Care of the Child with Diabetes Mellitus Type 2 (DM2) - Case Study Example

The research article by Dea et al. has explored the various conditions that lead to type 2 diabetes including obesity (p.42-48). Citing American Diabetes Association (2000), Dea et al. (2011) have said that obesity in children can raise the risk of type 2 diabetes (p.42). It is further explained by Dea et al. (2011) that initially obesity causes insulin resistance and it is the same that advances into DM2 (p.42). The procedure delineated by the American Academy of Pediatrics and American Diabetes Association has been explained in this article by referring to the screening of children conducted for obesity as a potential risk related to type 2 diabetes (Dea et al., 2011, p.44).

But it is also reminded that not all children who are overweight are prone to type 2 diabetes (Dea et al., 2011, p.45). Life style modification including a controlled diet regime is recommended along with medication for obese children who develop type 2 diabetes (Dea et al., 2011, p.47-48). The role of the nurse in this whole scenario is also elaborated in this article (Dea et al., 2011, p.48). The tasks of a nurse in this context are explained as “patient care, patient and family education, and case management” (Dea et al., 2011, p.48).

Taking note of the risk factors, routine BMI monitoring, and imparting education to the patient and the family on how to change life style are the major steps that come under the duties of the nurse (Dea et al., 2011, p.48). Generally, it is the complex nature of the causes type 2 diabetes and the consequences that involve many co morbidities that is stressed in this article (Dea et al., 2011, p.42-48). The study carried out by Fortmeier-Saucier et al. (2008) has revealed a direct connection between type 2 diabetes and obesity in the sample examined, that is, Mexican American children.

This research has taken a direct course towards linking BMI and higher lipid levels to obesity and then obesity to type 2 diabetes in children (Fortmeier-Saucier et al., 2008). The study conclusively showed that 90% of Mexican American children in the sample taken for this study were obese and 75% of them were having at least a lipid value of 2 (Fortmeier-Saucier et al., 2008, p.142-145). Fortmeier-Saucier et al. (2008) have thus attempted to provide a “physiological marker” for type 2 diabetes in children (p.147). There is enough evidence to suggest that Diabetes Mellitus type 2 (DM2) in younger people correspond with the increased prevalence of obesity among them (Dea et al., 2011;). Pointing out that occurrence of type 2 diabetes in younger people “has now reached epidemic proportions”, Dea et al. (2011) have revealed the connections between this disease and obesity and have also called for more research to find out further comorbidities (p.42-48). Another study that tested the BMI and lipid levels of Mexican American children who were suffering from type 2 diabetes found out that 90% of these children were having BMI that indicates obesity (Fortmeier-Saucier et al., 2008). Both these studies have contributed to the evidence based practice of pediatric nurses.

Viewed from the perspective of evidence-based practice in pediatric nursing, these and similar research findings form the basis of the administration of nursing care (Brown et al., 2009, p.372). It is these research evidences that help nurses to find “the gold standard for the provision of safe and compassionate healthcare” in nursing care (Brown et al., 2009, p.372). Especially, in pediatric nursing care, “education in finding and assessing evidence, (and) access to evidence” can enhance the quality of nursing care to great extent (Brown et al., 2009, p.374).

The benefit of evidence-based practice is enhanced outcomes in the health and the process of curing of the patient (Brown et al., 2009, p.376). In the research article by Dea et al. (2011), there are many points of relevance covered that could lead to evidence based practice in pediatric nursing. For example, first and foremost, the cause-effect relationship between obesity and type 2 diabetes in children is well-established in this article with the support of previous research done on the same topic (Dea et al., 2011). An authentic method to measure and identify obesity is put forth in the form of BMI by the researchers (Dea et al., 2011, p.42).

