Evid Based Nurs doi:10.1136/eb-2012-100945
  • Primary health care
  • Randomised control trial

Compared to standard physician care for diabetes, nurse specialists provide similar care in terms of quality of life

  1. Michelle L Litchman
  1. College of Nursing, University of Utah, Salt Lake City, Utah, USA
  1. Correspondence to: Michelle L Litchman
    College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT 84112, USA; michelle.litchman{at}

Commentary on:  Arts EE, Landewe-Cleuren SA, Schaper NC, et al. The cost-effectiveness of substituting physicians with diabetes nurse specialists: a randomized controlled trial with 2-year follow-up. J Adv Nurs 2012;68:1224–34

Implications for practice and research

  • Care provided by diabetes nurse specialists to uncomplicated patients with diabetes was not inferior to physician care, in terms of patient quality of life and expenditures.

  • Care patterns were not equal between study groups; diabetes nurse specialists followed a preset protocol and had referral limitations.


Diabetes is economically burdensome worldwide. Treating diabetes and preventing its complications cost at least US$465 billion in 2011, translating to 11% of total healthcare expenditures in adults.1 Despite the overwhelming costs of diabetes, overall care remains undesirable. Programmes demonstrating reduction in diabetes-related healthcare costs, while resulting in positive outcomes, will be important to replicate. Arts and colleagues explored whether diabetes nurse …

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