Addressing the Issue of Diabetes


Though diabetes is not a new issue, it still remains at the top of the leading death causes in Miami, FL. In order to address the lack of awareness regarding the issue, one must consider the introduction of new principles of diabetes issue management among the American advanced practice registered nurses (APRNs). By incorporating the principles of Lewin change theory, one will be able to instruct the U.S. APRNs on the means for increasing awareness among the citizens of the United States, as well as improve the ways of addressing the issue that are currently accepted among the U.S. APRNs, therefore, bringing the diabetes death rates down.

Introduction: Diabetes and What Is Being Done to Fight It

Despite being a relatively old concern, diabetes still contributes to the increase in death rates in Miami, FL to a threateningly high extent. While advanced practice registered nurses (APRNs) do everything possible to raise awareness among the potential victims of diabetes, more and more people pass away due to the disease. The incorporation of Lewin’s model for change into the process of reconsidering the current means for raising awareness on diabetes will help reduce mortality rates in the USA greatly and allow for a more adequate care for people with diabetes, which will be based on self-instruction and, therefore, allow the residents of Miami to prevent and fight diabetes more efficiently (Center for Disease Control and Prevention, 2011).

Target Group

As it has been stressed above, the entire population of Miami will be included into the target group that the nursing plan in question is going to embrace. Though Miami is not the only area in the U.S. that has been affected by the disease, the diabetes death rates within the area in question are deplorably high. According to the 2014 statistics, 4.7 out of 10,000 residents of Miami are affected by the disease and need efficient treatment (Age-adjusted hospitalization rate due to uncontrolled diabetes, 2014). The sharp increase of the number of people with diabetes in Miami compared to the previous year rates proves the necessity to come up with urgent measures for addressing the lack of awareness regarding diabetes symptoms and prevention among the Miami residents.


First and most important, the instructions regarding the strategies of tending to the needs of patients with the symptoms of diabetes should be handed out to the members of the Miami Diabetes Center. While the above-mentioned organization has had an impressive effect on the diabetes treatment in Miami, the lack of proper diagnosing tools and the unwillingness of the staff to utilize the latest technology in addressing the disease make the diagnosing process quite complicated.

Therefore, among the key strategies that must be incorporated into the improvement of nursing services for people with diabetes, integration of technological innovations, as well as new and more cohesive instructions for the staff, must be provided. The primary instructions will include risk assessment questionnaires and/or biochemical tests (diabetes II), as well as the use of the A1C test, also known as the A1C hemoglobin test.

The latter will allow for diagnosing the stage of prediabetes, which will help detect the disease at its earliest stage and, therefore, prevent its further evolution in the patient. To be more exact, it will be crucial to obtain a screening of the levels of glucose in the patient’s body for a specific period of time. At this point, the technological advances factor in. As far as the FPG test is concerned, it is admittedly less efficient than the A1C test and, therefore, needs to be dismissed in favor of a more superior A1C screening. Thus, the financial resources will be saved for the upgrade of the A1C screening and staff training.


As it has been stressed above, the Lewin Change Model is going to be adopted in order to facilitate a faster and a more efficient acquisition of the necessary knowledge by the target population (Shirey, 2013). The first step towards the change implementation, the analysis of the current issues that the nursing staff faces when assisting patients with diabetes (Ulbricht, 2011), will be carried out within two weeks. In the course of the specified procedure, the efficacy of the A1C test application and the analysis of the technological advances adopted at the Miami Diabetes Center will be conducted. Interpreted as the “unfreezing” stage of the change, this set of actions will help reveal the problems underlying the current deplorable rate of diabetes among the Miami residents (Sacks, Fonesca & Goldfine, 2011).

In the course of the screening, the rates of awareness and the tools, which the Miami APRNs use in order to raise awareness among the local residents, will be assessed as well. It is suspected that the unwillingness of the staff to integrate modern technology in the awareness campaign leads to diabetes compilations development in the patient (National Center for Chronic Disease Prevention and Health Promotion, 2011).

As far as the actual change, i.e., the second stage of Lewin’s model, is concerned, integration of new tests for screening for diabetes among the target population will be carried out. It will be crucial to update the A1C test so that it could include the analysis of the risk factors (Silvio, 2012), which should be conducted with the help of a data mining approach, or, to be more specific, a neural network based approach (Jain & Singh, 2012).

In addition, the information regarding the symptoms of diabetes, its detection and prevention will be made available to the target population once new brochures are printed and released for public access in local libraries. More to the point, the Center will also have to publish the relevant information concerning tending to the needs of people with diabetes, as well as the principles of self-care for the patients, who are ready to integrate into their everyday life. Eventually, the refreezing stage will require that the new behavioral patterns should be memorized and followed closely by both the nursing staff and the patients. This stage of Lewin’s model will be achieved through the consistent training of the staff and the promotion of the relevant literature to the Miami residents.

Advantages and Disadvantages of the Change

Speaking of negative aspects of the change, in order to design a campaign for raising awareness regarding diabetes and enhancing self-care behavior among patients, an impressive amount of time and money will be required; therefore, the financial resources for the services themselves will drop, which will lead to the deterioration of the specified services. As far as the positive aspects are concerned, the integration of Lewin’s model for change into the planning and the efficacy of the alterations are bound to trigger a rapid drop in diabetes, as well as a palpable decrease in death rates for people, who have diabetes.

Reference List

Age-adjusted hospitalization rate due to uncontrolled diabetes. (2014). Miami-Dade Matters. Web.

Center for Disease Control and Prevention. (2011). Diabetes public health resource. CDC. Web.

Jain, D. & Singh, D. (2012). A neural network based approach for the diabetes risk estimation. International Journal of Computer Applications, 73(10), 1–4.

National Center for Chronic Disease Prevention and Health Promotion. (2014). CDC. Web.

Sacks, N., Fonesca, C. & Goldfine, A. (2011). Diabetes: advances and controversies. Clinical chemistry, 57(2), 147–149.

Shirey, M. R. (2013). Lewin’s theory of planned change as a strategic resource. JONA: The Journal of Nursing Administration, 43(2), 69–72.

Silvio, E. (2012). Diagnosis of diabetes. The New England Journal of Medicine, 367(6), 542–550.

Ulbricht, C. (2011). Focus: Diabetes. Journal of Dietary Supplements, 8(3), 239–256.