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Evaluating interventions to delay the progression of prediabetes to type-2 diabetes mellitus in an uninsured Hispanic population

ABSTRACT Background: Diabetes is a chronic progressive disease affecting 34 million Americans. The Centers for Disease Control and Prevention estimates that 12.5% of people aged 20 years or older diagnosed with diabetes are Hispanic. The American Diabetes Association further estimates that 84.1 million Americans aged 20 years and older have prediabetes based on fasting blood sugar and hemoglobin A1c (HbA1c) levels alone. Local problem: In Georgia, the overall rate of diagnosed diabetes is 9.7%, undiagnosed is 6.5%, and prediabetes is 1.1%. The prevalence of diabetes for the Hispanic population in Georgia is 9% and is 10% among Clayton County residents. The purpose of this quality improvement project (QIP) was to evaluate interventions implemented to delay the progressions of prediabetes to type-2 diabetes in an uninsured Hispanic population. Methods: Retrospective chart review was conducted comparing pre- and postmeasurements for HbA1c and body mass index (BMI) in Hispanic patients identified as having prediabetes. Interventions: Patients with HbA1c of 5.7–6.1% were provided with a diabetes tool kit, whereas patients with an HbA1c of 6.2–6.4% were given the diabetes tool kit plus metformin. Results: A decrease in mean HbA1c was noted in both groups of patients. However, a paired sample t-test indicated nonsignificant decrease in HbA1c for the diabetes tool kit group (p = .51) but significant decrease for the diabetes tool group kit plus metformin group (p < .01). Conclusions: Although this QIP did not reveal statistically significant changes in HbA1c and BMI for both groups, the results were clinically significant among this Hispanic population.