Evidence-Based Practice Project—Intervention Presentation on Diabetes

A team which is led by Dr. Kaiser-Permanente and other scientists has designed and experimented with a realistic tool for the identification of diabetes among patients who has a higher probability of being admitted to the hospital because of hypoglycemia, or because of a lower level of low blood sugar. The outcome of this research is available in “JAMA-Internal-Medicine”. (Andrew J. Karter, E,2017)

Advancements in the healthcare sector and better treatment options have compacted the probability of long-term complications and treatments and reduced the death rate. Currently, there are twenty-five million people in the United States that are suffering from Diabetes, which is considered a higher level of blood sugar. Simultaneously, patients from time to time experience severely lower level of sugar in their blood. Whereas by using diabetes medicines, particularly after taking lunch or dinner or by doing more exercise than usual.

“Sometimes a person with diabetes is unaware that their blood sugar is dropping and can progress quickly into severe hypoglycemia, which has been associated with falls, automobile accidents, heart attacks, coma, and even death,” (Andrew J. Karter, E,2017) said by a senior researcher and scientist Andrew-J-Karter, along with the Dr. Kaiser-Permanente and the writer. “Hypoglycemia is often preventable with the proper clinical attention, and we believe this tool will help focus that attention on the patients who most need it.” (Reusch, J. E., & Manson, J. E, 2017).

With around one hundred thousand hypoglycemia-related unfavorable actions resulting in hospital visit every year across the US, hypoglycemia comes out to be the most adverse event among the patients that are suffering from type 2 Diabetes. Karter has further noticed that the patients that are older in nature and have a history of diabetes are more suspected.

The Scientist has made the hypoglycemia-risk-stratification tool that has successfully identified one hundred and fifty-six probable risk factors that are responsible for hypoglycemia and has collected the data from two hundred thousand patients who are suffering from type 2 diabetics and have received medication and healthcare from the Kaiser Permanente in Nothern California. With the help of machine-learning analytical tactics, the scientist has designed and implemented a model in order to correctly identify the twelve months probability of hypoglycemia among the patients.

The ultimate model was founded on sex variables:

1. The total number of previous visits of hypoglycemia-related visits to the hospital
2. The usage of insulin;
3. The usage of sulfonylurea (it is an oral medicine mostly used for the treatment of diabetic patients);
4. The last staged kidney infection;
5. The total number of hospital visits due to any treatment in the previous year;
6. And the age of the patient.

According to this model, a scientist has made a useful tool in order to classify the patients into higher (more than 5%), normal (from 1% to 5%), or lower (1% or less) yearly probability of hypoglycemia-related hospital visits. Afterward, the tool was tested with the data set of around 1 million members from the US’ Venternas and fifteen thousand members of Kaiser-Permanente who are diagnosed with level 2 diabetes.

The “Food and Drug Administration (FDA)” in the United States has funded the designing and testing of this tool to identify the risks that are involved in hypoglycemia in the Safe Use Initiative. Which was the joint effort made to decrease the adverse events that are associated with the use of medicines, as well as the diabetes medicines related to an enlarged chance of hypoglycemia? The outcome is being scattered with assistance from the “Centers for Medicare and Medicaid Services (CMS)” (Andrew J. Karter, E,2017).

Numerous public and private healthcare organizations and systems that include the “Mayo Clinic”, CMS, and “Kaiser Permanente” is currently studying how could this tool be used in order to increase awareness about diabetics and bring awareness and funds to assist the patients that are suffering from type 2 diabetes so that they could evade risky episodes in their near future.

“This work is an example of how federal agencies can work with private researchers to reduce preventable adverse drug events,” said a senior scientist and researcher “John Whyte, MD, MPH” for the FDA. The main aim of making this tool is to recognize the patients who have more risk of hypoglycemia, with the intention that the providers of health care could spotlight their awareness on the explicit requirements of the suffered patients and decrease avoidable harms of hypoglycemia.

Reference

Andrew J. Karter, E. Margaret Warton, Kasia J. Lipska, James D. Ralston, Howard H. Moffet, Geoffrey G. Jackson, Elbert S. Huang, Donald R. Miller. Development and Validation of a Tool to Identify Patients With Type 2 Diabetes at High Risk of Hypoglycemia-Related Emergency Department or Hospital Use. JAMA Internal Medicine, 2017;

Reusch, J. E., & Manson, J. E. (2017). Management of type 2 diabetes in 2017: getting to goal. Jama, 317(10), 1015-1016.