised that she modify her risk factors. She insisted on
modifying her risk factors, and A1C dropped to 5 within three months. This occurrence implied
that modifiable factors are better alternatives to medicine. Type two diabetes is a condition that
interferes with the way the human body utilizes glucose after digestion and disrupts how the
body stores and processes other different forms of energy like fat. Therefore, people with type 2
diabetes require regular monitoring and treatment to maintain their blood sugar levels at a
healthy level. “Professional Practice Committee” (2020) suggests that blood sugar levels can be
maintained by lifestyle changes for the patient, self-care measures, and medications that are not
necessary at some point. If blood sugar levels are not regulated, there can be a risk of
cardiovascular complications. The best way of keeping blood sugar levels at an optimal level is
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by managing the risk factors associated with this diabetes type 2. According to (Rawshani et al.,
2018), patients can manage diabetes type 2 by following a Mediterranean diet that is made up of
vegetables, whole grains, beans, and fruits. Patients should practice regular exercise at least daily
or weekly depending on their schedules or activities. If the patient is an active smoker, they
should quit smoking as it increases the risks of diabetes and related conditions. Insulin drugs
should be taken but not frequently, and this is usually prescribed to the patient when they can
take insulin drugs. The patients should be informed about symptoms that suggest their blood
sugar levels are higher than usual so that they can respond appropriately. When these practices
are put in place, levels of HbA1c drop within a short period.
Research Problem Statement
Since diabetes prevalence is high in the nation, especially among African Americans,
health workers and clinicians need to find the best way to handle diabetes and prevent it. This
paper tries to show the best methods of preventing and managing diabetes, focusing majorly on
managing risk modifiable factors and medication use.
Research Purpose
The purpose of this paper is to determine whether managing diabetes-related risk
modifiable factors is an effective way of reducing HbA1c than the use of medication within a
certain period on patients with diabetes type 2.
Research Question
In people with diabetes type 2, how does the management of risk factors reduce their
HbA1c levels compared to taking diabetic medication alone? Which one is effective?
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Research Utilization Model
Name of Model:
Promoting Action on Research Implementation in Health Services (PARIHS)
Citation: (Francis et al., 2019, pp. 403-412 and Ward et al., 2017)
Research Question/PICO (T)
How do modifiable risk factors reduce A1C in 3 months compared to medication in African
American adults?
Model explanation and application to research question and literature review paper in
narrative format.
The PARIHS (Promoting Action on Research Implementation in Health Services) model coined
by Kitson and partners helps probe the realization of quality development interventions in
medical facilities (Ward et al., 2017). The framework puts forward three instrumental aspects in
successfully implementing evidence-based practices (EBPs). The interacting elements include
evidence, context, and facilitation. Firstly, evidence (E) is defined as the codified and noncodified wellsprings of knowledge observed by various stakeholders. On the other hand, context
(C) depicts the quality of the setting where the implementation is taking place. Lastly, facilitation
(F) is a strategy of simplifying things for others, enabling them to modify attitudes and abilities
(Ward et al., 2017). The achievement of carrying out proof-based practice and the
maintainability of the development is subject to the strength and fittingness of these critical
components.
The PARIHS model can facilitate EBP changes since it guides the progress of a program to
realizable interventions. Notably, the framework can analyze the modifiable risk factors of
managing diabetes associated with implementing an EBP (E and C). Consequently, it will result
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in an implementation technique (F) that will effectively improve health outcomes. Diabetes
management is complex because it requires a balance of medications and regulation of
modifiable risk factors. The PARIHS model identifies diabetes self-modification of risk factors
as an essential care element. In developing the framework, thought should be accorded to the
modifiable risk factors such as physical inactivity and unhealthful eating patterns (Francis et al.,
2019, pp. 407). Therefore, to lower the A1C readings in three months, the diagnosis of the
PARIHS model should be employed.
This study will be developed in the guidance of the research/PICO(T) question while utilizing
the PARIHS model. From the framework, successful implementation is a function of evidence
(E) and context (E). The two depend on how the facilitation (F) introduces evidence into
practice. The PARIHS model is a determinant outline in that it details obstacles and enablers
impacting implementation results, in this case, modifiable risk factors. The utilization of this
model enables practitioners and researchers to sketch informed implementation plans. These
strategies comprise decisions regarding what information to assemble, portray, and clarify
implementation. In addition, the speculations about activity steps required, the evidence, context,
and facilitation. This research will give the grounds to make proposals to address the above
research question and figure out an EBP modification for future adoptions.
Search Criteria and Results
This study utilized articles from Cochrane, CDC, Cleveland Clinic, Medline, and other
articles between 2017 and 2021. The table below shows the keywords used to locate reliable
articles.
Table 1
Data Research Table
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Keyword
Cochrane
Diabetes AND
5
Cleveland Clinic
Medline
CDC
19
Smoking
Full Text
2017-2021
Diabetes AND
4
9
7
13
7
11
5
9
HbA1c
Full Text
2017-2021
Diabetes AND
Cardiovascular
diseases
Full Text
2017-2021
Diabetes type 2 AND
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5
management of risk
factors
Full Text
2017-2021
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A total of 6 articles were utilized to build this research project systematic reviews, two case
studies, two follow-up analyses, one clinical guide, and one non-experimental analysis. The
pyramid below provides a visual representation of the hierarchy of evidence used.
Evidence
Summaries:
1 sources
Experiemental Research
Studies:
2 sources
Nonexperimental Studies:
1 source
Qualitative Studies, Expert Opinion, Theory, Basic
Science:
2 sources
Figure 2
Hierarchy evidence rating pyramid
Clinical Recommendations
Diabetes mellitus type 2 is a chronic disease that can be prevented or managed; people are
advised to manage the risk factors associated with the disease. This practice will lower the
HbA1c levels and keep the individual healthy from other diseases. Managing these risk factors
majorly involves healthy nutrition, frequent exercise, and avoiding practices involving tobacco
products.
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Conclusion
According to various studies, it is evident that managing risk factors associated with diabetes
will help lower HbA1c levels in diabetic patients more effectively than using medications.
These, therefore, call for diabetic patients to adapt to this method of lowering their blood glucose
levels, especially those at risk.
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References
CDC. (2021, April 23). Diabetes Risk Factors. Centers for Disease Control and Prevention.
https://www.cdc.gov/diabetes/basics/risk-factors.html
Francis, A., Lindonne Glasgow, M. S. P. H., Amechi, L. N., & Emmanuel Keku, M. D. (2019).
Knowledge, attitudes, and practices of diabetic patients at a clinic in Grenada:
Implications for HBA1c levels. International Public Health Journal, 11(4), 403-412.
Mottalib, A., Salsberg, V., Mohd-Yusof, B.-N., Mohamed, W., Carolan, P., Pober, D. M., Mitri,
J., & Hamdy, O. (2018). Effects of nutrition therapy on HbA1c and cardiovascular
disease risk factors in overweight and obese patients with type 2 diabetes. Nutrition
Journal, 17(1), 42. https://doi.org/10.1186/s12937-018-0351-0
Professional Practice Committee: Standards of Medical Care in Diabetes—2020. (2020).
Diabetes Care, 43(Supplement 1), S3–S3. https://doi.org/10.2337/dc20-Sppc
Rawshani, A., Rawshani, A., Franzén, S., Sattar, N., Eliasson, B., Svensson, A.-M., Zethelius,
B., Miftaraj, M., McGuire, D. K., Rosengren, A., & Gudbjörnsdottir, S. (2018). Risk
Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes. New
England Journal of Medicine, 379(7), 633–644. https://doi.org/10.1056/NEJMoa1800256
Ward, M. M., Baloh, J., Zhu, X., & Stewart, G. L. (2017). Promoting Action on Research
Implementation in Health Services framework applied to TeamSTEPPS implementation
in small rural hospitals. Health Care Management Review, 42(1), 2–13.
https://doi.org/10.1097/HMR.0000000000000086
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