Other Titles
Treating the Disease, Not the Number: A Quality Improvement Project [Title Slide]
Abstract
Background: Diabetes Mellitus Type II (DMII) is a condition that affects millions of people every year and, while preventable, remains one of the top causes of death and disability in the United States. Typical treatment for DMII is focused on using pharmacological measures to lower and maintain hemoglobin A1C in a healthy range. Providers in a family practice clinic established a lifestyle change program to assist patients to reduce their A1C while also reducing the number of diabetic medications they take. The program was intended to improve metabolic health without relying solely on pharmacotherapy. The program encourages a low carb diet, intermittent fasting, and increased exercise with close follow up by providers. The purpose of this project was to evaluate the program to determine if the lifestyle change recommended, along with close monitoring by a healthcare provider, could improve the metabolic health of participants.
Methods: This clinic-based quality improvement project began in 2022 with iterative improvement cycles. Clinic providers presented researchers with deidentified patient data on patient age, gender, A1C, weight, blood pressure, BMI, and prescribed medications. At the end of the evaluation, results were compared and analyzed in excel using a paired t-test to determine the differences in mean A1C at baseline and post program.
Results: Data was collected from (n=86) patients within the program as well as (n=11) patients outside of the program who served as a control group, receiving treatment following the current standard of care. Among the intervention group, there was a 0.77 decrease in A1C from time point 1 (t1, baseline) to time point 3 (t3, post program) (p<0.001). The control group also saw an average A1C decrease of 2.5 from t1 to t3 (p<0.001). Regarding medications taken, participants saw a mean decrease of 0.57 medications from t1 to t3 (p<0.001), whereas the control group saw no change in medication usages from t1 to t3 (p<0.067). The intervention group experienced a significant reduction in A1C as well as diabetic medication use.
Conclusion: Participation in the structured lifestyle program was associated with meaningful improvements in glycemic control and a reduction in diabetes medication use. Despite the control group showing a larger mean A1C decrease, only participants in the lifestyle program demonstrated simultaneous A1C improvement and decreased pharmacologic burden.
Notes
References:
Gu, S., Hu, X., Zhen, X., Shi, L., Shao, H., Sun, X., Gu, Y., Huang, M., & Dong, H. (2022). Comparison of glucose lowering drugs as second line treatment for type 2 diabetes: a systematic review and meta analysis. Journal of Clinical Medicine, 11(18), 5435.
Hejazi, K., Mohammad Rahimi, G. R., & Rosenkranz, S. K. (2023). Effects of exercise training on inflammatory and cardiometabolic risk biomarkers in patients with type 2 diabetes mellitus: A systematic review and meta analysis of randomized controlled trials. Biological research for nursing, 25(2), 250-266.
Morales-Suarez-Varela, M., Collado Sanchez, E., Peraita-Costa, I., Llopis-Morales, A., & Soriano, J. M. (2021). Intermittent fasting and the possible benefits in obesity, diabetes, and multiple sclerosis: A systematic review of randomized clinical trials. Nutrients, 13(9), 3179.
Mosenzon, O., Del Prato, S., Schechter, M., Leiter, L. A., Ceriello, A., DeFronzo, R. A., & Raz, I. (2021). From glucose lowering agents to disease/diabetes modifying drugs: A “SIMPLE” approach for the treatment of type 2 diabetes. Cardiovascular diabetology, 20(1), 92.
Tsapas, A., Karagiannis, T., Kakotrichi, P., Avgerinos, I., Mantsiou, C., Tousinas, G., Manolopoulos, A., Liakos, A., Malandris, K., & Matthews, D. R. (2021). Comparative efficacy of glucose lowering medications on body weight and blood pressure in patients with type 2 diabetes: A systematic review and network meta analysis. Diabetes, Obesity and Metabolism, 23(9), 2116-2124.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Quality Improvement
Research Approach
Other
Keywords:
Primary Care, Coaching, Mentoring and Coaching, Type 2 Diabetes, Glycemic Control, Lifestyle Modification, Behavior Modification
Recommended Citation
Luthy, Karlen E.; Smith, Sydney; Platt, Christine Rae; Macintosh, Janelle L. B.; Peterson, Neil E.; and Johnson, Janessa, "Lifestyle Intervention: Effects on Glycemic Control and Medication Reduction in Type II Diabetes" (2026). International Nursing Research Congress (INRC). 230.
https://www.sigmarepository.org/inrc/2026/presentations_2026/230
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-27
Lifestyle Intervention: Effects on Glycemic Control and Medication Reduction in Type II Diabetes
Toronto, Ontario, Canada
Background: Diabetes Mellitus Type II (DMII) is a condition that affects millions of people every year and, while preventable, remains one of the top causes of death and disability in the United States. Typical treatment for DMII is focused on using pharmacological measures to lower and maintain hemoglobin A1C in a healthy range. Providers in a family practice clinic established a lifestyle change program to assist patients to reduce their A1C while also reducing the number of diabetic medications they take. The program was intended to improve metabolic health without relying solely on pharmacotherapy. The program encourages a low carb diet, intermittent fasting, and increased exercise with close follow up by providers. The purpose of this project was to evaluate the program to determine if the lifestyle change recommended, along with close monitoring by a healthcare provider, could improve the metabolic health of participants.
Methods: This clinic-based quality improvement project began in 2022 with iterative improvement cycles. Clinic providers presented researchers with deidentified patient data on patient age, gender, A1C, weight, blood pressure, BMI, and prescribed medications. At the end of the evaluation, results were compared and analyzed in excel using a paired t-test to determine the differences in mean A1C at baseline and post program.
Results: Data was collected from (n=86) patients within the program as well as (n=11) patients outside of the program who served as a control group, receiving treatment following the current standard of care. Among the intervention group, there was a 0.77 decrease in A1C from time point 1 (t1, baseline) to time point 3 (t3, post program) (p<0.001). The control group also saw an average A1C decrease of 2.5 from t1 to t3 (p<0.001). Regarding medications taken, participants saw a mean decrease of 0.57 medications from t1 to t3 (p<0.001), whereas the control group saw no change in medication usages from t1 to t3 (p<0.067). The intervention group experienced a significant reduction in A1C as well as diabetic medication use.
Conclusion: Participation in the structured lifestyle program was associated with meaningful improvements in glycemic control and a reduction in diabetes medication use. Despite the control group showing a larger mean A1C decrease, only participants in the lifestyle program demonstrated simultaneous A1C improvement and decreased pharmacologic burden.
Description
The purpose of this project was to evaluate a clinic-based lifestyle modification program for adults with Type II diabetes. The intervention group showed significant reductions in A1C and diabetes medication use, while the control group showed no change in medication use. These results suggest structured lifestyle modification, supported by regular provider monitoring, can improve metabolic health and reduce pharmacologic burden in Type II diabetes.