Select a patient you have encountered with a chronic health problem in your clinical practice. I chose a Diabetic Patient, but he is not a foster child. Interview the client/family members. Include the following information. Setting: Community Clinic, Private practice, Skilled nursing facility, Home Health

A Review of Critical Concepts

Continuous Glucose Monitoring

Glucose monitoring is conducted through continuous glucose monitoring (CGM), self-monitoring of blood glucose, or flash glucose monitoring systems (Brew et al., 2022). CGM is effective in glycemic control in children with type 1 diabetes mellitus. CGMs are used to detect hyperglycemia and hypoglycemia. Hyperglycemia signifies that the patient’s current insulin dose is ineffective, while hypoglycemia signifies that the patient’s current insulin dose is too high. Although children of a certain age can comprehend CGM, it is crucial to ensure they are monitored by adults such as their parents or guardians.

Insulin Delivery Systems

Insulin delivery systems used in children and young people with type 1 diabetes include insulin pumps. Insulin pumps are selected for type 1 diabetes mellitus patients who need continuous subcutaneous insulin infusion (Brew et al., 2022). Both guidelines recommended using smartphone applications to collect, store, and track glucose readings. Brew et al. (2022) highlight that smartphones are used as external processors for data collection between insulin delivery and glucose monitoring systems.

Closed Loop Systems

There should be a means of communication between glucose monitoring systems and insulin delivery systems. According to Brew et al. (2022), hybris closed loop systems facilitate communication between CGM and an infusion pump and send the data to an external processor such as a smartphone.

The Multiplicity of Viewpoints

Although the use of technology in diabetes has improved patient outcomes and quality of life, the effect of these technologies on the relationship between young people and their caregivers should be considered (Brew et al., 2022). The readings obtained from CGM usually differ from those obtained through a fingerstick, which makes CGM questionable. Readings on CGM that show hyperglycemia encourage a patient to continuously administer insulin, hoping that the glucose levels will fall. On the other hand, readings that show hypoglycemia encourage a patient to skip insulin administration (ADA-PPC, 2022). Critics argue that a patient should immediately visit a hospital in case of an abnormal reading.

Soundness of Research

The ADA-PPC (2022) and Brew et al. (2022) guidelines were developed through systematic reviews. Brew et al. (2022) used seventeen articles for a systematic literature review. The selected articles met the inclusion criteria by including glucose sensors, remote monitoring systems, and insulin pumps. The inclusion criteria showed that sound research was used. Similarly, the ADA-PPC (2022) guidelines are level 1 and evidence-based, showing that sound research was used.

Evaluation of EBM Guidelines

Brew et al. (2022) used 17 articles that fit the inclusion criteria. The articles used in Brew et al. (2022) were published between 2007 and 2019, while the ADA-PPC (2022) used 228 articles published between 2000 and 2021. Brew et al.’s (2022) guidelines are based on outdated data compared to ADA-PPC (2022). Brew et al. (2022) used 17 articles, while ADA-PPC (2022) guidelines are based on 228 articles, which shows that ADA-PPC (2022) has an enormous scope of researched information.

The Impact of Evidence on Practice

Evidence obtained from the two guidelines will be implemented to ensure the quality of life and improved patient outcomes for type 1 diabetes mellitus patients. The current positive impacts will encourage other patients to adhere to their therapy.

Cultural, Spiritual, and Socioeconomic Issues

ADA-PPC (2022) highlighted the need to ensure cost-effective technology in managing diabetes. Brew et al. (2022) recommended further research on the impact of technology’s size, cost, and usability in managing diabetes. Cultural and spiritual issues were not highlighted in the guidelines.

Conclusion

Technological advancements in managing type 1 diabetes mellitus include insulin delivery systems, continuous glucose monitoring, and closed-loop systems. Advancements that are yet to be fully embraced include the use of telemedicine. Guidelines highlight that the use of technology has led to improved quality of life. Advancements such as telemedicine need further research and training to ensure positive outcomes. The impact of technology should be addressed in all areas, including their cost and usability.

References

American Diabetes Association Professional Practice Committee. (2022). Diabetes technology: Standards of medical care in diabetes—2022. Diabetes Care, 45(1), 97–112. ht