Risk factors for unstable blood glucose level: integrative review of the risk factors related to the nursing diagnosis.
Andressa Magalhães Teixeira, Rosangela Tsukamoto, Camila Takáo Lopes and 1 others
PMID 28591300WHAT IT FOUND
Nurses assessing people with type 2 diabetes should watch for updated risk factors for unstable glucose, including diabetes management, mental status, comorbidities, weight loss, insulin therapy, and exercise.
The review did not test whether this improves outcomes.
Key findings
01The review included 22 primary studies and identified 19 risk factors for unstable blood glucose in people with type 2 diabetes.
02Eleven of the identified risk factors were not in the NANDA-I classification, and correspondences were found with six NANDA-I risk factors.
03The review also linked lower glucose risk to age, longer diabetes duration, insulin therapy, oral antidiabetic agents, macroalbuminuria, inadequate physical activity, and genetic factors.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The search was limited to 2010 to 2015, to Portuguese, English, and Spanish, and to primary studies, so relevant newer or other-language evidence may be missing. Gray literature was not included, so unpublished studies were not reviewed. The included studies were too heterogeneous to combine statistically, so no meta-analysis was done. The link between African-American ethnicity and hypoglycemia came from one study, so it should be read cautiously. The review did not test whether using these risk factors improves patient outcomes.
The easy way to misread this
Do not read the list as proof that these factors cause unstable glucose or that nurses can use it to predict outcomes. The evidence came from 22 heterogeneous studies, and the review did not test patient outcomes.