Improving Diabetes Self-Management (DSM) Among Patients with Uncontrolled Type 2 Diabetes Mellitus (T2DM): A Patient-Centered Education Model
Date of Graduation
Doctor of Nursing Practice (DNP)
School of Nursing and Health Professions
Family Nurse Practitioner
Dr. Prabjot (Jodie) Sandhu, DNP, FNP-C, PA-C, CNL
Dr. Joan Fraino, DNP, PMHNP, FNP, NP-C
Problem: Type 2 Diabetes Mellitus or T2DM is an epidemic of enormous proportions affecting many individuals globally. Considering the significant burden and adverse outcomes when uncontrolled diabetes and poor self-management remain unaddressed, it is critical to find ways in which clinicians or nurses can help motivate patients to participate in their care. The problem of patients with uncontrolled diabetes at the Davis Street Primary Care Clinic (DSPCC) has been ongoing; in fact, from the 2021 Uniform Data System (UDS) measure update, rates of patients with uncontrolled diabetes (measured by HbA1c values >7%) have gone up from 55% to 80%, which has now quadrupled from the Clinic's target goal of 20%. Problems identified include patients' inability to monitor home blood glucose routinely, sedentary lifestyle, poor diet intake, alcohol drinking and smoking, non-compliance with medication administration, and inability to follow up with their PCPs and referrals.
Intervention: This DNP project aimed to increase knowledge and practice by 50% and decrease participants' weight through Diabetes Self-Management (DSM) education within eight (8) weeks. As there are various ways DSM education is delivered, this DNP project utilized educational presentations, weekly diabetes support group meetings, and individual counseling among ten (10) patients with uncontrolled diabetes. Furthermore, the seven (7) Self-Care Behaviors formulated by the American Association of Diabetes Educators (AADE7) were introduced to participants.
Measures: The data collected included the DSM knowledge and practice using a questionnaire answerable with a Likert scale, weight measurement. Pre-test and Post-test were done to assess the knowledge of participants regarding the Seven (7) Self-Care Behaviors. The outcomes were evaluated by comparing the pre-survey and post-survey data on the 4th and 8th weeks.
Results: In the baseline assessment, data shows that most participants are very negligent in managing their diabetes where the average score for all ten (10) participants was observed to be 1.97. Most of them never check their blood sugar levels regularly with care and attention, record their blood regularly, follow dietary recommendations of the doctor or diabetes specialist, and go to their appointments. It also shows that most participants have no to little knowledge about the seven (7) self-care behaviors in managing their diabetes. After the eight (8) weeks of intervention, there are more than 3 (>3) point increase in the average scores of the participants, indicating that their knowledge about self-managing their diabetes has improved. In addition, the participants have decreased more than five (5) lbs of their weight from the 1st week to the 8th week of intervention.
Conclusion: The intervention of educational presentations, diabetes support groups and individual counseling for 8 weeks have increased the knowledge of the eight (8) out of ten (10) patients with uncontrolled type 2 Diabetes Mellitus (T2DM) by 50% with regards to blood sugar checking, blood sugar results recording, and adherence to dietary recommendations.
Seven (7) out of 10 participants have increased their knowledge by 50% with regards to the areas of healthy eating, being active, taking medications, healthy coping, problem-solving, reducing risks or complications, and monitoring blood sugar. The participant’s weight has also improved.
Keywords: diabetes self management, diabetes self-management education, dsme, diabetes education, uncontrolled diabetes
Mandecote, Maria Hannah Tiangha, "Improving Diabetes Self-Management (DSM) Among Patients with Uncontrolled Type 2 Diabetes Mellitus (T2DM): A Patient-Centered Education Model" (2022). Doctor of Nursing Practice (DNP) Projects. 289.