First Advisor

Dunemn, Kathleen

Degree Name

Doctor of Nursing Practice

Document Type


Date Created



Type 2 diabetes mellitus (T2DM) is a chronic disease that has reached epidemic proportions worldwide and is a leading cause of death in the United States. Despite the significant risk to morbidity and mortality, the most effective diabetes treatment is still unclear. Implementation of diabetes self-management education (DSME) programs is one method to address the educational needs of patients with T2DM. Barriers to goal attainment need to be more fully addressed if these education programs are to be successful in helping patients make positive behavioral changes. This project implemented shared medical appointments to provide DSME, address barriers to goal attainment, and encourage healthy behavior changes including healthy eating, being active, taking medication, monitoring blood glucose, problem solving, healthy coping, and reducing risks as outlined by the American Association of Diabetes Educators (AADE; Mulcahy et al, 2003). Through use of DSME, these behavior changes, AADE7 (AADE, 2017), and the barriers to goal attainment were addressed. The group process was used during these appointments to allow patients to brainstorm ideas to overcome barriers and support patient individually setting goals. Initial and final self-efficacy scores and HbA1Cs were compared to determine if there was an improvement using this intervention. Both self-efficacy scores and HgA1Cs had statistically significant improvements with implementation of the project. Barriers identified were perceived as iv less following the project. This project provided a new strategy for approaching diabetes education and management. Outcomes from this project supported the continued use of shared medical appointments to provide DSME and development of a template for providers and/or care managers to use for patient education and management.


Type 2 diabetes mellitus, Diabetes self-management education


91 pages

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Copyright is held by the author.