Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Cathy Koetting, PhD, DNP, APRN, CPNP, PMHS, FNP-C


Cathy Koetting, PhD, DNP, APRN, CPNP, PMHS, FNP-C

Sarah R. Jackson, DNP, APRN, FNP-C

Jessica E. Henke, MSN, APRN, FNP-C



Problem Over 70% of prediabetic patients progress to full diabetes. There are over 80 million American adults who are diabetic. Diabetes is the costliest chronic disease that often leads to many other health issues.

Methods This QI project utilized a descriptive observational design. Quantitative data was collected via retrospective chart review. Primary data collected was documentation of a patient visit to the registered dietician and the hemoglobin A1c (HbA1c) of patients who followed up in the office after the referral.

Results Eight patients followed up to the office for a second visit (n=8). Four patients did see the registered dietitian and four of the patients did not. There was a statistically significant decrease in the mean of the HbA1c of the entire sample. Those who saw the registered dietitian did not significantly lower their HbA1c but did more so than those who did not the registered dietitian.

Implications for Practice: Results of this QI project suggests that identification and discussion in office may be enough to lower HbA1c in prediabetic patients. Due to the small sample size, there was no statistical significance to show that seeing a registered dietitian made a significant decrease in HbA1c. However, this group did lower HbA1c more so than those who did not see the registered dietitian. Therefore, recommendations are made for a second PDSA cycle for this QI project with a larger sample size to have a more robust picture of the probable benefit of having a registered dietitian as a part of the multidisciplinary team in the care of prediabetic patients.