Introduction

Diabetes is a multifaceted disease that affects over 29 million individuals in the United States although most of them are not aware they are sick. The prevalenceof diagnosed diabetes is higheramong certain minorities such as Alaska Natives, American Indians, Hispanics, Asian Americans and non-Hispanic Black. Its reduces muscle, liver and adipose tissue insulin sensitivity to as well as a decrease pancreatic b-cell function leading which can impair insulin secretion.Diabetes mellitus (DM)can be in form of Type 1 DM, gestation DM, type 2 DM, Pre-DM or medication-induced DM while all bear high levels of blood glucose. Lately, new antidiabetic medications have been adopted for thetreatment of T2DM, includingdipeptidyl peptidase-4 (DPP-4)inhibitors, glucagon-like peptide 1(GLP-1) receptor agonists, anamylin analogue, and sodium-glucose cotransporter 2 (SGLT2) inhibitors. Of all cases of diabetes, 90% - 95% is accounted by type 2 DM (Olokoba, Obateru & Olokoba, 2012). It is characterized by the body failing to use insulin properly because of the relative deficiency in insulin or insulin resistance.Failure tomanage type 2 diabetesappropriately can cause grave complications such as neuropathy, retinopathy and cardiovascular diseases. .

Problem

Diabetes Mellitus type 2 has become an epidemic in the adult population and managing the glucose levels has become a serious problem with close to 285 million people worldwide affected (International Diabetes Federation. 2011). The number of Americans people affected by type 2 diabetes mellitus has continued to grow by 1.9 million cases every year. The problem has been rampant on older people in the United Stateswho account for 10.9 million cases.Among the factors identified as drivers of type 2DM epidemic is physical inactivity, increased age ofthe U.S. population, increase in the sub-populations proneto diabetes and obesity epidemic.The cost of type 2DM is enormous and in 2012, approximately $176 billion was used in direct medical costs and $69 billion in lost due to lack of productivity.

Review of the Literature

SLO1: Discussion of Various Designs

1. Will be able to use a cross-sectional descriptive correlational design,in future to perform various research related to nursing field.

2. Will be able to demonstrate my knowledge on random controlled clinical trialsindetermining an impact of the researched phenomena.

3. Will demonstrate the ability I have learned about descriptive and semi- experimental designs to find result that would improve specific issues.

4. Will be able to use follow-up telephone interventions to collect data that can be used as inference for various research outcome.

SLO2: Compare and Contrast select research Designs

1. The first research usedcombined research designs i.e.cross-sectional, descriptive and correlational design in its research.

2. The second used a single research design i.e. random controlled clinical trialsto reach individual privately.

3. The third used follow- up telephone intervention to collect research data from various sample

4. The fourth used two research designs i.e. descriptive and semi-experimental design to determine important strategies to patient well-being.

SLO3: 1. Examine the use of research and evidence based practice in healthcare

The research has identified Self-care behaviors as essential in controlling type 2 diabetes progression and for preventing long-term complications (American Diabetes Association, 2010). Patients are expected to integrate a complex set of self-care behaviors into their daily routines (Chatterjee, 2006; Funnell et al., 2010). Behavioral weight loss interventions can produce sustained meaningful intervention in overweight and obese individuals aged 65 to 76 who have type 2DM.

The research has identified improvement in education on patient with type 2DM as meant to improve self-efficacy in self-care. As unemployed older adults are at a high risk for inadequate health literacy, diabetes education material that requires lower literacy levels may be offered together with outreach health activities and diabetes screening. This would improve patient literacy on accurately interpreting glucose reading and knowing the correct times for taking medication. Nurses should incorporate self-efficacy in designing self-care behavior education programs that would enhance interventions. Such would include special attention on patient response on dealing with hypoglycemic situations, checking their weight, preparing food according to diabetes dietary plans and checking blood sugar levels as recommended

SLO4: 4. Deconstruct select research studies

Theresearch onPharmacotherapy of Type 2 DiabetesMellitus: Navigating Current and NewTherapies has not been able to provide a summary on larger research problem and the problem statement has not been adequately outline. However, the methodology and conclusion are clear and well extrapolated. The research on Health literacy, self-efficacy, and self-care behaviors in patientswith type 2 diabetes mellitus is well organized with a clear abstract and problem statement. The study methodology has also been emphasized with limitation, and analysis done professionaly. However, the conclusion and limitations are very shallow. References are also handful.

Research on Improving Patient Outcomes with EffectiveTreatment Strategies in the Management ofType 2 Diabetes Mellitus has been done shallowly and lacks a clear methodology. It however has an outline that reflects on its objective. The research on Evidence-Based Practice Protocol to

Improve Glucose Control inIndividuals with Type 2 DiabetesMellitus is the ultimate research paper in this clinical research. It has conformed to methodology, design, referencing, conclusion and problem statement. It is one that can be emulated by future researches.

Conclusion

There is a lot to be learned from the above researches on type 2 DM and how studies can be used to improve patients well-being as well as reduce the big load of cost associated with its control and treatment. The research also is important in understanding how nursing research should be carried to realize their objective especially to students in medicine field.

References

Bohanny, W., Wu, S. F. V., Liu, C. Y., Yeh, S. H., Tsay, S. L., & Wang, T. J. (2013). Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus. Journal of the American Association of Nurse Practitioners, 25(9), 495-502.
Espeland, M. A., Rejeski, W. J., West, D. S., Bray, G. A., Clark, J. M., Peters, A. L., & ... Hazuda, H. P. (2013). Intensive Weight Loss Intervention in Older Individuals: Results from the Action for Health in Diabetes Type 2 Diabetes Mellitus Trial. Journal of the American Geriatrics Society, 61(6), 912-922 11p. doi:10.1111/jgs.12271

Evans, M. (2010). Evidence-based practice protocol to improve glucose control in individuals with type diabetes mellitus. MEDSURG Nursing, 19(6), 317-322 6p.

International Diabetes Federation. (2011). IDF diabetes atlas. International Diabetes Federation, Executive Office.
Lew, K. N., & Wick, A. (2015). Pharmacotherapy of Type 2 Diabetes Mellitus: Navigating Current and New Therapies. Pharmacotherapy of Type 2 Diabetes Mellitus: Navigating Current and New Therapies, 24(6), 413-438

Olokoba, A. B., Obateru, O. A., & Olokoba, L. B. (2012). Type 2 diabetes mellitus: a review of current trends. Oman Med J, 27(4), 269-273.
Reid, T. S. (2014). Improving Patient Outcomes with Effective Treatment Strategies in the Management of Type 2 Diabetes Mellitus. Journal Of Managed Care Medicine, 17(1), 41-46 6p.