Halting Progression From Prediabetes to Diabetes Through Patient Education: A Quality Improvement Project in an Underserved Community

BACKGROUND: The incidence of prediabetes and diabetes increases each year drastically worldwide, including in the United States. Statistically, 5-10% of individuals with prediabetes will develop diabetes each year. Underserved populations are particularly vulnerable to prediabetes progression due to lower health literacy, language barriers, limited access to healthcare, and socioeconomic challenges. Lifestyle modifications can reduce progression from prediabetes to diabetes by at least 40%, according to the literature. OBJECTIVE: The goal of the study was to increase awareness of prediabetes among an underserved patient population attending a community health clinic and to assess changes in glycemic and anthropometric parameters following patient education. METHODS: A single-group, pre-post observational design was conducted as part of a quality improvement (QI) project at a community health clinic serving an underserved population in Chicago, Illinois. Patients were advised to follow up within a 3-6-month period for assessment of HbA1c, fasting glucose, and body mass index (BMI) changes. RESULTS: A total of 46 patients with prediabetes received education on prediabetes and lifestyle modifications. Of these, 25 patients completed both pre- and post-intervention glycemic laboratory and anthropometric assessments and were included in the final analysis. Following patient education, mean HbA1c decreased from 6.03 ± 0.22% at baseline to 5.88 ± 0.23% at 3-6 months post-intervention, corresponding to a mean reduction of -0.15% (paired t-test, p = 0.0005). Fasting blood glucose values before and after the intervention were available for 16 of the 25 participants. Mean fasting blood glucose decreased from 105 ± 19.0 mg/dL pre-intervention to 97 ± 8.6 mg/dL post-intervention, corresponding to a mean reduction of -8 mg/dL; however, the result did not reach statistical significance (paired t-test, p = 0.064). All 25 patients had pre- and post-intervention BMI recorded. Mean BMI decreased from 33 ± 8.8 kg/m² at baseline to 32.6 ± 8.6 kg/m² post-intervention (paired t-test, p = 0.022). CONCLUSION: This quality improvement initiative demonstrates that a single educational session may modestly improve HbA1c levels among underserved patients with prediabetes, highlighting the importance of developing more structured and intensive interventions to prevent progression to type 2 diabetes in this high-risk population.