Nurses Are Key to Patient Uptake of Diabetes Treatment


Enhancing the role of nurses can reduce delays in early adoption of insulin treatment.

Increasing nurses’ role in type 2 diabetes (T2D) management can significantly reduce delays in the start of insulin treatment.

In a study published in theBritish Medical Journal, investigators highlighted the benefits of the Stepping Up program, in which nurses lead the initiation of insulin treatment as part of routine care among patients within the practice.

The results of the study, which was conducted across 74 health clinics in Australia and included 266 patients, showed that the new health care model had a dramatic impact on patient uptake of insulin treatment.

Overall, 70% of patients at clinics trialing the program began treatment compared with 22% of patients at clinics with a traditional approach to diabetes management.

“By focusing on an enhanced role for the practicenurse, who is trained and mentored by a registered nurse with diabetes educator credentials, the model uses existing resources within the practice to improve outcomes,” said lead investigator John Furler.

The investigators compared patients in the intervention group—–which had consultations with the practice nurse as part of the Stepping Up Model––with a control group who received usual health care.

“After 12 months, we found that patients had significantly better HbA1c levels, which is associated with better long-term outcomes, such as reduced rates of kidney and eye disease, compared to the control group,” Furler said.

Based on the findings, an implementation study of the Stepping Up model of care will be conducted in the North-West Melbourne Primary Health Network. In addition to insulin initiation, the study will include intensification of diabetes therapy in general.

“By 2030, almost 600 million people worldwide will have T2D; therefore, innovation in delivering effective clinical care to patients with T2D is an urgent global priority.”

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