Insulin adjustment by a diabetes nurse educator improved glucose control in patients with poorly controlled, "insulin requiring" diabetes

Thompson DM, Kozak SE, Sheps S.Insulin adjustment by a diabetes nurse educator improves glucose control in insulin-requiring diabetic patients: a randomized trial.CMAJ 1999 Oct 19;161:959–62[Abstract/Free Full Text]

QUESTION: Does regular telephone advice by a diabetes nurse educator for insulin adjustment improve glucose control in patients with poorly controlled, "insulin requiring" diabetes?

Randomised (allocation concealed), blinded (outcome assessor), controlled trial with 6 months of follow up.

Hospital diabetes clinic in Vancouver, British Columbia, Canada.

46 patients with diabetes (mean age 49 y, 52% women) who had a glycated haemoglobin (HbA_1c) levels 8.5%, were on insulin therapy, had received standard diabetes education, were able to monitor blood glucose levels at home, and were receiving care by an endocrinologist. Exclusion criteria were inability to have regular telephone communication, contraindication to tight glucose control, other serious illness, or use of an insulin pump. Follow up was 100%.

Patients were allocated to receive regular telephone contact with a diabetes nurse educator for advice about adjustment of insulin therapy (nurse telephone intervention, n=23) or to continue regular clinic visits and usual contact with the endocrinologist for insulin adjustment (standard care, n=23). Patients in the nurse telephone intervention group received about 3 telephone calls per week, each . . . [Full text of this article]

Eileen Turner, RN, RNT, MSc

Lecturer/Practitioner, Diabetes Care King's College Hospital Denmark Hill, London, UK

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