Introduction
The medium- and long-term impact of diabetes on the individual, public health, and primary and secondary care services, financially, physically and practically, is of international concern. Type 1 and Type 2 Diabetes are the most common forms of diabetes. Other types of diabetes may be rarer, but when working in health and social care it is likely that you will come across a person with gestational- or surgical-related diabetes.
This module aims to discuss diabetes in relation to public health, but also the care cycle: assessment, diagnosis, treatment and management. You will relate this to a specific area of your experience and there will be use of real-life case studies to illustrate key points throughout the module. This module assumes that you have a basic knowledge of the anatomy and physiology of the endocrine and digestive system.
Due to the rapidly changing nature of the health and social care landscape, much of this module relies upon guided, self-directed study. This intends to facilitate the development of skills to enhance your ability to source high quality sources of evidence, and apply them in practice with specific reference to diabetes care. You will be provided with case studies and examples for you to propose evidence-based care.
You should be prepared to spend time researching, reading and digesting a wide range of information on the topic of diabetes, but also engaging in the online discussions.
You should spend an hour or so becoming used to the learning materials and layout of blackboard. The learning activities in all units help facilitate the background knowledge and basis of your module assessment.
Module Learning Outcomes
On successful completion of this module, you will be able to:
1. Critically evaluate evidence-base relating to the assessment, treatment and management of persons with a diagnosis of diabetes
2. Interpret data, evidence and the role of public health in the prevention and management of diabetes
Assessment Title
Diabetes Mellitus Case Study
Assessment Description
A written report of 3000 words that applies current, evidence based principles to an area relevant to practice. The case study may be local, national or international e.g. prevention strategies. The report needs to explore anatomy & physiology, concepts of public health and characteristics of diabetes. The case study could also relate to a specific patient or more overarching situations e.g. the role of policy in your location, the role of new technologies/advances in application to a type of diabetes or specific patient.
Key dates and details
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Assessment Type:
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Case Report CW1
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Assessment weighting:
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100%
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Word count/Length
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3000
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Learning Outcome/s:
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1 & 2
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Submission Method:
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Turnitin.
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Submission Date:
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Provisional Feedback Release Date:
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Check module timetable for sessions.
Guidelines
Background
A report is written for a clear purpose and to a particular audience. Specific information and evidence are presented, analysed and applied. Reports are presented in a clearly structured format making use of sections and headings so that the information is easy to locate and follow. Reports are used as forms of written assessment to identify what you have learned from your reading, research and experience and giving you an experience of a skill that is used in practice and research (e.g., incident, development, progress and scientific reports). Report writing skills may be increasingly useful as your career progresses.
Case reports allow episodes of care to inform the delivery of high-quality healthcare. A case report is a narrative that describes, for practice, research, or educational purposes, a health problem. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice and research needs.
Diabetes Case Report
- No individuals (including patients and staff) should be contacted.
- No medical, health or any other records should be used.
- Confidentiality needs to be maintained including the explicit use of pseudonyms and, as appropriate, removal or modification of personal identifiers.
Episode of Care
- Only one episode of care should be discussed – the episode of care that is discussed needs to be identified in the timeline (see the end of p. 7 and top of p. 8 for examples).
- The episode explored should be on diabetes primary diabetes prevention (e.g., delaying the development of type 2 diabetes in a population) OR secondary diabetes prevention (e.g., preventing persons with prediabetes from developing diabetes) OR tertiary diabetes prevention (i.e., preventing the complications of diabetes).
- The current diabetes condition should be assessed. This includes glycaemic control (management of blood glucose levels) and risk assessment for potential complications that may develop (assessment of signs and symptoms of complications). Thus, depending on the focus, discussions should include - meeting or not meeting diabetes therapeutic objectives (HbA1c goal/s) if set, self-management including adherence to therapy, psychological aspects of diabetes (e.g., self-efficacy) and a quality diabetes care plan (developing a plan or modifying the current one) including check-ups (e.g., yearly).
- Therefore the episode can be in a diabetes or primary care setting but cannot be at an emergency setting (e.g., A+E).
Focus
- The focus should be the patient.
- Therefore, each point should start with the patient e.g., related literature should come afterwards.
Case
Can be a:
- Patient recently or previously encountered by you or colleagues.
- Patient in your current or previous health settings.
- Patient you have professionally and anonymously discussed with other professionals.
- Patient encountered during student placement (during your nursing training).
- National case study e.g., health strategy.
- International case study e.g., global diabetes plan.
- Case related to a location e.g., role of policy.
- Case on technologies/advances for diabetes or a specific patient.
