Date of Award
5-2024
Degree Type
DNP Project
Degree Name
Doctor of Nursing (ND)
Department
Nursing
Chair
Roberta Durk-Gomez
Abstract
Background: This quality improvement project, conducted in the Texas-Mexico border region with high obesity rates, aimed to explore the utility of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) as a screening tool for insulin resistance (IR) among overweight and obese individuals. The study focused on patients with a Body Mass Index (BMI) greater than 25 who exhibited normal blood sugar levels or Hemoglobin A1c (HbA1c) levels less than 5.7%.
Aim/Methods: The aim is to identify early intervention strategies for metabolic disorders, particularly in obese populations. Obesity is often the precursor to comorbid conditions such as diabetes and cardiovascular disease. Insulin, which increases with high carbohydrate intake typical of the Standard American Diet (SAD), is identified as the underlying factor contributing to fat storage and eventual IR.
Results: The HOMA-IR test, a screening tool, was utilized on the selected cohort of patients who met the criteria. This enabled the implementation of individualized interventions and promoted health literacy and patient autonomy through further teaching. The results revealed that all screened patients exhibited a degree of IR, with an elevated HOMA-IR indicating a moderate to high risk for diabetes.
Conclusions: Despite its limitations, the HOMA-IR screening approach enhances awareness and motivation for early intervention. While not a definitive diagnostic test, it aids in identifying high-risk individuals and initiating timely, individualized interventions to prevent diabetes and reverse IR. Patients showed a sincere curiosity to understand the biological implications of IR and take steps for their own health by promoting patient empowerment. Strategies such as monitoring carbohydrate intake, utilizing metformin, practicing intermittent fasting, and engaging in low-impact resistance training are recommended for patient education to enhance insulin sensitivity.
Implications to practice: The findings underscore the importance of cost-effective, proactive measures in mitigating metabolic disorders, emphasizing the need for early detection and intervention in high-risk populations. This project contributes to the ongoing efforts to address the obesity epidemic, particularly among the Hispanic community in the border region, and the associated risk of developing metabolic disorders.
Recommended Citation
Ruvaclaba, Christine, "Tailoring Treatment Approaches with Supplemental Screening: Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) in an Obese Population" (2024). Cohort XII. 1.
https://scholarworks.utep.edu/cohort_12/1
Poster Presentation