PICOT Question Nursing Paper

PICOT Question Nursing Paper

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PICOT/Research question
In adult patients 65 years and older diagnosed with diabetes mellitus admitted to Inova Fairfax
Hospital medical units, how effective are the use of dietary supplements such as cinnamon
compared to medications such as insulin therapy/oral hypoglycemic in the prevention of diabetic
complications within one year period?
P Adult patients 65 years and older with diabetes admitted to Inova Fairfax
Hospital medical units.
Age is one of the most important risk factors for type 2 diabetes with a high
prevalence in older age groups. Selvin and Parrinello (2013), pointed out that
in the USA adults aged 65 or older, had 20% or more than eight times higher
prevalence of being diagnosed diabetes in 2011 than the prevalence among
adults 18 to 44 years of age (2.4% prevalence). PICOT Question Nursing Paper
I Dietary supplements like cinnamon.


It is believed that Dietary supplements like cinnamon help patients to control
blood glucose. As mentioned by Hasanzade et al., (2013), traditional herbs
and spices such as Ròu Guì and Cinnamomum cassia are commonly used for
control of glucose among has the greatest effect. They also added that adding
cinnamon to diet can help to lower the glucose level. Studies revealed that
spices such as cinnamon (Ròu Guì; Cinnamomum cassia), and carnation,
walnut, green tea, and mint have similar effects with insulin action in terms
By SN Ijeoma Amaoji – T2 2020
of reduction of sugar level and the most active of them is cinnamon
(Hasanzade et al., 2013).
C Insulin/Oral hypoglycemic medications.
Insulin alone or in addition to oral glycemic medications are universally used
to treat /manage diabetes due to their ability to bring down blood sugar
levels. Research has shown that insulin offers a unique ability to control
hyperglycemia, when used from the time of diagnosis in some circumstances
and when metabolic control is disturbed by medical illness, procedures, or
therapy, and also being used in the longer term ( Home et al., 2014).
O Prevention of diabetic complications. The ultimate goal of diabetes
management is prevention of long-term complications. Uncontrolled
diabetes can lead to a number of short and long-term health complications,
including hypoglycemia, heart disease, nerve damage and amputation, and
vision problems. According to Vinik & Vinik (2003), chronic complications
can be devastating to patients with diabetes mellitus. The major cause of
morbidity and mortality among these patients, are the complications like
Cardiovascular illness, macrovascular disease, with heart attacks, strokes,
and gangrene; and microvascular disease, with retinopathy, nephropathy, and
neuropathy (P. 571). PICOT Question Nursing Paper
By SN Ijeoma Amaoji – T2 2020
T Within one year of being diagnosed.
In most cases, people are diabetic for quite a while without knowing before
receiving the actual diagnosis for it. Complications are said to begin to
develop after having diabetes for a number of years. I chose the time of one
year in consideration to the actual length of time they must have developed
diabetes without knowing. There are no set time frame for complications to
start occurring. It all depends on how uncontrolled the management has
been. The duration of diabetes and the degree of glycemic control achieved
are noted to be risk factors for complications (Nickerson & Dutta, 2012).
Selvin, E., & Parrinello, C. M. (2013). Age-related differences in glycemic control in diabetes.
Diabetologia, 56(12), 2549–2551. https://doi.org/10.1007/s00125-013-3078-7
Hasanzade, F., Toliat, M., Emami, S. A., & Emamimoghaadam, Z. (2013). The Effect of
Cinnamon on Glucose of Type II Diabetes Patients. Journal of traditional and complementary
medicine, 3(3), 171–174. https://doi.org/10.4103/2225-4110.114900
Home, P., Riddle, M., Cefalu, W. T., Bailey, C. J., Bretzel, R. G., Del Prato, S., Leroith, D.,
Schernthaner, G., van Gaal, L., & Raz, I. (2014). Insulin therapy in people with type 2 diabetes:
opportunities and challenges? Diabetes care, 37(6), 1499–1508. https://doi.org/10.2337/dc13-
Vinik, A. I., & Vinik, E. (2003). Prevention of the complications of diabetes. The American
journal of managed care, 9(3 Suppl), S63–S84. Retrieved from
Nickerson, H. D., & Dutta, S. (2012). Diabetic complications: current challenges and
opportunities. Journal of cardiovascular tran