Routine diabetes maintenance care from an endocrinologist-supervised nurse provides better treatment outcomes for diabetic patients than care from a primary care physician.
Researchers randomly enrolled 367 patients with diabetes in a managed care program that involved treatment from a specially trained nurse who was supervised by an endocrinologist and who followed detailed treatment guidelines recommended by the American Diabetes Association. The patients remained in the program for one year, and researchers compared their records during the program with the records one year prior to enrollment in the program. The study found that patients met ADA process measures 98% of the time during the year in the managed care program, compared with 54% of the time during the previous year.
The study concludes that nurse-management programs improve outcomes for patients with diabetes. Researchers suggest that nurses and pharmacists provide better care than physicians because they spend more time with patients and are devoted specifically to managing the patients' diabetes. They conclude that, although such programs initially might cost more than traditional primary care, policymakers should support such preventive programs because they will result in lower costs over the long term (Davidson et al., American Journal of Managed Care, April 2006).