Introduction
Diabetes is a common disease among the young people in the United States of America. The increased prevalence of obesity among the children and the adolescents in US has resulted in increased cases of diabetes type II (Olfson, Blanco, Liu, Wang & Correll, 2012). Dietary practices and sedentary lifestyle are the main risk factors for the development of type II diabetes. However, recent studies point to a relationship between diabetes type II and use of some medications to manage psychotic conditions (Olfson et al., 2012). Prescription of the antipsychotics for the children and youth has tremendously increased. According to Samaras, Correll, Mitchell and De Hert (2014), atypical antipsychotics (AAP) are currently used to manage non-psychotic disorders. The following is a summary of the research article by Bolbo et al. (2013), Antipsychotics, and the risk of type II diabetes mellitus in children and youth.
The metabolic studies carried show that the use of the antipsychotic increases the chance of developing type II diabetes in adolescents aged between 12 and 19 (Samaras et al., 2014). According to Olfson et al. (2012), obese youth and children have higher chances of developing type II diabetes compared to their counterparts who have the right BMI. There are view studies on the prescription of antipsychotic drugs and their risks among the children and adolescents. The use of the antipsychotics has continued without consideration of the available safer alternatives.
Significance to Nursing
In the past, the primary uses of antipsychotics were to manage cases related to schizophrenia and other diseases related to psychotic disorders (Bolbo et al., 2013). However, the use has been expanding to include other disorders such as bipolar and affective disorders yet the conditions have alternative medications that are relatively safe. Nowadays, AAP is used as primary medication for different psychotic disorders in which the risk-benefit evaluation is not considered. Therefore, there is the need for evidence-based research to determine the risks of the AAP and the relationship with type II diabetes. The evidence will be critical for nurses in the policy formulation as well as in the care of children and adolescents with psychotic problems (Bolbo et al., 2013).
The purpose of the Study
In the recent past, increased prescription of atypical antipsychotics (AAP) for youth and children has been witnessed (Bolbo et al., 2013). The trend predisposes the adolescents to high chances of diabetes mellitus type II. The main purpose of the study was to find out the risk of type II diabetes in adolescents that have been initiated to AAP.
The Objective
The primary aim of the study was to establish the role of antipsychotic drugs in development of diabetes in adolescents. A control group of patients using alternative drugs was included in the study.
Methods of the Study
The study was a quantitative study in which data was obtained from Tennessee Medicaid Program. The data was from the computerized files (Bolbo et al., 2013). The data used for the inclusion included the date of enrollment, the affiliated hospital, and nursing home.
Research Design
A retrospective cohort study was applied. The study was limited to the people in the age brackets of 6 and 24 years. In the sampling of the study participants, the patients already diagnosed with diabetes and schizophrenia were excluded. The study sample included 28,858 patients for the study group. The main inclusion criterion was the patients that had just initiated antipsychotic drugs. The control group included 14, 429 patients on alternative medicines (Bolbo et al., 2013). The propensity scores were calculated for the control groups. The groups were followed for a duration of one year. The follow-up started immediately after filing of the AAP prescription or the control drug. There were different exposures to the AAP. The exposures depended on the physicians’ prescriptions (Bolbo et al., 2013). At the end of the study, the incidences of diabetes in relation to the exposure level of the AAP in the cohort aged 6-17 years were analyzed. Hazards ratio (HR) was used to compute the relative risk of developing diabetes type II (Bolbo et al., 2013).
Results of Study
The results indicated that the group on AAP had an increased risk of developing type II diabetes compared to the group of the alternative drugs. The hazard ratio showed that the children and youth initiated to AAP had three-fold increased risk. During the follow-up, Bolbo et al. (2013) found that the accumulation of the AAP dose resulted in increased risks of diabetes. The analysis of the study group between ages 6 and 17 showed that the users of AAP in the cohort had three-fold increased risks. Consequently, the risk increased as the dose accumulation of the AAP increased (Bolbo et al., 2013). Therefore, as the days progressed, the higher the risks of the diabetes.
Implication for Nursing
The management of diabetes is expensive and time-consuming. In addition, it has negative economic, social and mental impacts (Olfson et al., 2012). Thus, there is the need for the healthcare professionals such as nurses to undertake measures that reduce the risk of diabetes development. The study established that prescription of the atypical antipsychotic for the adolescents raises the probability of developing type II diabetes (Bolbo et al., 2013). In order to reduce the risk of diabetes type II in children and adolescents, AAP should only be used as a secondary option.
Ethical Considerations
The study was conducted under the authorization of the Tennessee Bureau of Medicaid. In addition, the Department of Health supported the research and helped in the collection of the data from Tennessee Bureau Medicaid (Bolbo et al., 2013). During the study, confidentiality of the patients’ information was upheld. The inclusion criterion was by consent in which the information of individual patients was not disclosed to a third party. In relations to the treatment, there were no ethical challenges relating to the treatment. The study relied on the patients’ data. The basis for choosing the control, and the experiment group depended on the records. For instance, the control group comprised of patients undergoing treatments with the alternative psychotic drugs.
Conclusion
Diabetes presents a significant challenge to the children and youth. There is the need for nurses to ensure that measures are taken to prevent factors that increase the risks of diabetes. The prescription of antipsychotic drugs for the children has increased. Currently, it is used in the cases where it was considered a secondary option. The research provided evidence-based implication of the AAP on the children and adolescents. Nurses have a great role in the policy formulation and decision-making that relate to patient care. There is the need for nurses to lobby for the reduced usage of the AAP.
References
Bolbo, W., Cooper, W, Stein, C., Olfson, M., Graham, D., Daugherty, J., & Ray, W. (2013). Antipsychotics and the risk of type II diabetes mellitus in children and youth. JAMA Psychiatry, 70 (10), 1067-1075.
Olfson, M., Blanco, C., Liu, S. M., Wang, S., & Correll, C. U. (2012). National trends in the office-based treatment of children, adolescents, and adults with antipsychotics. Archives of General Psychiatry, 69 (12), 1247-1256.
Samaras, K., Correll, C., Mitchell, A., & De Hert, M. (2014). Diabetes risk potentially underestimated in youth and children receiving antipsychotics. JAMA Psychiatry, 71 (2), 209-210.