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 .
Home-based Management Can Achieve Intensification Cost-effectively in Type I Diabetes
Background . Newly diagnosed insulin-dependent diabetic children are most often admitted to hospital for education and insulin management and subsequently followed in outpatient clinics or office setting s. However , most could be managed at home , given adequate family and health care team support and subsequent follow-up facilitated by home-based nursing intervention . We conducted a r and omized trial of clinical , psychosocial , and cost effects of home-based management in a 2-year follow-up study of newly diagnosed diabetic children . Methods . Sixty three patients were r and omly assigned to  traditional hospitalization and outpatient follow-up ( hospital-based group ) or home management ( home-based group ) . Treatment differences between the two groups consisted of duration of initial hospital stay , site and timing of initial teaching , and nature and extent of subsequent nursing follow-up . Metabolic control was assessed by means of quarterly glycosylated hemoglobin measurements for 24 months and then at 36 months . Diabetes-related adverse events , knowledge of diabetes , adherence to the diabetes regimen , psychosocial impact , and social ( total ) costs incurred were assessed for 24 months . Findings . Glycosylated hemoglobin concentrations were significantly lower in the home-based group at 12 to 24 months and at 36 months . Both groups had comparable numbers of diabetes-related adverse events . There were no significant group differences in psychosocial impact . Parents in the home-based group spent significantly fewer hours on diabetes care and incurred significantly lower out-of-pocket expenses during the 1st month . Health care sector costs were significantly higher . Hospital costs were $ 889 higher , and government costs $ 890 higher per child . Social ( total ) costs were only $ 48 higher per case ( NS ) with home care when parents ' time was valued at $ 11.88 per hour . Interpretation . Home-based management for newly diagnosed diabetic children can result in better metabolic control and similar psychosocial outcomes compared with traditional hospital- and clinic-based care without notable effects on social ( total ) costs
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 .