Benchmark Assignment: EBP Project-Paper on Diabetes

Benchmark Assignment: EBP Project-Paper on Diabetes

Benchmark Assignment EBP Project-Paper on Diabetes

            Diabetes is one of the leading causes of mortality in the United States of America. A number of risk factors predispose people to developing diabetes (Johnson et al., 2018). With the rising prevalence rate of obesity in the United States of America, concerns have been raised about the difficulty to distinguish type 1 diabetes (T1D) from type 2 diabetes (T2D) among young adults. TID is an autoimmune disease that can occur at all ages and people with the condition are more likely to be obese. With the rising incidences if obesity, more young populations are developing T2D (Eakin et al., 2014). Due to inaccuracies in autoantibody measurements among young adults, it is difficult to diagnose a specific kind of diabetes for the population. As such, genetic risk score (GRS) has been developed to identify T1D and T2D among young adults diagnosed with obesity. However, the use of GRS to identify autoimmune diabetes is challenging due to a cluster of autoimmune diseases associated by polygenic risk and islet. Therefore, the subsequent illustration is based on the analysis of the research done on GRS, the associated clinical findings and their relevance in nursing practice for patients with diabetes.

            In any clinical setting, it is important for nurses and other health workers to identify the type of a given diabetes to facilitate planning of treatment accordingly. The GRS is one of the novel tools that is readily used to discriminate monogenic from type 1 diabetes to facilitate in the development of a diagnosis for diabetes. According to Bonifacio et al. (2018), the tool measures 30 genetic variants of DNA in a person and combines all the potential risks with a single score to predict diabetes. If the score of genetic risk is high, then a person is likely to have a T1D. On the other hand, in the event that the score is low, a person will be predisposed to T2D.

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            The GRS works on a principle of identifying the common genetic variants for type 1 diabetes and type 2 diabetes. According to findings by Layton et al. (2018), a monogenic autoimmune condition occur during the very-early-onset of diabetes. The study

indicates that individuals are likely to develop infantile-onset multisystem autoimmune diabetes due to mutations of the dominant gain-of-function STAT3 or as are result of recessively inherited LRBA. However, Thomas et al. (2018) postulates that some people host a causative mutation for a single gene for the very-early-onset diabetes which indicates that they have a strong polygenic risk of developing an autoimmune disease. Moreover, the study illustrates that autoimmune disease results from a shared predisposing genetic loci. Accordingly, Oram et al. (2016) affirm that HLA-DR3 haplotype is related to the development of type 1 diabetes due to its strong correlation with HLA-DQ2 haplotype. Besides, outside the region of HLA genes, the IL2RA polymorphism rs706778 are strongly linked to increased risk of type 1 diabetes and the onset of autoimmune disorders.

            Johnson et al. (2018) illustrate that GRS is used for calculating factors predisposing one to diabetes by genotyping the top risk alleles followed by a summation of their effective weight so as to assign a numeric score. Furthermore, the researcher argues that despite being present in people with monogenic autoimmunity, islet autoantibodies are considered to be highly discriminatory for type 1 diabetes as compared to type 2 diabetes. In essence, GRS can be used to distinguish between monogenic autoimmunity and polygenic clustering which are vital in the development of an autoimmune disease. 

            According to Oram et al. (2016), current diagnostic tests used to categorize subtypes of obesity have limitations. For example the use of autoantibodies to diagnose diabetes cannot be used as perfect discriminators to classify different types of diabetes among young adults. Besides, the study indicates that islet autoantibody positivity is lower for persons diagnosed with type 1 diabetes especially if such individuals are tested after diagnosis. However, studies by Layton et al. (2018) affirm that the measurement of endogenous insulin, particularly using serum of C-peptide assessments can be accurately used to distinguish TID from T2D. Guided by this premise, Johnson et al. (2018) suggest that genetic components that makes one susceptible either to T1D or T2D can be measured through the assessment of single nucleotide polymorphism (SNP). According to the author, HLA regions are considered to have strong risks as well as protective alleles for developing type 1 diabetes. Moreover, the researcher posits that SNP genotyping approach can be accurately used to capture the high risk DR3 and DR4-DQ8 alleles potential in causing T1D.  The GRS is used to record the genetic scores of SNPs to classify patients into the sub-groups of diabetes. Findings by Layton et al. (2018) indicates that 40 SNPs found outside the HLA regions are associated with the risk of TID. However, high-risk HLA genotypes of over 69 SNPs have been linked to the development of T2D (Thomas et al., 2018).

            According to Bonifacio et al. (2018), use of genetic risk score provide a simple but yet a very inexpensive test to distinguish type 1 diabetes from type 2 diabetes. Specifically, the GRS helps to classify individuals who require insulin treatment by assessing the possibility of a deficiency. Besides, GRS help to identify patients considered to have monogenic etiology for them to be classified as having type 1 diabetes or type 2 diabetes to help in prompt intervention.

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Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource