The prevalence of the various forms of diabetes has led to increased research on the condition to find the best possible ways of improving the lives of diabetic persons. The evidence-based practise in diabetics range from diagnosis, interventions, and education and management activities. Evidence-based operations on diabetes have long time been documented.
Evidence-Based Tests and Diagnosis of Diabetes
Research has shown that all the diagnosis activities of any condition should be carried out in a health facility by a qualified doctor. Evidence indicates that over the years, multiple diagnostic approaches have been devised. Research indicate that four main methods are used in diagnosing diabetes in the U.S. A1C approach measures the average blood sugar for the past 1-3 months ( Kumar et al., 2016) . The results of the tests are explained in that a person has a normal sugar level when the average of sugar in the blood is below 5.7%, pre-diabetic when the results read between 5.7% and 6.6% and diabetics if the A1C tests read 6.5% or higher.
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The second approach is the Fasting Plasma Glucose (FPG). The approach checks the sugar levels in the plasma when one has not eaten anything for at least eight hours. Evidence shows that the test is best done early in the morning ( Kumar et al., 2016) . The body sugar level results of the test are interpreted as normal when the glucose in the plasma is 100mg/dl or less, Pre-diabetic when the reading is between 100mg/dl and 125mg/dl and diabetics when the reading is above 125mg/dl. The third test is the Oral Glucose tolerance test (OGTT). The OGTT tests evaluate how the body process sugar. A person has to take a special sweet drink 2 hours before the test is done. After the 2hrs one can be diagnosed with diabetes if the reading is greater than 200mg/dl, normal when the readings are 140 mg/dl and less and pre-diabetic when the reading is between 140mg/dl and 199mg/dl. Casual plasma glucose tests are undertaken when a person has severe diabetes symptoms. The test is carried out randomly and one is diagnosed diabetic if the test reading is greater than 200mg/dl.
Evidence-Based Treatment of Diabetes
Long term studies show that for type 1 diabetes, insulin is used as the mainstay treatment strategy. Evidence indicates that type 1 diabetes is a condition where one fails to secrete insulin a hormone used in regulating blood sugar. Insulin administration mimics the natural process of pancreatic insulin secretion. It is a treatment method that is combined with other activities such as exercise to treat type 1 diabetes. Researchers have emphasized on developing different types of artificial insulin. The different insulin types have been tailored to optimize glucose control. Rapid-acting insulin such as lispro takes effects in 5 minutes after administration. Regular insulin takes effects after about 30 hours and lasts up to 6 hours. Intermediate-acting insulin takes about 3 hours to take effect. Long-acting insulin takes up to 6 hours to take effects and can last for a day ( Hilliard, Powell, & Anderson, 2016) .
Evidence indicates medication and management approaches are the most approach to control type 2 diabetes. For type 2 diabetes, doctors prescribe different treatment approaches which include the use of medications, diet, exercises and weight loss ( Kumar et al., 2016) . Evidence indicates that medication is an effective way of treating diabetes. Medications are used to increase insulin secretion by the body, control the amount of glucose released by the liver, increase cell sensitivity to insulin and decreasing carbohydrate absorption.
American diabetes association and the FDA have authorized the use of metformin, sulfonylureas, meglitinides, thiazolidinediones, alpha-glucosidase inhibitors, DPP-4 inhibitors, SGLT2 inhibitors and GLP-1 receptors ( Kumar et al., 2016) . All these types of medications are used for different underlying reasons. The medications can also be used in combination.
Evidence indicates that a combination of some of the above medication is used in treatment for type 2 diabetes. Examples of such combination are the glyburide/metformin, metformin/sitagliptin ( Kumar et al., 2016) . The combinations of all these types of medications are beneficial in that they improve cell compliance and also reduces the number of pills taken at a time.
Management and Education
A systematic approach today is being applied to support patients’ behaviour change as a way of managing diabetes. Lifestyle choices, self-management, and prevention of complications are the three main approaches used in the management of diabetes. Available studies show that when diabetes is properly managed then the patients have a chance of survival and avoid chronic diseases closely relating to diabetes.
Making healthy lifestyle changes after being diagnosed with diabetes has proven key to managing the condition. Available data show that conditions such as lack of physical activities, smoking, excess weight, and unhealthy eating can cause complications for diabetic people. Physicians and nutritionist advice patients to choose a healthy lifestyle. Research indicates that healthy eating which avoids unnecessary foods with excess calories such as soda can go a long way in managing diabetes. Weight management for diabetic persons is a great concern for healthcare providers. Diabetes patients are required to observe their weights. Patients are educated to engage in physical activities at least 30 minutes at least five days a week. Research indicates that smoking can help in the management of diabetes ( Hilliard, Powell, & Anderson, 2016) .
Evidence indicates that engaging in self-management activities such as medications management, glucose monitoring and blood-pressure help in managing the condition ( Worswick et al., 2013) . While pre-diabetic patients are advised to use nutritional approaches to manage the condition, some diabetic patients use medication to help in managing the conditions. Research indicates that following the medication prescriptions and regular check-ups help manage the diabetic condition. Glucose self-monitoring practices have proven successful as a way of checking blood sugar levels. Patients who use insulin have been provided with glucose monitoring gadgets that help in monitoring glucose. In addition patients have been educated on how to use the blood pressure monitoring tools.
Evidence indicates that regular check-ups can help in preventing diabetes complications. Studies show that patients with chronic diabetes are at risk of getting complications such as heart, eyes, foot and renal problems ( Hilliard, Powell, & Anderson, 2016) . Patients are therefore required to engage in monitoring foot health and screening for eyes.
According to Hilliard, Powell, and Anderson, (2016), diabetes self-management education (DSME) has demonstrated important in glucose control, satisfaction and overall self-management for patients. Patient education on how to manage diabetes include an integrated approach that includes behavioral strategies, clinical content and engaging in psychological concerns.
References
Hilliard, M. E., Powell, P. W., & Anderson, B. J. (2016). Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families. American Psychologist , 71 (7), 590.
Kumar, R., Nandhini, L. P., Kamalanathan, S., Sahoo, J., & Vivekanadan, M. (2016). Evidence for current diagnostic criteria of diabetes mellitus. World journal of diabetes , 7 (17), 396.
Worswick, J., Wayne, S. C., Bennett, R., Fiander, M., Mayhew, A., Weir, M. C, & Grimshaw, J. M. (2013). Improving quality of care for persons with diabetes: an overview of systematic reviews-what does the evidence tell us? Systematic reviews , 2 (1), 26.
