Purpose/Objectives:

This project explored the effectiveness of the current American Diabetes Association (ADA)-recommended diet and blood glucose and A1c in hospitalized, type 2 diabetics.

Significance:

Diabetes is the sixth leading cause of death in the United States. Prevention of diabetes complications rests with adequate blood glucose (BG) control, as measured by the current standard of care, hemoglobin A1c (HbA1c). The target goal of <7% is documented to be predictive of diabetes complications (ADA, 2008). Diet is the most recommended method of controlling blood glucose in type 2 diabetics. A weight loss of 5% of body weight has been shown to lower measurements of blood glucose and insulin resistance (ADA, 2008). Whether the ADA diet is effective is controversial.

Design/Background/Rationale:

Descriptive design using retrospective chart review.

Methods/Description:

Twenty-five randomly selected computerized records from patients hospitalized on one floor from May 15, 2008, to November 15, 2008, with an ICD 9 code for type 2 diabetes were reviewed. All patients were on physician-ordered ADA diets. Snacks were closely monitored; no outside food or drinks were allowed. A researcher-designed Excel spreadsheet was used by one nurse researcher to collect demographic indices, days hospitalized, first and last fasting blood glucose, and admission A1c data. The project was approved by the University IRB.

Findings/Outcomes:

The mean age of the subjects was 45 years; the majority were Hispanic, married, hospitalized for 14 days and had an admission BMI of 34 or greater. The mean admission blood glucose was 163 mg/dL; the mean discharge fasting blood glucose was 132 mg/dL. The difference was significant (t = 2.5; df = 20; P <= .02). The difference in diastolic blood pressure from admission to discharge was also significant (t = 2.5; df = 22; P <= .02).

Conclusions:

The ADA diet, the standard of care, is effective in reducing levels of blood glucose in hospitalized patients and may also influence blood pressure.

Implications for Practice:

Clinical nurse specialists can implement standards of care for diet, which can change health outcomes for patients with type 2 diabetes. More study of non-hospitalized populations is needed to determine ways to encourage dietary adherence.

Section Description

The journal is proud to share the student abstracts accepted for poster presentation at the 2009 National Association of Clinical Nurse Specialists Conference. These abstracts are submitted under a separate later deadline and therefore did not appear in the journal with the general abstracts. Congratulations to these CNS students and their faculty mentors.