The effect on patient outcomes remained less clear as these were rarely assessed .
Arrangements for follow-up ( organisational intervention ) also showed a favourable effect on process outcomes .
Multiple interventions in which patient education was added or in which the role of the nurse was enhanced also reported favourable effects on patients ' health outcomes .
REVIEW ER 'S CONCLUSIONS Multifaceted professional interventions can enhance the performance of health professionals in managing patients with diabetes .
Organisational interventions that improve regular prompted recall and review of patients ( central computerised tracking systems or nurses who regularly contact the patient ) can also improve diabetes management .
The addition of patient-oriented interventions can lead to improved patient health outcomes .
BACKGROUND Diabetes is a common chronic disease that is increasingly managed in primary care .
Different systems have been proposed to manage diabetes care .
The Health and Functional Status of Veterans With Diabetes
OBJECTIVE To determine the extent of functional impairment among veterans with diabetes and investigate whether such functional impairment is associated with measures of glycemic control , sensory neuropathy , lower extremity macrovascular disease , or other comorbid conditions . RESEARCH DESIGN AND METHODS A 20-item general health survey ( SF-20 ) developed by the Medical Outcomes Study ( MOS ) Group , was administered to 577 subjects participating in a prospect i ve study of risk factors for diabetic foot ulceration . Measures of glycemic control and neurovascular disease included GHb , sensory lower extremity neuropathy assessed by aesthesiometry , and segmental lower extremity doppler blood pressures .  RESULTS Veterans with diabetes have major decreases in all domains of functional status ; 87 % were in poor health in terms of physical functioning and 86 % in terms of health perceptions . Those with advancing age , symptoms of neuropathy and claudication , and a medical history of complications associated with diabetes had significantly more impairment of health status than those without . GHb values did not correlate with functional status measures . Subjects with neuropathy had statistically significant functional impairment . Subjects with vasculopathy had only two significantly low health status measures . CONCLUSIONS In summary , the findings from this survey reveal that veterans with diabetes have low functional status scores . The presence of symptoms and complications accounts for only part of the impairments experienced by this group
The effect on patient outcomes remained less clear as these were rarely assessed .
Arrangements for follow-up ( organisational intervention ) also showed a favourable effect on process outcomes .
Multiple interventions in which patient education was added or in which the role of the nurse was enhanced also reported favourable effects on patients ' health outcomes .
REVIEW ER 'S CONCLUSIONS Multifaceted professional interventions can enhance the performance of health professionals in managing patients with diabetes .
Organisational interventions that improve regular prompted recall and review of patients ( central computerised tracking systems or nurses who regularly contact the patient ) can also improve diabetes management .
The addition of patient-oriented interventions can lead to improved patient health outcomes .
BACKGROUND Diabetes is a common chronic disease that is increasingly managed in primary care .
Different systems have been proposed to manage diabetes care .