Date of Award

11-26-2024

Document Type

Capstone

Degree Name

Doctor of Nursing Practice (DNP)

School Name

Donna and Allan Lansing School of Nursing and Health Sciences

Department

Nursing

Major Advisor

Dr. Heather Owens, PhD, RN

Second Advisor

Dr. Gabri Warren, DNP, RN

Third Advisor

Dr. Arti Masturzo, MBA, MD

Abstract

Diabetes affects 37 million people annually in the United States, with direct medical costs exceeding $237 billion per year (American Diabetes Association, 2018; Xu et al., 2018). Complications account for up to 64% of diabetes-related expenses, emphasizing the importance of glycemic stability in preventing costly and debilitating outcomes (Dieleman et al., 2016). Diet and nutrition, essential for glycemic control, are often undermined by food insecurity—defined as inconsistent access to adequate, nutritious food—affecting 16% of adults with diabetes (Casagrande et al., 2022; Kirby et al., 2021). Food insecurity is linked to higher HbA1c levels, increased complications, and hospitalizations (Thomas et al., 2021). A 1% reduction in HbA1c correlates with annual savings of $545 in total care and $555 in diabetes-specific care (Lage & Boye, 2020), yet food-insecure individuals with diabetes face $4,414 higher healthcare costs annually (Berkowitz, Seligman, & Basu, 2018). This quality improvement project implemented a food insecurity screening program using the USDA Six-Item Short Form, coupled with referrals to community resources for individuals with positive screenings. The goal was to enhance diabetes management and glycemic stability by addressing food insecurity. Outcomes included improved time-in-range (TIR), glucose management indicator (GMI%) stability, better access to food, and enhanced food security scores. These findings highlight the power of targeted interventions to advance health equity, improve diabetes outcomes, and reduce healthcare costs, demonstrating the critical need for addressing social determinants of health in diabetes care.

Available for download on Thursday, November 27, 2025

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