Date of Award

Fall 11-20-2023

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Robin Kirschner, EdD, DNP, RN, NEA-BC, CNL, CNE

Second Advisor

Erin Schlechter, DNP, APRN, FNP-BC


Practice Problem: The overall management of Type II Diabetes Mellitus (DM II) and the complications that accompany along with comorbidities are debilitating and financially exhausting. The American Diabetes Association dietary recommends a consistent low-carbohydrate diet to maintain optimal blood glucose levels to prevent complications and progression of other comorbidities. Uncontrolled diabetes mellitus leads to the development of chronic kidney disease (CKD) which can lead to the progression to End Stage Renal Disease.

PICOT: In patients in the outpatient setting aged 18 years and older(P), how does the ADA dietary guidelines for patients with type II DM(I) compared with patients self-reported diet(C) affect kidney function(O) within 8 weeks(T)?

Evidence: An exhaustive literature search resulted in 68 peer-reviewed articles. A total of 10 were included after filtering for duplicates and keywords and evaluating for strength and quality evidence.

Intervention: By implementing the DMQ-R questionnaire it provided guidance for the healthcare provider to establish behavioral characteristics that lead to poor diabetic control of those DM II with underlying CKD stage 3 and 4 which allowed appropriate education, referral to diabetic educators, or referral to an endocrinologist for more specialized treatments. In addition, the Urine -albumin (UrA) levels were monitored to track the progression of CKD and adequate blood glucose control that allowed proper interventions in the treatment regime.

Outcome: The analysis of the evaluation data by implementing existing research findings shows the relationship between controlling blood sugar levels with a carbohydrate-controlled diet plan and the lack of progression of CKD.

Conclusion: This project implemented the evidence-based practice by providing a behavioral tool, education, discussing with stakeholders, and having a collaborative team approach with other healthcare professionals. As the results the organization is aware of the significant difference that behavioral characteristics of a DM II has effects on their overall health outcomes.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.

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This work is licensed under a Creative Commons Attribution 4.0 License.