Symptom Experience of Older Adults With Type 2 Diabetes and Diabetes-Related Distress.
Lenore Hernandez, Heather Leutwyler, Janine Cataldo and 3 others
PMID 31465305WHAT IT FOUND
Older adults with type 2 diabetes and distress said fatigue, low blood sugar, diarrhea, pain, and falls limited daily life.
Ask about medication side effects and fear of falling when teaching self-care.
Key findings
01Twelve participants described fatigue, including being too tired to complete tasks and taking small energy bottles to clean one room.
02Ten participants reported hypoglycemia, and severe incidents led to falls and decreased level of consciousness.
03Eight participants experienced diarrhea; some attributed it to metformin, self-modified doses, or took antidiarrheals while providers continued increasing metformin despite objections.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Sixteen participants were recruited by convenience sampling, so the findings may not represent all older adults with type 2 diabetes. The sample was mostly White, and the authors note that cultural background can influence how symptoms are experienced and expressed. Medication information was based on self-report and a daily pill count, not a systematic medication review, so links between metformin, other drugs, fatigue, hypoglycemia, diarrhea, or falls cannot be established. Participants were selected for moderate or greater diabetes-related distress, so their symptom burden may be higher than in people with less distress. This is a qualitative symptom experience study, not a treatment trial, so it cannot show that any intervention will reduce symptoms or improve outcomes.
Declared interests
The authors declared no conflicts of interest. The article text does not state who funded the study or whether a sponsor designed or wrote it.
The easy way to misread this
Do not conclude that metformin caused these participants' diarrhea or that time-release metformin will improve symptoms. The study only reports some participants' beliefs and self-adjusted doses; it did not test medication effects or outcomes.