Doctor of Nursing Practice

Main Content

Diabetes Exercise Protocol Based on Comorbidities in Primary Care

Geraldine Q. Young
University of Alabama at Birmingham
Degree track: DNP
Degree awarded: May 2010
Capstone Chair: Dr. Susan Appel


Purpose: The diabetes exercise protocol presented here was intended to heighten primary healthcare professionals’ awareness of the significance of implementing effective, structured, and individualized exercise regimens into the management plan for patients with type 2 diabetes. Thus, an evidence-based exercise protocol based on participants’ level of comorbid conditions was implemented to guide primary healthcare professionals in the education and prescription of safe and appropriate exercise regimens for patients living with type 2 diabetes. Promoting behavior change among patients with type 2 diabetes to essentially prevent and minimize complications, improve the quality of life, minimize level of obesity, and abate diabetes-related costs was also a goal of the diabetes exercise protocol implementation.

Review of the Literature: The evidence utilized to create this protocol was based on a substantive review of the literature first focusing on randomized control trials then expert opinions. CINHAL 1987-2016 and PUBMED 1986-2016 databases were searched to uncover pertinent literature; specific attention was also given to literature which explicated Pender’s Health Promotion Model (HPM).

Implications for Practice: The obesity epidemic is directly associated with the increase in type 2 diabetes. Obesity coupled with type 2 diabetes serves to further complicate the patient’s metabolic profile and risk for further complications. Diabetes exercise protocols need to be individualized and based on the patient’s current level of comorbidities. Having a protocol algorithm can be of assistance in primary care as it is a cost-effective tool that can be utilized for improving the health outcomes of patients with type 2 diabetes through safely directing exercise-related behavior change.

Financial Relationships or other conflicts: None

Summary of Innovation of Practice: Exercise has been proven to improve the outcomes of patients with type 2 diabetes via glycemic control (A1C) and reducing BMI and waist circumference. Thus, primary care areas overtly affected by the epidemic of both obesity and diabetes can benefit from the use of the diabetes exercise protocol. Implementing a diabetes exercise protocol into practice to guide primary healthcare professionals in educating and prescribing structured exercise regimens to patients with type 2 diabetes can induce health-promoting behaviors, prevent unnecessary diabetes complications, and lead to improved health outcomes.

Primary healthcare professionals highly support the use of the diabetes exercise protocol as a guide in primary care as favorable patient outcomes are evident. With the implementation of the diabetes exercise protocol, perceived level of self-efficacy and benefits of exercise increased and barriers of exercise decreased for participants. Evidence of decreased A1C, BMI, and waist circumference were also explicit. Thus, the diabetes exercise protocol is a useful tool for improving the behavior change of patients with type 2 diabetes and their health outcomes.