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Poster presentation on implementing diabetes screening in family medicine practice

Furlan, Makilah

Otterbein University 
Digital Commons @ Otterbein 
Masters Theses/Capstone Projects Student Research & Creative Work 
Spring 5-2023 
Evaluating Implementation of Diabetes Screening In Family 
Practice 
Makilah Furlan 
makilahwitt@gmail.com 
Follow this and additional works at: https://digitalcommons.otterbein.edu/stu_master 
 Part of the Family Practice Nursing Commons 
Recommended Citation 
Furlan, Makilah, "Evaluating Implementation of Diabetes Screening In Family Practice" (2023). Masters 
Theses/Capstone Projects. 114. 
https://digitalcommons.otterbein.edu/stu_master/114 
This Project is brought to you for free and open access by the Student Research & Creative Work at Digital 
Commons @ Otterbein. It has been accepted for inclusion in Masters Theses/Capstone Projects by an authorized 
administrator of Digital Commons @ Otterbein. For more information, please contact 
digitalcommons07@otterbein.edu. 
EVALUATING IMPLEMENTATION OF DIABETES SCREENING IN FAMILY PRACTICE
Makilah Furlan, RN BSN
DIABETES SCREENING IN PRIMARY
CARE
Otterbein University, Westerville, Ohio
CURRENT STANDARDS OF
CARE
RESEARCH METHODS
A retrospective chart review (RCR) was 
conducted in a rural family practice clinic in 
northeastern Ohio. 
Chart selection inclusion criteria 
• Asymptomatic, nonpregnant adult patients 
aged 35-70 years of age, with a BMI over 25, 
that were seen for wellness visits between 
September 1 – September 30, 2022.
Chart selection exclusion criteria
• Pediatrics, adults ≤ age 34 and ≥ 71, pregnant 
adults, adults diagnosed with diabetes, 
patients symptomatic for diabetes between 
September 1 – September 30, 2022.
Standards utilized 
• The USPSTF guidelines were utilized as the 
standard of care for diabetic screening 
guidelines. 
Current standards of screening are set 
by the U.S. Preventive Services Task 
Force  and the American Diabetes 
Association. 
SUPPORTIVE EVIDENCE-BASED
PRACTICE
REFERENCES
FINDINGS
Benefit of offering screening to 
asymptomatic patients 
The supporting systematic review in creating 
USPSTF guidelines found that providing 
interventions to overweight patients was 
associated with reduced incidence of diabetes 
(Jonas et al., 2021). For recently diagnosed and 
overweight patients, screening and offering 
benefits improved patient outcomes (Zhou et 
al., 2020).
Benefit of screening ages 35-70
According to a systematic review, providing 
screening at this targeted age group provides 
early intervention, which reduces the burden of 
costs associated with diabetes care  (Zhou et al., 
2020).
Utilizing BMI as a screening criteria 
According to a systematic review, a BMI 
between ≥25 and ≥30 is the strongest risk 
factor for developing diabetes (Zheng et al., 
2017). BMI is a reliable screening tool to 
utilize to identify patients with increased risks 
of developing diabetes. 
Selecting the appropriate tests to screen 
for diabetes
According to the standards set by the 
American Diabetes Association, screening for 
diabetes should be performed by either an 
A1C, fasting glucose, or glucose tolerance test 
(American Diabetes Association, 2020).
Benefit of offering interventions at 
screening 
According to a meta-analysis, offering 
interventions aimed at weight reduction to 
asymptomatic patients at risk for acquiring 
diabetes is associated with weight reduction 
and decreased overall risk of later acquiring 
diabetes and decreases the disease progression 
of prediabetes (Galaviz et al., 2018). 
Does the patient population meet 
criteria for diabetes screening?
• 50 patients met screening criteria in 
September 2022. 
Are patients receiving appropriate 
diabetes screening?
• 43 out of 50 patients received 
appropriate diabetes screening. 
• 7 out of 50 patients met screening 
criteria but were not offered screening.  
Did the patients receive the appropriate 
tests to screen for diabetes?
• 42 patients received fasting glucose 
testing.
• 1 patient received A1C testing. 
Were patients diagnosed with 
prediabetes or diabetes after screening?
• 47 out of 50 patients did not meet criteria 
to be diagnosed with diabetes. 
• 3 out of 50 patients met criteria to 
diagnose with type II diabetes but failed 
to be diagnosed after screening. 
Were preventative interventions offered 
along with screening? 
• 47 out of 50 patients received 
appropriate preventive interventions 
such as diet, physical activity, and/or 
metformin at their time of screening. 
• 3 out of 50 patients met criteria for 
prevention but did not receive preventive 
interventions at their visit. The U.S. Preventive Services Task recommendation 
was given a “B” rating, indicating this intervention is 
demonstrated to have a moderate benefit (Davidson 
et al., 2021). 
American Diabetes Association recommendation 
was given a level A and B of evidence, which 
indicates data is gathered from meta-analysis and 
case-controlled studies (American Diabetes 
Association, 2021).
• 1.3 million Ohioans are estimated to have 
prediabetes but have not been diagnosed 
(Ohio Department of Health, 2018). 
• 8th leading cause of death in Ohio (Ohio 
Department of Health, 2018). 
• $15.8 billion spent annually in Ohio on 
diabetes cost (Ohio Department of Health, 
2018). 
• Diabetes causes serious comorbidities 
including renal disease, retinopathy, 
cardiovascular disease, liver disease, and 
obstructive sleep apnea (Tomic et al., 2022).
IMPLICATIONS FOR ADVANCED
PRACTICE NURSES
The goals of this project are to 
• Identify standards of care in diabetes 
screening.
• Assess if the standard of care was 
implemented in a local community family care 
practice.
• Educate advanced practice nurses about 
implementing secondary prevention and 
opportunities for growth in local diabetic care. 
GOALS OF RESEARCH
3 
EA 
I 
AGE 
Adults aged 35 to 70 
~ years (Davidson et al., 
~ 2021). 
POPULATION 
Adu Its who are 
overweight or have 
obesity as determined by 
BM! (~25 and ~30) 
(Davidson et al., 2021). 
TIMING 
Testing should be 
performed every three 
years (Davidson et al., 
2021). 
TESTING MODALITIES 
• • •• Screening may be 
performed through A1C, 
-:=asting plasma glucose, or 
glucose tolerance test 
(Davidson et al., 2021). 
RISK FACTORS 
Patients who have one or 
more of the following risk 
factors: cardiovascular 
disease, hypertension, 
obesity, family history of 
diabetes, or high-risk 
ethnicity (American 
Diabetes Association, 
2021). 
All primary care providers should 
understand the screening 
recommendations, implement 
screening in their practice, and offer 
interventions to reduce patient risk of 
developing chronic disease. 
IMPLEMENT 
APPROPRIATE 
SCREENING 
Integrate 
screening for 
diabetes into 
eligible patients' 
annual visit . 
I 
OTTERBEIN 
UNIVERSITY 


English

Evaluating Implementation of Diabetes Screening In Family Practice

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Otterbein University 
Digital Commons @ Otterbein 
Graduate School University Documents & Records 
Fall 2023 
News from the Graduate School- Athletic Training Fall 2023 
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