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

PICOT is aquestion format which helps in giving answers to research based questions.P-Patient/Population,I-Intervention/Indicator,C-Comparison/Control,O-Outcome,T-Time.

• In an 80 year old with Type 2Diabetes Mellitus(P), what is the effect of insulin along with other oral hypoglycemic agents (I)compared to insulin degludec(C) on hypoglycemia (O)within 12 years(T)?
• It is based on Therapy/Intervention and the question is based on the treatment of an illnesss.Here the focus of the question is based on the treatment of Diabetes mellitus type 2treated with insulin and OHAs,but still the patient experienced hypoglycemia,and the treatment regimine was shifted to insulin degludec which improved the patient condition.
• References-Adapted from the PICOT Question Template,Ellen Fineout-Overholt,2006.