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  1. Beacham, Tracilia RN, MSN
  2. Williams, P. Renee RN, PhD
  3. Askew, Rebecca RN, MS
  4. Walker, Jean RN, PhD
  5. Schenk, Laura RN, PhD
  6. May, Marilyn RN, PhD


The number of Americans with diabetes mellitus (diabetes) has skyrocketed in the past 2 decades. An estimated 21 million Americans have the disease, and approximately 6 million additional people are unaware that they even have diabetes (National Diabetes Educational Program [NDEP] Fact Sheet, 2007). Among all the developed nations on the globe, the United States leads the world in cases of diabetes, 90% of which are type 2 diabetes (Kitis & Emirogluk, 2006; National Diabetes Fact Sheet, 2005). Unfortunately, these numbers are expected to climb even higher.