The standards for measuring BMI as is suggested by credible agencies have been delineated as well (Dea et al., 2011, p.44). This information could be used by pediatric nurses to identify potential patients. The significance of the issue is stressed by noting that, “over the past 20 years, the prevalence of T2DM among pediatric patients newly diagnosed with diabetes has increased significantly” as the figures showed a “2% to 4% range” in 1992 and “8% to 45% of newly diagnosed children >10 years of age” in recent studies (Dea et al., 2011, p.43).

By identifying the “risk factors” that lead to type 2 diabetes, this study has provided the nurses with core areas of early preventive intervention (Dea et al., 2011, p.43). The steps in the evolution of a health condition towards type 2 diabetes is described as starting from beta “cell failure” and progressing towards “insulin resistance”, and the identification of these steps could help the nurse to decide the stage of progression of the disease and plan intervention strategies accordingly (Dea et al., 2011, p.44).

Further the conditions that could be described as prediabetes and diabetes are explained, again an information that could be very useful in the evidence-based practice in a nurse’s profession by imparting ways to identify which child is prone and to what extent (Dea et al., 2011, p.44). The symptoms of the disease in young children and the challenges that are linked with diagnosis are also presented by this study (dea et al., 2011, p.45). Knowledge of the same could be made use of by pediatric nurses in their evidence-based practices to keep alert of the possible errors in diagnosis.

The treatment options and necessary life style modifications summarized by this article are helpful for the pediatric nurses to lead the patient, once diagnosed, towards scientific management of the disease and also monitor the progress of the same (Dea et al., 2011, p.45). Departing from the normal option of medication, thus the pediatric nurse will be capable of applying a combination of options to ensure maximum effectiveness of care. The article has suggested that the options could include “medical nutritional therapy”, “glycemic control”, “oral agents” and insulin (Dea et al., 2011, p.46-47).

A “routine care” regime is also set forth which the pediatric nurse could adopt and modify according to patient-specific needs (Dea et al., 2011, p.47). In this manner, this article has contributed to the evidence based practices in pediatric nursing care by ensuring that the nurses have all the scientific information needed to anchor their care options on research evidences. Along with that evidence for the relevance of close monitoring in all stages for comorbidities is also presented (dea et al., 2011, p.46).

Whereas, the research findings of Fortmeier-Saucier et al. (2008) have also made similar conclusions by taking BMI and lipid levels as indicators of obesity and then finding the link between obesity and type 2 diabetes through their measurements. By making the measurements in accordance with the standards set by American Academy of Pediatrics, this study has provided pediatric nurses with dependable data that helps in identifying potentially obese children (Fortmeier-Saucier et al., 2008, p.144).

The statistical importance of the findings with respect to the lipid levels has been stressed by this study, thereby giving the pediatric nurses the information required to associate obesity with type 2 diabetes while trying to convince patients and their families of the need for life style modifications and medication (Fortmeier-Saucier et al., 2008, p.145). The racial and demographical aspect of the obesity-type 2 diabetes connection is also revealed by this study (Fortmeier-Saucier et al., 2008, p.145). This information provides the pediatric nurses, a better framework within which potential patients could be identified and monitored.

The need for cost-effective intervention strategies, in view of the socio-demographic and racial aspects involved, could be understood by the nurses in this event, through the evidences presented. The conclusions presented by this study could be used the nurses also as “physiological marker”s that could be crucial in diagnosis and treatment of type 2 diabetes (Fortmeier-Saucier et al., 2008, p.147). References Brown et al., (2009 January 1). Nursing practice, knowledge, attitudes and perceived barriers to evidence-based practice at an academic medical center, Journal of Advanced Nursing, 65 (2), 371-381.

Dea et al., (2011 January/February). Pediatric obesity & type 2 diabetes, American Journal of Maternal Child Nursing, 36 (1), 42-48. Fortmeier-Saucier et al., (2008 September). BMI and lipid levels in Mexican American children diagnosed with type 2 diabetes, Worldviews on Evidence-Based Nursing, 5 (3), 142-147.