A case study describing the experience of three New Brunswick adults with prediabetes while partaking in a nurse-guided health promotion lifestyle intervention

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University of New Brunswick


The number of individuals developing prediabetes and Type 2 Diabetes Mellitus (T2DM) in New Brunswick (NB) increases dramatically each year (Bilanzie & Rosella, 2017). This suggests that the current preventative strategies and management of these diseases may be ineffective (Hallberg, Gershuni, Hazbun, & Athinarayanan, 2019). Emerging research indicates insulin resistance is the hypothesized pathological condition underpinning prediabetes and Type 2 Diabetes (Crofts, Zinn, Wheldon & Schofield, 2015), and that it is the over-consumption of refined carbohydrates which is the prominent driving factor in the development of insulin resistance. Studies demonstrate that prediabetes and T2DM are reversible when adopting low refined carbohydrate and intermitting fasting therapy (Hallberg et al. 2019; Furmli, Elmasry, Ramos, & Fung, 2018). This study utilized a case study design method to describe the experience of three NB adult females with prediabetes. These three participants participated in a 4-week nurse-guided lifestyle intervention. The intervention included: a low refined carbohydrate meal plan, intermittent fasting plan, virtual education, and continuous nursing support. This case study research concluded that: a low refined carbohydrate diet and intermittent fasting intervention was adopted by all three participants with prediabetes; the nurse researcher positively influenced the participants; biomarker improvements were noted; the case study methodology approach allowed the nurse researcher's role to be interactive; and participants had common barriers to health behaviour change. These included time barriers, monetary barriers, and limited family and social support.