Correlation between Non-Insulin Diabetic Patients and A1C Hemoglobin LevelsCorrelation between Non-Insulin Diabetic Patients and A1C Hemoglobin Levels

Problem StatementIs there a significant correlation between Is there a significant correlation between diabetic diet educational teaching class diabetic diet educational teaching class offered by a registered nurse and offered by a registered nurse and hemoglobin A1C levels?hemoglobin A1C levels?

Statement of PurposeTo determine if there is a significant To determine if there is a significant correlation between diabetic diet correlation between diabetic diet educational teaching class offered by a educational teaching class offered by a registered nurse and hemoglobin A1C registered nurse and hemoglobin A1C levels in non-insulin depended diabetic levels in non-insulin depended diabetic levelslevels

HypothesisThere is a correlation between teaching a There is a correlation between teaching a patient regarding proper diabetic diet patient regarding proper diabetic diet offered by a registered nurse will lower offered by a registered nurse will lower hemoglobin A1C levels in a non-insulin hemoglobin A1C levels in a non-insulin dependent diabetic patientsdependent diabetic patients

Independent Variable• Diabetic diet education class offered by Diabetic diet education class offered by the registered nursethe registered nurse

Dependent VariableDependent Variable•Hemoglobin A1C level of the patients in Hemoglobin A1C level of the patients in the studythe study

Literature Review• Diabetic education provided by a nurse or Diabetic education provided by a nurse or dietician improved overall health of the participant.dietician improved overall health of the participant.• Diabetic education decreased hemoglobin A1C Diabetic education decreased hemoglobin A1C levels and blood pressure. levels and blood pressure. • By reviewing carbohydrates in a diabetic diet By reviewing carbohydrates in a diabetic diet hemoglobin A1C levels will decreasehemoglobin A1C levels will decrease• Diet has a positive impact on blood glucose levels Diet has a positive impact on blood glucose levels in type 2 diabetics in type 2 diabetics • Hemoglobin A1C is a reliable predictor of Hemoglobin A1C is a reliable predictor of diabetesdiabetes• A simple regimen could reduce elevated A1C A simple regimen could reduce elevated A1C levels without altering type 2 diabetics daily levels without altering type 2 diabetics daily routines which suggest successful self-routines which suggest successful self-management strategmanagement strateg• Diet has a significant effect on hemoglobin A1c Diet has a significant effect on hemoglobin A1c levels. levels.

Operational Definitions• Hemoglobin A1C- level less than 6%Hemoglobin A1C- level less than 6%•Education-Visual Aids, Pre/Post Test, Food diaryEducation-Visual Aids, Pre/Post Test, Food diary• Non-Insulin Dependent Diabetic- Blood sugar above Non-Insulin Dependent Diabetic- Blood sugar above 120120• Diabetic Diet-portion control, food substitution, Diabetic Diet-portion control, food substitution, carbohydrate countscarbohydrate counts

Theoretical FrameworkTheoretical Framework• Adult learning theory by Malcolm KnowlesAdult learning theory by Malcolm Knowles• Adults need specific information on why certain things Adults need specific information on why certain things are taughtare taught• Adults learn by hands on experience or by visual or Adults learn by hands on experience or by visual or auditory learningauditory learning• Adults do not need supervision or guidance when Adults do not need supervision or guidance when they make mistake s during learning. They learn by they make mistake s during learning. They learn by

theirtheir own mistakesown mistakes

Research Design• Type: Non-experimental, consensusType: Non-experimental, consensus• A four hour day in-service will provided A four hour day in-service will provided to discuss the plan of carbohydrates, with to discuss the plan of carbohydrates, with examples of a meal and portion controlexamples of a meal and portion control•Visual aids, auditory discussions and Visual aids, auditory discussions and open question will be available. open question will be available. • A written book with all the information A written book with all the information discussed in class will be provideddiscussed in class will be provided• Dietary journals will be providedDietary journals will be provided• Hemoglobin A1C levels of be evaluated Hemoglobin A1C levels of be evaluated with educational programs within a three with educational programs within a three month period. month period. • These materials will be analyzed along These materials will be analyzed along with the post hemoglobin A1C levelswith the post hemoglobin A1C levels

Research SettingBrazos Valley Home Health Services. Brazos Valley Home Health Services.

Population & Sampling• 60 type 2 diabetics will be selected and 30 60 type 2 diabetics will be selected and 30 will participate in in-service based on the will participate in in-service based on the American Diabetic Association diet and 30 American Diabetic Association diet and 30 participants will not be offered the in-serviceparticipants will not be offered the in-service• Male and female volunteers will be sought Male and female volunteers will be sought between the ages of 30 and 75 with a between the ages of 30 and 75 with a diagnosis of DM Type 2 within the last 6 diagnosis of DM Type 2 within the last 6 months will be chosenmonths will be chosen

Collection ToolsCollection Tools

• Pre-post testPre-post test• Food diaryFood diary• Hemoglobin a1c prior and post in-Hemoglobin a1c prior and post in-serviceservice

Data Collection• Brazos Valley Home Health Facility Brazos Valley Home Health Facility • Consent forms will be given.Consent forms will be given.• Hemoglobin A1C levels will be collected Hemoglobin A1C levels will be collected on all participants by a phlebotomist on all participants by a phlebotomist pre/post in-service class pre/post in-service class • Blood specimen will be transported to Blood specimen will be transported to Clinical Laboratory PathogensClinical Laboratory Pathogens• Ten question pre/post test will be given Ten question pre/post test will be given to test knowledge pre/post in-service to test knowledge pre/post in-service classclass• All these materials will be taken into All these materials will be taken into consideration to determine if the diabetes consideration to determine if the diabetes in-service participants utilized the in-service participants utilized the nutritional guidelines to decrease their nutritional guidelines to decrease their hemoglobin A1c levels. hemoglobin A1c levels.

Data Analysis Hemoglobin A1C levels should be Hemoglobin A1C levels should be lower in those who took the four lower in those who took the four hour in-service than those who did hour in-service than those who did not receive the in-service.not receive the in-service. Diabetic education helps lower Diabetic education helps lower A1C levels. A1C levels.

Significance to Nursing• Hemoglobin A1C is a reliabl predictor Hemoglobin A1C is a reliabl predictor of diabetic glycemic controlof diabetic glycemic control• Diabetic education is a successful tool Diabetic education is a successful tool in helping diabetics control diabetes in helping diabetics control diabetes without medication.without medication.• Nurses are need to educate diabetics Nurses are need to educate diabetics on how to control diabetes to prevent on how to control diabetes to prevent other medical complications such as other medical complications such as heart failure, neuropathy, renal failure heart failure, neuropathy, renal failure and poor wound healing.and poor wound healing.

Pre in-service hemoglobin A1C

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1% 3% 5% 7% 9%

Hemoglobin A1C

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In-serviceparticipant

Non-inserviceparticipant

Post in-service hemoglobin A1C

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1% 3% 5% 7% 9%

Hemoglobin A1C

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In-serviceparticipant

Non-inserviceparticipant