An Education Program for Obese Patients With Pre-Diabetes, Research Paper Example

Problem Statement

The literature has indicated that there obese patients are more likely to develop type 2 diabetes compared to their non-obese peers. As a result, many education programs have been put in place for members of demographic populations that are at higher risk for the development of the disease. However, it would be more beneficial to create an education program for obese patients with pre-diabetes. Members of this population have a demonstrated risk of diabetes and can therefore be advised to take more drastic lifestyle changes to prevent their diet from causing greater bodily harm. Research has indicated that the odds ratio (OR) between individuals with a high waist circumference and impaired fasting glucose, a symptom of pre-diabetes is 3.1 (Abraham et al., 2013). Studies have shown that it is possible to reduce the development of diabetes by intervening before its initial onset. Therefore, it is reasonable to create and implement programs that are targeted towards members of this patient population (Kushner, 2015). Will providing education programs to patients with pre-diabetes be effective in preventing development of type 2 diabetes? This project will determine if using education programs as an intervention will be effective in preventing the development of type 2 diabetes which will be measured through testing of blood glucose and insulin levels.

Context

Of the people diagnosed with type 2 diabetes, about 80 to 90 percent are also diagnosed as obese. Therefore, there is a key relationship between obesity and development of the disease. Nurses could reasonably intervene with this pattern by providing education programs to obese patients with pre-diabetes to prevent further damage to their endocrine systems. Obesity education programs typically focus on the implementation of diet and exercise to reduce trauma to pancreatic beta cells. Thus, advising patients with pre-diabetes to consume diets that consist of less sugars and to monitor the amount of food that is consumed should be effective. This regimen should be paired with light to moderate exercise to ensure that all sugars consumed are metabolized. Blood glucose and insulin measures will serve as an indicator of health status, both in terms of improved health status or disease development (Centers for Disease Control and Prevention, 2015).

Approach/Methods

 Baseline blood and glucose levels will be determined for each participant at the beginning of the study and the measurements will be taken again at follow-up. The height and weight of each participant will also be taken at both time points. A pre and post questionnaire will be given to patients during their visits during the clinic to assess self-efficacy for weight loss and physical activity, barriers to physical activity and weight loss, expected outcomes resulting from physical activity and weight loss, perceived body image, depressive symptomatology, sleep patterns, weight history, dietary disinhibit ion and restraint, and behaviors typically related to weight loss (e.g., self-weighing, meal planning, etc.). An assessment of patient demographics will also be conducted. The education program will focus on the ability of the obese patients with pre-diabetes to monitor their own diet and activity and to associate this changed behavior with changes in mental and physical health. IRB approval will be obtained prior to beginning the project and all patients will be provided with informed consent.

Research Design

Lewins Theory of Change will be used for this DNP project. Altering diet and exercise can only be effective if patients recognize the benefits that these practices will have in terms of their quality of life. Lewins Theory of Change consists of three phases: unfreeze, change, and refreeze (Amer et al., 2012). During the unfreeze stage, patients will learn that they must alter their current lifestyle in order to benefit. The nurse will help them understand this and find ways to do so that are consistent with their particular needs. During the change phase, participants will be asked to track their changes and determine how these changes make them feel. It is expected that this will be challenging for participants at first, but should become easier as these changes feel more regular. The last stage of the research design, refreeze, allows the participants to continue to perform their new behavior. This will be supported by affirmation by the nurse who will provide them with an understanding of the benefits of these new lifestyle choices. The goal of the project is to provide patients with a means to change their lifestyle choices in a manner that will remain a permanent part of their lives following the study. The nurse’s role is to empower and provide recommendations to the participants throughout their journey.

References

Abraham TM, Fox CS. (2013). Implications of Rising Prediabetes Prevalence. Diabetes Care, 36(8): 2139-2141.

Amer Y, Quinn D, Lonie A, Blackmore K, Thompson L, Pettigrove M. (2012). Leading change: Applying change management approaches to engage students in blended learning. Australasian Journal of Educational Technology, 28(1): 16-29.

Centers for Disease Control and Prevention. (2015). Centers for Disease Control and Prevention Diabetes Prevention Recognition Program Standards and Operating Procedures. Retrieved from www.cdc.gov/diabetes/prevention/recognition

Kushner RF. (2015). Clinical Assessment and Management of Adult Obesity. Circulation, 10.1161/CIRCULATIONAHA.111.075424.