Specialist nurses in diabetes mellitus

Area of Science:

• Endocrinology
• Nursing Science
• Public Health

Background:

• Diabetes management requires extensive patient education on diet, monitoring, and treatment.
• Specialist nurses play a crucial role in empowering patients for diabetes self-management.
• This review evaluates the impact of specialist nurse care versus usual care on diabetes outcomes.

Purpose of the Study:

• To assess the effectiveness of diabetes specialist nurses (DSNs) or nurse case managers in improving metabolic control for patients with type 1 and type 2 diabetes mellitus.

Main Methods:

• A systematic search of Cochrane Library, MEDLINE, and EMBASE databases was conducted up to November 2002.
• Included were randomized controlled trials and controlled clinical trials evaluating specialist nurse practitioners' effects on short and long-term diabetic outcomes.
• Data extraction and quality scoring were performed independently by three investigators.

Main Results:

• Six trials with 1382 participants (6-12 month follow-up) were analyzed; two trials focused on adolescents.
• No significant differences in glycated hemoglobin (HbA1c) were observed between intervention and control groups at 12 months.
• One study showed a significant HbA1c reduction at 6 months with DSN intervention; one trial noted differences in hypoglycemia and hyperglycemia episodes.

Conclusions:

• Diabetes specialist nurses may enhance short-term diabetic control, but long-term benefits are not yet evident from available trials.
• No significant overall differences were found in hypoglycemic or hyperglycemic episodes or hospital admissions.
• Quality of life was not demonstrably affected by the involvement of diabetes specialist nurses.