Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis

Abstract

Objective:to identify evidence in the literature on the possible risk factors for the risk of unstable blood glucose diagnosis in individuals with type 2 diabetes mellitus, and to compare them with the risk factors described by NANDA International. Method:an integrative literature review guided by the question: what are the risk factors for unstable blood glucose level in people with type 2 diabetes mellitus? Primary studies were included whose outcomes were variations in glycemic levels, published in English, Portuguese or Spanish, in PubMed or CINAHL between 2010 and 2015. Results:altered levels of glycated hemoglobin, body mass index>31 kg/m2, previous history of hypoglycemia, cognitive deficit/dementia, autonomic cardiovascular neuropathy, comorbidities and weight loss corresponded to risk factors described in NANDA International. Other risk factors identified were: advanced age, black skin color, longer length of diabetes diagnosis, daytime sleepiness, macroalbuminuria, genetic polymorphisms, insulin therapy, use of oral antidiabetics, and use of metoclopramide, inadequate physical activity and low fasting glycemia. Conclusions:risk factors for the diagnosis, risk for unstable blood glucose level, for persons with type 2 diabetes mellitus were identified, and 42% of them corresponded to those of NANDA International. These findings may contribute to the practice of clinical nurses in preventing the deleterious effects of glycemic variation.

Nursing Diagnosis Risk for Unstable Blood Glucose Level in Patients with Diabetes Mellitus

“…Seven studies presented the concept of unstable blood glucose (Akirov, Diken-Cohen, Masri-Iragi, & Shimon, 2017;Cavalot, 2013;Deane & Horowitz, 2013;Fabris et al, 2014;Hirsch et al, 2012;Sertbas et al, 2017;Teixeira et al, 2017). Glycemic variability is a term used for diabetic patients who have similar mean glucose levels in varying degrees, leading to episodes of hyperglycemia and hypoglycaemia (Sertbas et al, 2017).…”

“…The developers of this taxonomy value studies aiming at validating and improving its diagnoses in specific populations and contexts in order to increasingly improve the taxonomy, by the recognition of altered human responses, thereby contributing to a more effective nursing care (Herdman & Kamitsuru, 2017). Teixeira, Tsukamoto, Lopes, and Silva (2017) found in their study risk factors of unstable blood glucose level in people with type 2 diabetes that are not listed in the current version of the NANDA-I classification, such as age, black race, delayed diagnosis of diabetes, daytime sleepiness, macroalbuminuria, genetic polymorphisms, use of insulin, use of oral antidiabetic drugs, use of metoclopramide, inadequate physical activity, and low fasting glucose.…”

Development of a clinical protocol for detection of cervical cancer precursor lesions

“…During the evaluation of articles, an instrument adapted from the literature was used to extract the data 10 , including the following items: identification of the original article; methodological characteristics of the study; evaluation of methodological rigor; interventions measured; and the results found in the study. For analysis and subsequent synthesis of the articles that met the inclusion criteria, a synoptic table was used to present data, also adapted and specially prepared for this purpose, including the following aspects: title of the research; authors’ name; intervention studied; results; recommendations; and conclusions 10 . It is noteworthy that during the elaboration of the clinical guideline, the levels of evidence and degrees of recommendation were used to classify the evidences found 11 .…”

Desempenho De Pessoas Com Diabetes Mellitus Na Insulinoterapia

“…O Instituto para Práticas Seguras no Uso de Medicamentos classifica todos os tipos de insulinas exógenas como potencialmente perigosos pelo alto risco de danos decorrentes de falha no processo de utilização (5) . O risco de glicemia instável é potencializado pelo uso inadequado da insulina, pois além do descontrole da hiperglicemia, podem ocorrer episódios de hipoglicemia, complicação aguda que pode ser fatal (1,6) .…”