Question

Choose one case study, and formulate one searchable, clinical question in the PICO(T) format. There are several potential questions that could be asked. Identify whether the focus of your question is assessment, etiology, treatment, or prognosis. Remember to integrate references.

An 80?year?old retired army officer, staying alone, has type 2 diabetes for the last 12 years and renal function test was normal and patient was on insulin along with other OHAs. Despite this, the patient was getting attacks of hypoglycemia, which scared the patient of unconsciousness and even death. The limiting factors were that the patient was staying alone and was dependent upon an attendant to get injections. During the weekends or holidays, the attendant was not on a regular time, and this led to irregular insulin injections, causing hypoglycemic episode to patient. This patient as well was put on insulin degludec and over a period the dose of degludec was also increased. His HbA1c and fasting blood glucose level improved without any episode of hypoglycemia. The outcomes of this case are that degludec along with dietary modifications gave desired diabetes control without any hypoglycemia.

Answer 1

PICO(T) is an evidence-based practice used to frame a clinical question.

P - Patient/Problem An 80-year-old patient with type 2 diabetes.

I - Intervention/Indicator Put on degludec insulin.

C - Comparision/Control Oral Hypoglycemic agents.

O - Outcome Control of diabetes without any hypoglycemia.

Problem statement:

An 80-year old man with type 2 diabetes (patient), how effective is degludec insulin (Intervention), compared to oral hypoglycemic agents (comparison), in controlling of diabetes without any hypoglycemia (Outcome).

Intervention:

In 80-year old retired man with type 2 diabetes (patient), what is the effect of degludec insulin(Intervention), on control of diabetes without any hypoglycemia(Outcome), compared to Oral Hypoglycemic agents(comparison)?

Etiology:

Are the Old man(P) who have type 2 diabetes on OHA(I) are increased the risk for hypoglycemia(O) compared with diabetic patients(P) without any anti-diabetic drugs(C).

Prognosis:

Does the degludec insulin(I), influence in the old man with type 2 diabetes(P), improve diabetic control without any hypoglycemia(O).