Peer Responses:
Length: A minimum of 200 words per post, not including references
Citations: At least two high-level scholarly reference in APA per post from within the last 5 years
Relate to another journal reading
Peer response to Adam
Screening is an important part of what family practice and primary care nurse practitioners are responsible for. Diabetes is indeed a common problem that NPs can expect to diagnose and manage. According to the U.S. Preventive Services Task Force (USPSTF), reasonable screening in asymptomatic adults with overweight or obesity between 35 and 70 years of age should consist of a HgbA1C, fasting plasma glucose, or oral glucose tolerance test every 3 years for as long as results are normal (2021). If screening reveals abnormal results, then patients should be referred, treated, and educated as appropriate, to include diet and lifestyle modifications for optimal outcomes (USPSTF, 2021).
Patient who already have diabetes mellitus (DM) types 1 or 2 are at increased risk of other serious health conditions including eye, heart, and kidney diseases, so should be screened for health regularly as well (American Diabetes Association [ADA], 2024). Screenings recommended by the ADA based on the Standards of Medical Care in Diabetes should include an A1C level every 3 months until in target range and every 6 months while within target (ADA, 2024). Further, an albumin-to-creatinine ratio yearly can check for excess urine protein, which is a sign of kidney damage, a common complication of DM. Estimated GFR is another lab test that should be utilized annually for evaluating kidney function. If patients develop symptoms of peripheral artery disease, like leg pain, weakness, or numbness, an ankle-brachial index can screen for this complication (ADA, 2024). Blood pressure and BMI should be screened with every visit due to the likelihood of elevation of these measures in patients with DM. Eye screenings should be conducted within 5 years of diagnosis and then every 1-2 years following (ADA, 2024). Cholesterol and triglyceride levels require screening after age 40 and every 5 years, unless abnormal or on statin medications, which will require more frequent screenings (ADA, 2024).
These recommendations for screening of patients with DM reflect a summary of the ADA’s recommendations, as they are a trusted source for DM related care and treatment. Likewise, the recommendations for screening of patient without an established DM diagnosis reflect the recommendations of the USPSTF, which is a useful source of routine screening related recommendations for the general public that can be quickly and easily accessed and interpreted by providers in routine care of patients. Following these recommendations can help ensure appropriate preventative care and management of disease for those with or at risk of developing DM.
References
American Diabetes Association. (2024). Life with diabetes: Health checks for people with diabetes. https://diabetes.org/living-with-diabetes/newly-di…
U.S. Preventive Services Task Force. (2021). Prediabetes and type 2 diabetes: Screening. https://www.uspreventiveservicestaskforce.org/usps…
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Example response:
According to the American Diabetes Association (ADA, 2024), regular screening allows providers to monitor changes over time and intervene sooner if complications arise. As outlined in their Standards of Medical Care in Diabetes, the ADA recommends an A1C every 3-6 months, annual albumin-to-creatinine ratio and estimated GFR, and screenings like eye exams and cholesterol checks at specific intervals.
The U.S. Preventive Services Task Force (USPSTF, 2021) also stresses the importance of screening asymptomatic adults aged 35-70 who are overweight or obese. They recommend a HgbA1C, fasting plasma glucose, or oral glucose tolerance test every 3 years for those with normal initial results. Abnormal findings should prompt referral and treatment including lifestyle modifications.
Thank you again for bringing these references to our discussion on diabetes screening guidelines. Incorporating evidence-based sources helps validate the recommendations and emphasizes multi-factorial care over the lifespan for patients. Please let me know if any part of my response needs further clarification or expansion. I aim to thoughtfully engage with peers while meeting assignment expectations.
