Evidence-based Integration Essay

Evidence-based Integration Essay

            It is normal for patients to feel dissatisfied with some of the treatment methods and options practitioners adopt in the treatment of their chronic conditions. This is the case with Mrs. Howard, a patient with hyperglycemia requiring her level of blood sugar regulated. As a nurse, one of the treatment procedures is applying medical therapy with the use of metformin (some form of medicine). In addition, dieting and exercising were recommended as a lifestyle adjustment option for her to control type 2 diabetes. Mrs. Howard, however, is not completely satisfied with the treatment options she is currently receiving. She is requesting acupuncture as an alternative. Studies reveal that acupuncture is a successful non-pharmacological treatment option of type 2 diabetes (chronic condition); however, the alternative treatment option combines with metformin, and it should be done right to realize positive recovery outcomes.

Description of the Chronic Condition

           Type 2 diabetes is one of the chronic conditions known as metabolic disorders. According to Marín-Peñalver et al. (2016), lifestyle or environmental factors make up the etiology for type 2 diabetes, which includes obesity or overweight, lacking exercise or physical laxity, including depression. The risks associated with this chronic condition also increases with age. Genetics is also another factor as people with a type 2 diabetes medical history has a high possibility of being diagnosed with the condition (Marín-Peñalver et al., 2016). 

           Regarding pathophysiology, patients with type 2 diabetes exhibit symptoms connected to impair insulin production and resistance. Tran et al. (2015) observe that abnormal changes in insulin production refers to a condition resulting in the human body becoming slow in how it response to glucose, and resistance to insulin production, thus an understanding of the failure by insulin to act effectively in line with the supply of blood (Tran et al., 2015). Therefore, early detection of various pathophysiological features results in better and effective control and treatment.

Options for Treatment

           The first option for treatment for type 2 diabetes is using metformin. Metformin serves some purposes in the treatment of the chronic condition. Tran et al. (2015) note that metformin helps to increase glucose absorption in peripheral cells, as well as facilitates the loss of weight and increases sensitivity levels to hepatic insulin. Guidelines to evidence-based practice show the high effectiveness of metformin when it is combined with dieting and exercising (Tran et al., 2015). Mrs. Howard’s current treatment comprises the drug, physical activity, and diet; the patient, however, requests for acupuncture as an alternative. 

           Acupuncture is a second-line option for treatment, and it involves, first, identifying the right location to conduct an acupuncture procedure. A recommended point is the umbilicus area considering there are at least nine points in the body that can act as acupoints. One located, needles are connected to low-frequency electric wires/lines before insertion into the acupoint before the lines are attached to the acupuncture technology. Marín-Peñalver et al. (2016) recommend the combination of acupuncture with metformin as there is the effectiveness increase, especially in the control of the level of blood sugar, reducing weight, increasing insulin sensitivity, and minimizing the level of pain (Marín-Peñalver et al., 2016). However, studies show that limited clinical trials are indicating that acupuncture, in treating type 2 diabetes, gives permanent results. 

Summarizing the Current Research

           Previous research evidence demonstrates that the use of metformin for treating type 2 diabetes is among the mono-therapies, but it is not as effective, especially in the control of hyperglycemia and pain related to disease when compared to acupuncture combined with the drug. A research was conducted to compare the effectiveness of two types 2 diabetes treatment alternatives, and one of the options was a metformin monotherapy, and the second is the electro-acupuncture (Firouzjaei et al., 2016). In this case, the study respondents (n-40) were separated into two groups, and the experimental study involved 10 study respondents, while the control group was made up of 19 respondents. In the former, the participants received combined electro-acupuncture and metformin therapy; however, the control group was only treated with metformin monotherapy (Firouzjaei et al., 2016). The experimental participants registered a better weight reduction and management of glucose levels compared to the control group. The conclusion was that the addition of metformin to acupuncture boosts control of glucose and reduction in weight among patients with type 2 diabetes and, in this case, Mrs. Howard. 

           Accordingly, experimental studies on measuring the effectiveness of using acupuncture technique on the treatment of patients with type 2 diabetes have been conducted before. A sample of men (n=40) was divided into two equal groups namely placebo and treatment groups (Saunders, 2018). The average level of blood sugar was at 147.1 mg/L, but after the procedure, it reduced to 138.15 mg/dL, but there was no notable blood sugar reduction in the placebo group (Saunders, 2018). In this case, it was determined that using acupuncture helps in reducing the level of blood sugar among patients with type 2 diabetes. Therefore, it was established that acupuncture operates successfully when it is done at the correct points. 

Recommendation on the Options of Non-pharmacological Treatment

           Based on the empirical findings from both research above, the evidence is that the treatment of type 2 diabetes is ineffective when adopting pharmacological options alone. The effectiveness can only be improved when the pharmacological treatment options are combined with non-pharmacological treatment alternatives. For instance, facilitating a pharmacological treatment option using metformin alone is not as successful compared to combining it with acupuncture when combined with it. Therefore, using metformin results in an outcome, but a combination of this treatment method with a non-pharmacological option like electro-acupuncture increases the effectiveness of treating type 2 diabetes. 

           In this case, acupuncture boosts clinical results and outcomes, especially for patients with type 2 diabetes, which makes it an effective option as a non-pharmacological treatment. The research conducted by Firouzjaei et al. (2016) showed that using acupuncture is supported, but the emphasis is on choosing the right acupoint. Therefore, the therapeutic treatment must function better as an option of non-pharmacological treatment (Firouzjaei et al., 2016). In this case, the treatment of Mrs. Howard means she should continue with exercise and dieting as an option of non-pharmacological treatment, but the intention is to include acupuncture as another option. 

Lessons Learnt

           The one lesson I learned from this research is that effective treating type 2 diabetes should involve the use both pharmacological and non-pharmacological treatment options. I also learned a lot about metformin as a therapy, which gives better results compared to known drugs. At the same time, it is better to treat type 2 diabetes based on research-based approaches since best practices have been formulated for boosting treatment outcomes. Therefore, of importance is that when a non-pharmacological option of treatment like acupuncture is used, there is a high likelihood the treatment process would be better.

References Evidence-based Integration Essay