GUIDELINE AND IMPLEMENTATION
CLC – EBP Develop Clinical Guideline and Implementation Plan
Studies have shown that diabetic patients can have difficulty regulating their glucose
levels when stress impacts their life. T
...
GUIDELINE AND IMPLEMENTATION
CLC – EBP Develop Clinical Guideline and Implementation Plan
Studies have shown that diabetic patients can have difficulty regulating their glucose
levels when stress impacts their life. The information given in this paper describes the
development and implementation of stress reduction techniques for diabetic patients to help with
glycemic control.
Problem Statement
It is widely known that stress has many negative effects on the human body. “The
experience of stress is associated with the release of counter-regulatory hormones and energy
mobilization, often resulting in elevated glucose levels…Several studies have demonstrated a
relationship of stress to glycemic control in samples of patients with type 2 diabetes” (Surwit,
Van Tilburg, Zucker, McCaskill, & Parekh, 2002). In fact, even in healthy persons, acute
psychological stress does impact glucose control and it has been found that even the anticipation
of stress can raise blood glucose in Type II diabetics (Faulenbach, Utoff, Schwegler, Spinas,
Schmid, & Wiesli, 2011). These elevated glucose levels further exacerbate the disease and make
it more difficult to control. Therefore, by identifying these stressors early, patients can receive
education on how to manage and lower these stress factors for better glycemic control.
Evidence-Based Practice Question
"How does psychological stress affect the blood glucose and well-being in diabetic
patients?"
Literature Review
Searches for peer reviewed research articles were conducted through GCU library database.
Search words included diabetes, stress, diabetic related stress, psychological stress, effect of
stress on glucose metabolism, teaching stress management, and comorbidity in diabetes. Thirty2
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GUIDELINE AND IMPLEMENTATION
five articles initially met the inclusion criteria, the articles spanned period from 1980 to the
present. These were fine-tuned to reflect more recent publications in the past 15years. The 8
articles reviewed in this research assignment made the final list. All the articles except 2 were
from primary sources, the two that were not, were as a result of systematic literature review.
Adili, et al (2006) searched eight different databases including Pub-Med, CINAHL, Proquest,
Elsevier, Blackwell Synergy, Ovid, Ebsco, Rose net and Google. Criteria were then selected by
peer-reviewed journals from 1995-2006 using certain key words. Studies were then classified per
psychological problem, type of intervention and target population. The benefits of interventions
were determined and discussed. Friis, et, al (2015) utilized similar approach including 14
randomized, controlled trials to evaluate psychotherapy, pharmacotherapy, and collaborative care
in 1,724 diabetes patients with comorbid depression. The study showed moderate effects for
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