- Made-up case study, accommodating diabetes issues you would like to explore, within the confinements of the Learning Outcomes.
Cannot be from:
- Journals.
- The internet.
- Books.
- Published sources.
- Similar sources to the above.
Type of Diabetes
ONE of the following types of diabetes should be discussed in relation to the case study:
Type 1 Diabetes Mellitus (T1DM).
Type 2 Diabetes Mellitus (T2DM).
Gestational Diabetes Mellitus (GDM).
Diabetes Mellitus as a result of pancreatitis or pancreatectomy.
Headings needed for the report
Introduction
Patient Information
Clinical Findings
Timeline
Diagnostic Assessment
Therapeutic Intervention
Follow-up and Outcomes
Discussion
References
Minor part of the report
(presenting the context) (guidance 300-500 words)
what is relevant from the following should be considered:
Introduction: brief, key background information (e.g., patient attended their yearly diabetes review appointment, is on a medical ward due to.. OR similar), relevant literature including explaining the type of diabetes and its pathophysiology and what this case report will explore.
Patient information: demographic of the patient, the patient’s main compliant/s, relevant medical, family, and psychosocial history (e.g., diet, lifestyle and family history information, relevant comorbidities and past interventions and the outcomes of the relevant comorbidities and past interventions).
Clinical findings: presentation including signs, symptoms and relevant vital signs and observations, physical examination findings, clinical findings.
Timeline: Most relevant dates for interventions and outcomes (text; not a table or figure).
E.g., 1.
- 2012 – Obesity diagnosis.
- Episode of care being reported (2020) – T2DM diagnosis.
E.g., 2.
- 2014 – T2DM diagnosis in primary care.
- 2014 – Lifestyle advice.
- 2015 – Poor glycaemic control.
- 2016 – Started on an OHA in primary care.
- 2016-2022 – Poor glycaemic control.
- Episode of care being reported (2022) – E.g., Yearly diabetes appointment, admitted to a health setting OR similar.
E.g., 3.
- 2016 – Prediabetes diagnosis during an acute hospital admission, lifestyle advice.
- Episode of care being reported (2018) – Elevated blood glucose, referred to a diabetes clinic in primary care. T2DM diagnosis, diabetes care plan developed, referred to a diabetes lifestyle programme.
- 2020 – Diabetes clinic review, started on an OHA.
- 2022 – Diabetes clinic review, started on another OHA.
Major part of the report
(main part) (guidance 2500 words)
what is relevant from the following should be considered:
Diagnostic Assessment: Diagnostic methods (patient assessment, laboratory testing, imaging, surveys), diagnostic challenges, diagnosis, differential diagnoses and how these were ruled out, prognosis,
Therapeutic Intervention: therapeutic intervention (pharmacologic, surgical, preventive), administration of therapeutic intervention (dosage, strength, duration), changes in therapeutic interventions with explanations, effectiveness of therapeutic relationship, self-care, self-efficacy,
Follow-up and Outcomes: clinician- and patient-assessed outcomes, follow-up results (e.g., patient assessment, or test results), intervention adherence and tolerability, adverse and unanticipated events, biopsychosocial impact,
Discussion: discussion of the relevant literature, arguments with rationale, inferences explained, lessons learnt or what we can take from the discussions, considerations for practice and/or research going forward, strengths and/or limitations of the report.
Sources for the presentation of case reports
Gagnier, J.J., Kienle, G., Altman, D.G., Moher, D., Sox, H., Riley, D. and CARE group, 2014. The CARE guidelines: consensus‐based clinical case reporting guideline development. Journal of Clinical Epidemiology, 67 (1). Available at: https://ezproxy.derby.ac.uk/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S089543561300317X&site=eds-live
Ortega-Loubon, C., Culquichicón, C. and Correa, R., 2017. The importance of writing and publishing case reports during medical training. Cureus, 9 (12). Available at: https://ezproxy.derby.ac.uk/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=29492353&site=eds-live
Riley, D.S., Barber, M.S., Kienle, G.S., Aronson, J.K., von Schoen-Angerer, T., Tugwell, P., Kiene, H., Helfand, M., Altman, D.G., Sox, H. and Werthmann, P.G., 2017. CARE guidelines for case reports: explanation and elaboration document. Journal of clinical epidemiology, 89, pp.218-235. Available at: https://ezproxy.derby.ac.uk/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S0895435617300379&site=eds-live
Rubric guidance
On the following page you will find the rubric that your marker will use as a guidance for marking. The rubric will help identify different areas of strength and those areas in need of further improvement. Your marker will also provide personalised feedback and feedforward in relation to the Learning Outcomes for this module.
