Evidence Based Practice - Diabetes. Health, Medicine, Nursing Essay

        Evidence Based Practice - Diabetes Name Institution Course Date   In the research study by Meloni, DeYoung, Han, Best & Grimm (2013), the researchers sought to identify the treatment options most useful in meeting the glycemic and cardiovascular in patients with type 2 diabetes mellitus. The aim of the study was to determine the effectiveness of weekly dose of exenatide once weekly compared with oral glucose-lowering medications or insulin glargine in treating and managing diabetes type 2. Exenatide (Byetta, Bydureon) is an incretin mimetics, which stimulates the insulin secretion from the pancreas, while insulin glargine (Lantus) is used to control the high blood sugar levels in both diabetes type 1 and 2 and especially in type 1 where the body does not produce insulin. The exenatide once weekly (QW), acts similar to the natural incretins the hormones, which stimulate the secretion of insulin when there is food intake (Nauck, 2016). They also inhibit glucagon secretion, which reduce intestinal motility and increase the feeling of gastrointestinal fullness, reducing the sensation of hunger. If there is greater reduction in the hemoglobin A1c levels then the HbA1c glycemic goal is met ,  and the results favored the use of exenatide to meet  the goal of HbA1c goals of <7.0% and ≤6.5% when compared to the sitagliptin, pioglitazone, or insulin glargine  options (Meloni et al., 2013).  The differences in results were compared for exenatide QW vs metformin, exenatide QW vs sitagliptin, exenatide QW vs pioglitazone and exenatide QW vs insulin glargine interventions (Meloni et al., 2013).              Exenatide was not only effective in improving glycemic control it was associated with unstained loss of body weight and lower the risk of hypoglycemia when compared with of insulin glargine. Achieving glycemic control has a positive impact on the morbidity and mortality of those with diabetes, high blood pressure and those at risk of cardiovascular diseases. The HbA1c (glycated hemoglobin) is the parameter, which reflects the glycemia (blood glucose level) and predicts the risk of complications among patients with diabetes. A HbA1c value <6.5% is the tight glycemic control level, which is associated with low risk of hypoglycemia. In the 26-week, randomized, controlled trial study, the researchers positive results from the weekly use of exenatide (EQW), compared to the daily use of oral glucose-lowering medication or  insulin glargine, administered in combination with other medications like sulfonylureas, thiazolidinedione and metformin to treat Type 2 Diabetes. In 2011 the FDA app...