DIABETES PREVENTION THE HARD WAY: MODIFIED DIET AND INCREASED EXERCISE

Purpose: The aim of this Evidenced Based Project (EBP) is focused on prevention of the progression of diabetes mellitus or reversal of pre-diabetic participants back to a normal glycated hemoglobin A1C (HgA1C) level of < 5.7%. Evidenced based research has shown that diet alone does not provide a long term solution for most individuals, as weight regain is common. Weight loss has been known to decrease insulin resistance and risk for diabetes as well as other metabolic abnormalities. The goals of diabetic prevention are delaying the onset of diabetes, preserving beta cell function, and preventing or delaying microvascular and perhaps cardiovascular complications. This project involves lifestyle intervention with the purpose of 7% weight loss and a minimum of 150 minutes of physical activity a week.

Background:  The estimated overall prevalence of diabetes among adults in the United States ranges from 5.8 to 12.9 percent. Diabetes accounts for almost 14 percent of United States health care expenditures, half of which is related to complications associated with underlying microvascular and macrovascular changes contributing to problems such as myocardial infarction (MI), stroke, end-stage renal disease, retinopathy, and foot ulcers. Quality of life and economic factors are directly related to a high prevalence of diabetes and adversely impacts employment, absenteeism, and work productivity.

Methods: My approach is modeled after the Diabetes Prevention Program (DPP). This evidenced based project will be implemented in a primary care setting where an average of forty percent of the population are diabetic. Patients will be identified based on pre-diabetic HgA1C levels between 5.7 and 6.4%, over the past 6 months. There will be weekly meetings over a 12 week period with participants, and/or weekly phone calls, if they are unable to attend meetings. The project will educate and monitor participant’s progress with regards to weight loss and activity levels. The data collected will be used for pre and post measurements: HgA1C level, weight, height, activity level, nutrition habits, and BMI.

Outcomes:  are to be determined: To reduce HgA1C < 5.7% and 7% overall weight loss.

Conclusion: Reducing the overall prevalence of pre-diabetics in this practice, may lead to lower health costs, a healthier patient population, and decreased cardiovascular incidents related to diabetes. Furthermore, the results from this program could be used in conjunction or comparison with decreasing the rates of metabolic syndrome among the diabetic population.