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
Optimizing diabetes control in people with Type 2 diabetes through nurse-led telecoaching.
AIMS To study the effect of a target-driven telecoaching intervention on HbA1c and other modifiable risk factors in people with Type 2 diabetes . METHODS We conducted a r and omized controlled trial in patients receiving hypoglycaemic agents .  The primary outcome was HbA1c level at 6 months in the entire sample and in a subgroup with HbA1c levels ≥ 53 mmol/mol ( 7 % ) at baseline . Secondary outcomes were HbA1c at 18 months ; total cholesterol , LDL , HDL , triglycerides , blood pressure , BMI and proportion of people who had achieved guideline -recommended targets at 6 and 18 months . RESULTS A total of 287 participants were r and omized to telecoaching and 287 to usual care .  The mean ( sd ) baseline HbA1c level was 53 ( 11 ) mmol/mol [ 7.0 (1.0)% ] overall and 63 ( 10 ) mmol/mol [ 7.9 (0.9)% ] in the elevated HbA1c subgroup . At 6 months , the between-group differences in favour of telecoaching were : HbA1c -2 ( 95 % CI -4 ; -1 ) mmol/mol [ -0.2 ( 95 % CI -0.3;-0.1)% ; P=0.003 ] overall and -4 ( 95 % CI -7 ; -2 ) mmol/mol [ -0.4 ( 95 % CI -0.7 ; -0.2)% ; P=0.001 ] in the elevated HbA1c subgroup ; BMI -0.4 kg/m(2 ) ( 95 % CI -0.6 ; -0.1 ; P=0.003 ) ; total cholesterol -6 mg/dl ( 95 % CI -11 ; -1 , P=0.012 ) . The proportion of participants on target for the composite of HbA1c , LDL and blood pressure increased by 8.9 % in the intervention group and decreased by 1.3 % in the control group ( P=0.011 ) . At 18 months , the difference in HbA1c was : -2 ( 95 % CI -3;-0 ) mmol/mol [ -0.2 ( 95 % CI -0.3 ; -0.0)% ; P=0.046 ] overall and -4 ( -7 ; -1 ) mmol/mol [ -0.4 ( 95 % CI -0.7 ; -0.1)% ; P=0.023 ] in the elevated HbA1c subgroup . CONCLUSION Nurse-led telecoaching  improved glycaemic control , total cholesterol levels and BMI in people with Type 2 diabetes . Twelve months after the intervention completion , there were sustained improvements in glycaemic control
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