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Dissertation - Help

Jo C C

Member
Messages
6
Type of diabetes
Researcher
Treatment type
Diet only
Hi,

I'm a 3rd year student nurse - Adult field I'm interested in doing my dissertation on Diabetes my initial idea for my topic was;
Lifestyle and health behaviours of adults with type 1 diabetes. I met with my dissertation supervisor on Friday and they advised me that I may struggle when I come to the application in practice part which is where I a student nurse has to identify a service improvement for my patients. My supervisor pointed out in acute hospitals that diabetes is not always managed correctly so how would I has a student be able to improve this. If anyone has any other thought/ideas on a topic I could do around diabetes & service improvements I would really appreciate them :)

Kind Regards
Jo
:banghead::banghead::banghead: -stressed student nurse
 
Hello Jo.
You will learn a lot looking at threads in this forum,a lot of people think diabetics just stay off sugar,all the best.
 
understand that carbohydrate = insulin =fat
insulin puts fatty acids into cells as triglycerides, insulin deficiency takes it out as fatty acid
 
Last edited by a moderator:
Hi Jo and welcome to the forum.

TBH patient care has come on a long way in recent times for type 1's in hospitals, once over you had to rely on the nursing staff to give you your insulin as you weren't allowed to have your own by your bed, now they are quite happy to let you inject and test your own bg.

I can't think of anything at the moment, so good luck with your dissertation and hope other members can come up with a few suggestions.
 
Not sure exactly what you need but some thoughts:
1) Need to guide older longer-term T1s onto pens and carb-counting where they may still be on older regimes. This, or course, should only be done where there is BS control need, ease of use and the user wants to move on.
2) Need to ensure that users understand that it isn't insulin that causes weight-gain but too many carbs with too many shots; help users understand this and that excess weight will affect insulin swings and so on.
3) Let an inpatient do their own insulin with guidance where needed and where the user has some understanding. Don't just do sliding-scale stuff and mess up as some posts have demonstrated
4) Ref 2) above try to ensure where possible that meals and drinks aren't over-carby. This means low-carb not low-fat e.g. avoid orange juice and similar
5) If you have only recent experience of diabetes then do listen to the user who may know more and/or ask someone who has more experience

Some of the above apply more to clinics rather than acute. I've had some excellent local surgery and hospital nurse management of my diabetes, but we sometimes see some horror stories in forum posts
 
I think that a lot of people who have experienced it, seem to be concerned about the use of 'sliding scales' (although that term is apparently not supposed to be used now) ie variable rate IV insulin to manage peoples glucose according to a protocol in hospital.
There are anecdotal reports of people being kept on these when they are back to eating normally. They don't work in this situation as they are reactive rather than proactive.
Personally, I'm concerned as to whether there are always policies in place on the use of an insulin pump. More of us have them now but how many nurses understand their use.
Simple things are also important, I've read of people having hypos and the ward having no fast glucose available to treat it.
 
Hi Jo and welcome to the forum.

TBH patient care has come on a long way in recent times for type 1's in hospitals, once over you had to rely on the nursing staff to give you your insulin as you weren't allowed to have your own by your bed, now they are quite happy to let you inject and test your own bg.

I can't think of anything at the moment, so good luck with your dissertation and hope other members can come up with a few suggestions.
This information is invaluable your very kind for replying, thanks you so much:)
 
I think that a lot of people who have experienced it, seem to be concerned about the use of 'sliding scales' (although that term is apparently not supposed to be used now) ie variable rate IV insulin to manage peoples glucose according to a protocol in hospital.
There are anecdotal reports of people being kept on these when they are back to eating normally. They don't work in this situation as they are reactive rather than proactive.
Personally, I'm concerned as to whether there are always policies in place on the use of an insulin pump. More of us have them now but how many nurses understand their use.
Simple things are also important, I've read of people having hypos and the ward having no fast glucose available to treat it.
My supervisor said one her previous students had done their dissertation on the benefits of insulin pumps as apposed to pens, I will definitely consider this thank you so much.
Jo
 
Not sure exactly what you need but some thoughts:
1) Need to guide older longTer-term T1s onto pens and carb-counting where they may still be on older regimes. This, or course, should only be done where there is BS control need, ease of use and the user wants to move on.
2) Need to ensure that users understand that it isn't insulin that causes weight-gain but too many carbs with too many shots; help users understand this and that excess weight will affect insulin swings and so on.
3) Let an inpatient do their own insulin with guidance where needed and where the user has some understanding. Don't just do sliding-scale stuff and mess up as some posts have demonstrated
4) Ref 2) above try to ensure where possible that meals and drinks aren't over-carby. This means low-carb not low-fat e.g. avoid orange juice and similar
5) If you have only recent experience of diabetes then do listen to the user who may know more and/or ask someone who has more experience

Some of the above apply more to clinics rather than acute. I've had some excellent local surgery and hospital nurse management of my diabetes, but we sometimes see some horror stories in forum posts

Thanks for this its really useful :)
 
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