Where reported , emergency admissions and quality of life were not found to be significantly different between groups .
No information was found regarding BMI , mortality , long term diabetic complications , adverse effects , or costs .
REVIEW ER 'S CONCLUSIONS The presence of a diabetes specialist nurse / nurse case manager may improve patients ' diabetic control over short time periods , but from currently available trials the effects over longer periods of time are not evident .
There were no significant differences overall in hypoglycaemic episodes , hyperglycaemic incidents , or hospital admissions .
Quality of life was not shown to be affected by input from a diabetes specialist nurse/nurse case manager
BACKGROUND The patient with diabetes has many different learning needs relating to diet , monitoring , and treatments .
In many health care systems specialist nurses provide much of these needs , usually aim ing to empower patients to self-manage their diabetes .
The present review aims to assess the effects of the involvement of specialist nurse care on outcomes for  people with diabetes  , compared to usual care in hospital clinics or primary care with no input from specialist nurses .
OBJECTIVES To assess the effects of diabetes specialist nurses / nurse case manager in diabetes on the metabolic control of patients with type 1 and type 2 diabetes mellitus .
Primary care outcomes in patients treated by nurse practitioners or physicians: a randomized trial.
CONTEXT Studies have suggested that the quality of primary care delivered by  nurse practitioners is equal to that of physicians . However , these studies did not measure nurse practitioner practice s that had the same degree of independence as the comparison physician practice s , nor did previous studies provide direct comparison of outcomes for patients with nurse practitioner or physician providers . OBJECTIVE To compare outcomes for patients r and omly assigned to nurse practitioners or physicians  for primary care follow-up and ongoing care after an emergency department or urgent care visit . DESIGN R and omized trial conducted between August 1995 and October 1997 , with patient interviews at 6 months after initial appointment and health services utilization data recorded at 6 months and 1 year after initial appointment . SETTING Four community-based primary care clinics ( 17 physicians ) and 1 primary care clinic ( 7 nurse practitioners ) at an urban academic medical center . PATIENTS Of 3397 adults originally screened , 1316 patients ( mean age , 45.9 years ; 76.8 % female ; 90.3 % Hispanic ) who had no regular source of care and kept their initial primary care appointment were enrolled and r and omized with either a nurse practitioner ( n = 806 ) or physician ( n = 510 ) . MAIN OUTCOME MEASURES Patient satisfaction after initial appointment ( based on 15-item question naire ) ; health status ( Medical Outcomes Study Short-Form 36 ) , satisfaction , and physiologic test results 6 months later ; and service utilization ( obtained from computer records ) for 1 year after initial appointment , compared by type of provider . RESULTS No significant differences were found in patients ' health status ( nurse practitioners vs physicians ) at 6 months ( P = .92 ) . Physiologic test results for patients with diabetes ( P = .82 ) or asthma ( P = .77 ) were not different . For patients with hypertension , the diastolic value was statistically significantly lower for nurse practitioner patients ( 82 vs 85 mm Hg ; P = .04 ) . No significant differences were found in health services utilization after either 6 months or 1 year . There were no differences in satisfaction ratings following the initial appointment ( P = .88 for overall satisfaction ) . Satisfaction ratings at 6 months differed for 1 of 4 dimensions measured ( provider attributes ) , with physicians rated higher ( 4.2 vs 4.1 on a scale where 5 = excellent ; P = .05 ) . CONCLUSIONS In an ambulatory care situation in which patients were r and omly assigned to either nurse practitioners or physicians , and where nurse practitioners had the same authority , responsibilities , productivity and administrative requirements , and patient population as primary care physicians , patients ' outcomes were comparable
Where reported , emergency admissions and quality of life were not found to be significantly different between groups .
No information was found regarding BMI , mortality , long term diabetic complications , adverse effects , or costs .
REVIEW ER 'S CONCLUSIONS The presence of a diabetes specialist nurse / nurse case manager may improve patients ' diabetic control over short time periods , but from currently available trials the effects over longer periods of time are not evident .
There were no significant differences overall in hypoglycaemic episodes , hyperglycaemic incidents , or hospital admissions .
Quality of life was not shown to be affected by input from a diabetes specialist nurse/nurse case manager
BACKGROUND The patient with diabetes has many different learning needs relating to diet , monitoring , and treatments .
In many health care systems specialist nurses provide much of these needs , usually aim ing to empower patients to self-manage their diabetes .
The present review aims to assess the effects of the involvement of specialist nurse care on outcomes for  people with diabetes  , compared to usual care in hospital clinics or primary care with no input from specialist nurses .
OBJECTIVES To assess the effects of diabetes specialist nurses / nurse case manager in diabetes on the metabolic control of patients with type 1 and type 2 diabetes mellitus .