There were no significant mean reductions for body mass index or serum cholesterol .
Nurse-led interventions produced greater improvements than ' usual care ' for HbA1c , serum triglyceride and smoking cessation and support an increased independent role for nurses in diabetes management
Nursing Case Management and Glycemic Control Among Brazilians With Type 2 Diabetes: Pragmatic Clinical Trial
Background Type 2 diabetes mellitus is a chronic condition that requires ongoing , life-long care in order to be controlled . Objectives The aims of the study were to assess the effect of nursing case management on glycated hemoglobin ( HbA1c ) levels compared to usual care in people with type 2 diabetes mellitus and to determine if effects of nursing case management varied by gender , age , duration of disease , education , and income . Methods This is a pragmatic clinical trial , conducted in the municipality of B and eirantes , Paraná , Brazil , in 2011 and 2012 . Eighty individuals were recruited and r and omized equally to receive nursing case management or usual care . Covariates were sociodemographic and clinical factors . The outcome was HbA1c measured at baseline , 6 months , and 12 months . Results The sample consisted predominately of women ; most had been diagnosed with type 2 diabetes mellitus within the previous 5 years . Mean age was 50.14 ( SD = 7.00 ) , with 5.27 ( SD = 4.39 ) years of schooling and an average HbA1c of 9.90 % ( SD = 2.49 ) . Hemoglobin A1c was reduced from an average of 10.33 % to 9.0 % ( p < .01 ) in the nursing case management group and from 9.57 % to 8.93 % ( p = .05 ) in the usual care group ; the group by time effect was not significant . Case management effects varied by younger age ( p = .05 ) , duration of type 2 diabetes less than 5 years ( p = .03 ) , up to 4 years of schooling ( p = .04 ) , and being in the lowest-income stratum ( p = .02 ) . Discussion Both groups showed a statistically significant reduction of HbA1c at 6 and 12 months following baseline . The difference in proportional reduction of HbA1c between groups was not statistically significant
There were no significant mean reductions for body mass index or serum cholesterol .
Nurse-led interventions produced greater improvements than ' usual care ' for HbA1c , serum triglyceride and smoking cessation and support an increased independent role for nurses in diabetes management