Disease Description
Diabetes mellitus is a chronic metabolic disorder that imposes a substantial health burden across the globe. The most vulnerable are adversely affected more than any other group. With advancements in healthcare, it is dynamic that social factors, cultural differences, and access barriers are to blame for diabetes being higher and more complicated among vulnerable people.
Learning about these issues and evidence-based research is the foundation for developing successful policies and interventions. Through this, the existing inequalities will be removed, and the health of the people vulnerable to diabetes will flourish. Thus, this paper will focus on diabetes rates among vulnerable populations and conclude that evidence-based practice models should be used.
Clinical Problem
Vulnerable groups, such as people with LSM, fall into the category of the population that also includes racial and ethnic minorities and those who face access issues to health services. Diabetes among these populations increases in prevalence towards severity. Socioeconomic barriers, such as poverty, inadequate education, and underdeveloped healthcare, compromise the health of the most vulnerable individuals (Hill-Briggs et al., 2021).
Many of these populations have trouble obtaining food that is as nutritious as their own, live in unsafe conditions, and have access to higher-quality health care services that are vital for controlling diabetes. Alongside that, language and cultural obstacles make communication with health care providers more challenging and cause people to not take the treatment as a priority, which makes diabetes critically worse.
The clinical problem is the statistical data that represent the diagnosis and the precise, correct monitoring and treatment of the disease. Particularly susceptible individuals also achieve fewer benefits from anti-diabetic drugs. Thus, they have poorer glycemic state control, increased diabetes-related complications, and higher mortality (Rogvi et al., 2021).
In the dark light of these problems, stressors of the environment, such as a limited amount of food as well as the less probable chances of physical activity, only result in a higher risk of diabetes and many of the associated comorbidities. Clinical diabetes problems faced by vulnerable groups can only be resolved through a comprehensive evaluation of the socioeconomic, cultural, and environmental determinants responsible for the disease.
Literature Review
The literature on diabetes and vulnerable populations makes clear that social determinants, accessibility, and healthcare are, in the end, intricate problems. Hill-Briggs et al. (2021) point out that socioeconomic determinants, such as salary, education levels, and environment, contribute to health inequalities in diabetes outcomes. The assuredness is typically instrumental, coupled with the diagnosis of the disease and the provision of effective therapeutics. Furthermore, Lee (2023) demonstrates that the relationship between the population and diabetes care is exceptionally high among the elderly. It demonstrates the importance of tailoring intervention measures to specific demographic groups.
Moreover, vulnerable populations have limited access to necessary medical care. Taylor (2020) investigated the high cost of diabetes medications and how this factor, along with other difficulties, impacts the lives of less fortunate people. Additionally, Rogvi et al. (2021) discuss the challenges of providing care to vulnerable people with type 2 diabetes, highlighting the importance of patient-centered care and support services.
Finally, the adoption of evidence-based approaches by remote healthcare providers will be crucial to diabetes management among these populations. Dusin et al. (2023) outline various models and frameworks for scientific evidence-based practice implementation within healthcare systems. It must focus on collaboration among the best possible evidence, practical nursing experience, and patient preferences to improve health outcomes. These studies offer a holistic perspective on diabetes care, calling for consideration of social, economic, and clinical factors to address disparities.
Theoretical Framework
The Social Determinants of Health (SDH) theory sheds light on the complex, multidimensional nature of diabetes inequities in vulnerable communities by applying a wide-angle conceptual framework. SDH highlights the contribution of social, economic, and environmental factors to an individual’s health status (Hill-Briggs et al., 2021). One of the critical elements of the SDH paradigm is socioeconomic status (SES), which includes income, education, job opportunities, and resources.
Studies conducted worldwide show a fairly robust relationship between lower socioeconomic status and higher rates of diabetes prevalence and complications (Rogvi et al., 2021). People with fewer financial means could have difficulty affording food, medications, and other diabetes-related treatments, which could make them miss timely treatment, resulting in inadequate glycemic control.
In addition, the SDH framework highlights social and environmental determinants that are significant predictors of health outcomes. Many at-risk populations live in regions without stores that carry healthy food, and fast-food restaurants are the only option. Moreover, the cost of diabetes medications, such as insulin, is usually high for people without health insurance (Taylor, 2020).
SDH makes the point that how people seek and use care, and the quality of that care, are important factors in shaping diabetes outcomes. Vulnerable populations may lack access to healthcare services due to a lack of health insurance, transportation challenges, and difficulty finding providers who speak their language (Lee, 2023). Furthermore, implicit bias and bias in health systems among racial and ethnic minorities might be the reason for misdiagnosis, inappropriate treatment, and worse outcomes for patients with diabetes.
Evidence-Based Practice Model
Evidence-based practice (EBP) is one of the models proposed by the Johns Hopkins EBP Nursing model. It offers a standardized system that integrates the most recent empirical evidence, clinical practice, and patient preferences to develop care plans for the vulnerable diabetic population (Dusin et al., 2023). It indicates a systematic approach to describing problems, analyzing existing evidence, and implementing best practices.
Diabetes management in vulnerable populations could include exploring factors that affect glycemic control, such as access to healthcare services and medication adherence challenges. The clinical problem under investigation must be determined first before going to the library or the internet to search for credible evidence (Dusin et al., 2023). Nurses conduct systematic reviews of the existing literature using evidence-based methodologies. After this critical assessment, they define the application to vulnerable contexts of people with diabetes.
Once the evidence is analyzed, the cardinal principle of the Johns Hopkins EBP model is teamwork among the interdisciplinary group to determine and implement evidence-based interventions. It incorporates decision-making that uses relevant research evidence and the patient’s preferences and values (Dusin et al., 2023). Consequently, the Johns Hopkins EBP Model emphasizes the importance of assessing the effectiveness of implemented measures and further enhances this knowledge by using this information to inform future practice. Nurses do not cease monitoring and reviewing the effects of evidence-based interventions on diabetes outcomes among disadvantaged people (Dusin et al., 2023). It aims to develop care processes further to achieve the desired results and eliminate disparities.
References
Dusin, J., Melanson, A., & Mische-Lawson, L. (2023). Evidence-based practice models and frameworks in the healthcare setting: A scoping review. BMJ, 13(5), 1-9.
Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., Thornton, P. L., & Haire-Joshu, D. (2021). Social determinants of health and diabetes: A scientific review. Diabetes Care, 44(1), 258-279.
Lee, S.-H. (2023). The growing challenge of diabetes management in an aging society. Diabetes & Metabolism Journal, 47(5), 630-631.
Rogvi, S.A., Guassora, A.D., Wind, G., Tvistholm, N., Jansen, S. M-B., Hansen, I. B., Perrild, H.J.D., & Christensen, U. (2021). Adjusting health care: practicing care for socially vulnerable type 2 diabetes patients. BMC Health Services Research, 21, 1-9.
Taylor, S. I. (2020). The high cost of diabetes drugs: Disparate impact on the most vulnerable patients. Diabetes Care, 43(10), 2330-2332.