Date of Award

Spring 5-27-2023

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Pedro Colio, PhD, DNP, MSN

Abstract

Non-insulin-dependent diabetes mellitus (DM) is a complicated multisystem disease that accounts for over 20% of health care spending in the United States (Hildebrand et al., 2019). Uncontrolled DM can lead to heart disease, stroke, blindness, amputations, and peripheral artery disease. The literature supports the use of practice guidelines to improve patient outcomes with diabetes self-management education (DSME) and pharmacological interventions.

The purpose of this evidence-based project was to improve hemoglobin A1c (HgbA1c) levels by introducing the 2021 American Diabetes Association (ADA) Standards of Care guideline to improve diabetes self-management in a largely underserved adult Latino community. The intervention included a referral to a certified diabetes educator (CDE) for weekly DSME courses in a period of six weeks. The project was designed with a retrospective-prospective data analysis comparing HgA1c levels pre- and post- intervention. Data included biological gender, age, HgbA1c, and CDE referral.

Results of this project demonstrated improved HgbA1c among the intervention group. Patients referred to DSME courses had an average HgbA1c decrease of 1.8% with an improved glycemic control. Implementation of the DSME program following the 2021 ADA Standards of Care was clinically significant with a substantial financial return on investment. This project can be easily replicated in other adult patient clinics to improve diabetes management, glycemic control, healthcare expenditure, and meet the national objective goals of Healthy People 2030.

Keywords: diabetes mellitus, diabetes education, American Diabetes Association, diabetes self-management

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