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Uncontrolled Hemoglobin A1c in Older Adults: A Pilot Study Establishing an Evidence-Based Practice Protocol in a Long Term Care Facilit

Posted on:2018-07-17Degree:D.N.PType:Dissertation
University:Saint Peter's UniversityCandidate:Potash, DianeFull Text:PDF
GTID:1479390020953497Subject:Nursing
Abstract/Summary:
Many elderly living with diabetes struggle to maintain their HgbA1C at the individualized levels that current guidelines recommend (ADA, 2012). Even adults living in long-term care facilities, where professional healthcare providers manage medication and where balanced meals are provided, struggle to maintain their HgbA1c levels. Pharmaceutical companies have developed newer products, such as basal insulin, to lower glucose levels and, therefore, HgbA1c. This project compared the efficacy of adding basal insulin, including Toujeo (Sanofi), which is a newly-available, long acting human insulin analog, to treatment with oral hypoglycemic agents in patients with Type II diabetes. This evidence-based project was a retrospective chart review of an initiative being implemented in a New Jersey LTC facility as a pilot study of a basal insulin algorithm to decrease adjusted hemoglobin A1c to <8.5%. The retrospective chart review was completed to determine if there would be significant improvement in glucose control for this population with the addition of basal insulin compared to glucose control in another New Jersey LTC facility using predominantly oral medication. Based on these findings, indication for widespread implementation to the remaining five sister facilities of Arista Care was determined.
Keywords/Search Tags:Care, Basal insulin
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