Date of Award
2025
Document Type
Doctor of Nursing Practice (DNP)
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Committee Chair
Tracy Lakin
Subject(s)
Prediabetic state--Treatment, Diabetes--Prevention, Patient education
Abstract
Prediabetes is an expanding worldwide issue that requires more attention. It increases the patient’s risk for type 2 diabetes. Moreover, it increases other comorbidities, such as cardiovascular disease, due to increased insulin resistance. It is estimated that 85-90% of adults are unaware they have prediabetes. Screening could detect many undiagnosed prediabetes cases, suppressing the increasing trend of developing diabetes that needs treatment. Prediabetes can be reversed. Of those patients who progress to diabetes, an estimated 80% are diagnosed with obesity, which increases the patient’s mortality rate by 2.5-3 times in comparison to those who are not diagnosed with obesity. The American Diabetes Association recommends annual screening for those with prediabetes and high-risk individuals. The first-line approach to prediabetes is a reduced-calorie diet and routine moderate-vigorous exercise of 150 minutes weekly. This evidence-based project aimed to implement a pre-diabetic protocol to increase screening from 50% to at least 85% and decrease glycohemoglobin, weight, and waist circumference in adult patients 18 and older at risk of developing diabetes over 12 weeks. The evidence-based procedure was a clinical practice change implementing a pre-diabetic protocol to increase prediabetes screening at McLeod Primary Care Associates in Florence, South Carolina. It was estimated that 40% of the patients at this clinic have prediabetes. The evidence-based project promoted clinical practice guideline adherence to improve the quality of care. A pre-diabetic protocol will streamline practices with up-to-date research and prevent practice variations. The Diffusion of Innovations Theory (2010) provided the theoretical framework. The staff worked with 50 patients diagnosed with prediabetes with a glycohemoglobin of 5.7%-6.4% and who met the inclusion criteria. The Association of Diabetes Care and Education Specialists 7 Self-Care Behaviors lessons were followed for 12 weeks via Zoom; then, patients returned for a follow-up appointment. Pre- and post-implementation data were compared: Prediabetes risk tests demonstrated increased staff compliance with screening patients for prediabetes, a reduction in weight, waist circumference, and glycohemoglobin (glycemic control). The patients gained knowledge on prediabetes as evidenced by their increased post-test scores.
Recommended Citation
Plemons, Tammy, "Clinical practice change: implementation of a pre-diabetic protocol" (2025). Doctor of Nursing Practice (DNP). 145.
https://louis.uah.edu/uah-dnp/145