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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 …