Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Neesha Ramchandani


Almost half (49%) of the United States population has prediabetes or type 2 diabetes. Type 2 diabetes has many associated comorbidities and is the seventh leading cause of death in the United States. It is also the most expensive chronic condition in the nation. Identifying patients with prediabetes allows for early intervention to prevent or delay the onset of type 2 diabetes. The objective of this quality improvement project was to develop and implement a screening algorithm in the primary care setting using the Prediabetes Risk Test and point of care HemoglobinA1c testing to improve identification of patients with prediabetes and increase referrals to lifestyle intervention. Over the 12-week implementation period, fifteen patients were identified as having prediabetes, three agreed to a referral to lifestyle intervention, and one was started on metformin. This was a marked increase compared to two prior recent years. The algorithm was feasible and effective at improving identification of prediabetes, in addition to improving staff and provider knowledge and retention. Future studies should include a broader patient population in a variety of locations with longitudinal follow-up. Updating the Prediabetes Risk Test to specify physical activity for future studies may also be beneficial.


This is an Open Access Thesis.

Open Access

This Article is Open Access