Background: Decreasing glycosylated
hemoglobin (HbgA1c) is a primary diabetes treatment goal. Despite the
simplicity of the HbgA1c goal, failure to achieve this goal is a major
healthcare concern. Healthcare providers fail to adequately educate patients on
how to implement behavioral modifications needed for successful goal
achievement. Narrowed focused patient encounters, reliance on patient
self-education, denial, and delayed follow-up appointments limit a patient’s
ability to implement required behavioral changes. Aim: This study was a quality
improvement intervention designed to determine whether a personalized nutrition
and exercise plan in conjunction with bi- monthly telephone reinforcement calls
improved the HbgA1c of patients with type 2 diabetes mellitus. Setting: The
study was conducted at a community clinic located in the southeastern U.S. that
provides care predominantly to the working poor and uninsured patients. Sample:
Type 2 diabetic patients (n = 40) with a baseline HbgA1c > 7%. Intervention:
A nurse practitioner; certified diabetic educator and an exercise physiologist
developed an individualized action plan with each participant. Baseline HbgA1c
values were documented and participants were scheduled for three education
sessions as well as telephone calls twice monthly for three months followed by
a repeat HbgA1c. Results: Pretest and posttest HbgA1c data were analyzed using
the Wilcoxon T-test statistic to determine if a personalized nutrition and
exercise action plan in addition to bi-monthly telephone calls to the
participants contributed to a decrease in the HbgA1c. Level of significance was
set at an alpha value of less 0.05. The observed value of the test statistics t
= 2.2714, with df = 62, p-value = 0.01292 rejects the null hypothesis. The
p-value (0.012) demonstrated a significant improvement. Conclusion:
Individualized attention and frequent reinforcement facilitated patients’ need
to develop and integrate self-management behaviors, thereby, reducing the HbgA1c
level and helping them to reach the desired goal.
Cite this paper
Hickson, S. V. , Farrell, K. , Orr, P. and Davenport, D. (2014). Decreasing Glycosylated Hemoglobin with Nutrition, Exercise and Bi-Monthly Telephone Calls in Patients withType 2 Diabetes Mellitus. Open Access Library Journal, 1, e560. doi: http://dx.doi.org/10.4236/oalib.1100560.
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