Date of Award

Spring 5-28-2022

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Kevin Maxwell, PhD, DNP, FNP-BC

Abstract

This Evidenced-Based Project (EBP) aimed to decrease the incidence of patients diagnosed with prediabetes converting to Type 2 diabetes. By utilizing the Diabetes Self-Management Education and Support (DSMES) program, the project will enhance patient knowledge of diabetes and self-care practices. Education in patients diagnosed with prediabetes in a small community clinic in Tijuana, Mexico.

Background: The American Diabetes Association (ADA) recommends that patients diagnosed with prediabetes attend Diabetes Self-Management Education and Support (DSMES) classes. DSMES focuses on the lifestyle management of diabetes, and it facilitates knowledge, skills, and abilities necessary for optimal self-care. The focus is on supporting patient empowerment by providing them with tools to make informed decisions on their diabetes management ("Prevention or delay of type 2 diabetes and associated comorbidities: Standards of medical care in diabetes-2022", p. S39-S43).

Evidence-Based interventions: The evidence recommends a weight loss of 7% from baseline and a minimum of One hundred fifty minutes of exercise per week. Participants between the ages of 18 to 75 with an A1c of 5.7% to 6.4% and referred to their primary care provider or community clinic healthcare provider if they did not have a primary care provider. Patients attend diabetic education classes, which include content on diet and exercise.

Results: Of 57 participants, 53 were between the ages of 20 to 81 and had Hgb A1c completed. Nine had Hgb A1c between 5.7% to 6.4%, and three had a history of hypertension. Four participants had Hgb A1c greater than 6.5%, and they all had a known history of Type 2 diabetes. Of the four, three of them had a history of hypertension also. The other 40 participants had Hgb A1c within normal limits of less than 5.6%.

Conclusion: Early detection and education of prediabetes can reduce the incidence of Type 2 diabetes and the complications associated with diabetes. This, in turn, will improve patients' quality of life, and it will also reduce healthcare costs for patients and healthcare facilities.

Keywords: Prediabetes, Diabetes Self Management, and Hemoglobin A1c

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