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RESEACH - Essay Example

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Research Name Institution Introduction Diabetes has consistently placed a challenge in its management owing to the increase in prevalence of the disease in the United States and other countries globally. Past statistics by the Center for Disease Control revealed that the prevalence rate by 2008 was 18.1 million patients in the United States…
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Research Introduction Diabetes has consistently placed a challenge in its management owing to the increase in prevalence of the disease in the United States and other countries globally. Past statistics by the Center for Disease Control revealed that the prevalence rate by 2008 was 18.1 million patients in the United States. Currently, there are over 26 million persons affected by diabetes in the United States. Among this cohort, 18.8 million have been diagnosed while 7 million people remain undiagnosed (Center for Disease Control, 2010). Moreover, among people aged above 65 years, 10.9 million had diabetes by 2010. Within the adult cohort by 2010, statistics indicate that 79 million people above the age of 20 had diabetes (Center for Disease Control, 2010). Hemoglobin A1c as a Diagnostic Tool for Diabetes Screening and New-Onset Diabetes Prediction In recognition of the fact that diabetes is a leading cause heart related diseases, kidney malfunction and blindness; concerted efforts have been dedicated to conventional early diagnostic measures. To this end, the American Diabetes Association has conducted research on the Hemoglobin A1c (Choi et al. 2011). The research conducted has been based on establishing it as an early diagnostic tool for screening diabetes as well as new onset prediction. The research came against the backdrop of knowledge that certain cut off levels of A1c were effective in screening diabetes. Consequently, the research’s objective was to evaluate the feasibility of A1c levels during screening of undiagnosed diabetes. Furthermore, the research sought to establish A1c levels as an indicator of diabetes in a cohort population with a 6 year incident period (Choi et al. 2011). Research Design and Tools The research design incorporated a total of 10, 038 participants taken from Ansung Ansan population study (Choi et al. 2011). The selected cohort of study was an ongoing community based population study from the Korean Health and Genome survey. The choice of the cohort was due its association in the diabetes program that aimed at investigating new trends and related risk factors. Furthermore, the participants were selected based on age eligibility threshold of between 40-69 years. In addition, the participants had to be residing within the survey region for a minimum of 6 years prior to testing. They also had to be of sound physical and mental health. The method of survey involved the use of a cluster sample technique stratified by sex, residential area and age. Moreover, all the participants were subjected to tolerance tests of 75-g oral glucose during baseline and at subsequent follow ups biennially. To this end, 572 participants with verifiable type 2 diabetes were excluded as well as 91 participants whose glucose status was unknown. The purpose for this measure was to derive the curve from receiver operating characteristic. Consequently, the curve was used to investigate the diagnostic potency and accuracy of the A1 cut off. In addition, the Coz proportional hazards design was applied in the prediction of diabetes after 6 years. Results At this point, the results derived at the baseline indicated 635 individuals had been undiagnosed with diabetes in the past. Furthermore, 5.9% of A1 cut off reflected the greatest percentage of sensitivity and specificity at 68% and 91% respectively. Furthermore, the cut off curve revealed 77% specificity in the identification of concurrent 6 year indicative diabetes. Results further indicated that 10.2% of the cohort study had contracted incident diabetes at 6 years. Lastly, upon conducting a multivariate adjustment, women were identified to have a 3.1 fold higher risk of new-incident diabetes while men had a 2.4 fold higher risk. Discussion From the above results, the research ascertained that a 5.9% A1c cut off was sufficient in identifying persons with undiagnosed diabetes. Furthermore, persons with A1c ? 5.6 % were at an advanced risk of developing to type 2 diabetes. The research findings equally acknowledged that it had applied stringent methods in the diagnosis of diabetes within the large cohort of study. To this end, the research had administered the OGTT (Oral Glucose Tolerance Test) to the entire individuals and utilized similar procedure and tools in the biochemical and clinical evaluations during the 6 year duration. Furthermore, in the research study, the screening of diabetes was founded on plasma glucose findings from the 75-g OGTT. Moreover, the A1c statistic of 5.9% was effective in the screening of undiagnosed type 2 diabetes within the cohort of study. Conclusion Consequently, the major conclusion from the research study was that hemoglobin A1c was an effective diagnostic tool for screening type 2 diabetes. Moreover, it was equally a reliable diagnostic predictor of future diabetes. To this end, the research established that an A1c cut of percentage of 5.9% was reliable in identifying a large number of people with undiagnosed type 2 diabetes. In addition, the research established that persons who had an A1c greater than or equal to 5.6% had a higher risk of developing future diabetes. Consequently, early prevention intervention would be necessary. To this end, the implication from the research study to nursing was that the A1c assay could be effectively used for early screening type 2 diabetes among patients. In addition, the diagnostic tool could be used as a future predictor of the onset of diabetes among individuals. Consequently, early preventive care and medical treatment of diagnosed patients will be increasingly efficient. References Center for Disease Control. (2010). National diabetes fact sheet, 2011. Center for Disease Control. Retrieved October 28, 2012, from www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf Choi, S. H., Kim, T. H., Lim, S., Park, K. S., Jang, H. C., & Cho, N. H. (2011). Hemoglobin A1c as a diagnostic tool for diabetes screening and new-onset diabetes prediction. Diabetes Care, 34(4), 944–949.. Retrieved October 28, 2012, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3064055/ Read More
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