Date of Award

1-1-2015

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Ruth McCorkle

Abstract

Abstract

Purpose

The purpose of this project was to develop an evidence-based educational program to reduce hypoglycemic events in elderly veterans with type 2 diabetes mellitus (T2DM) enrolled in the Veterans Healthcare Administration system. US elderly persons are especially affected by T2DM and at great risk for complications. Until recently, tight glycemic control has been advocated to avoid hyperglycemic events. However, this approach has been shown to have no major benefit but instead has resulted in increased hypoglycemic events, morbidity, and mortality. Hypoglycemia is now seen to be the most serious complication in the treatment of T2DM in all adults, and is especially dangerous in elderly persons. Updated guidelines have emphasized the importance of hypoglycemia prevention and recommend individualized and less stringent glycemic control.

Methods

We conducted a comprehensive literature review, which led to the development of evidence-based content for an educational program. Several categories and sub-categories of content were identified and subsequently evaluated by a panel of experts in the field of diabetes management. Expert evaluations were summarized and informed program development.

Results

Experts were unanimous on the importance and relevance of the categories and provided insight into the priority of sub-categories of content.

Conclusions

Developing an evidence-based educational program for health care providers on prevention of hypoglycemia has important clinical implications. The rigorous process used in this project can serve as a model for developing educational programs on other topics.

Key Words: hypoglycemia, type 2 diabetes, educational program, veterans, elderly.

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