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 .
Failure to maintain the benefits of home-based intervention in adolescents with poorly controlled type 1 diabetes.
OBJECTIVE To determine whether a 6-month home-based intervention program in adolescents with poorly controlled diabetes improves metabolic control and whether benefits are maintained after the intervention . RESEARCH DESIGN AND METHODS Adolescents with a mean HbA1c of > 9.0 % over the preceding 12 months received either  routine care in a diabetes clinic and an ambulatory intervention for 6 months ( n = 37 ) or routine care only ( n = 32 ) . A diabetes educator provided monthly home visits and weekly phone contact to educate and support the adolescents in setting goals for insulin adjustment , blood glucose monitoring , and target blood glucose range . There was no systematic change in the frequency of insulin injections . After the intervention , there was a 12-month follow-up when the intervention and control groups both received only routine care . Outcome measures were HbA1c and Diabetes Knowledge Assessment ( DKN ) . RESULTS During the intervention , mean HbA1c fell ( baseline : 11.1 + /- 1.3 % , 6 months : 9.7 + /- 1.6 % ; P = 0.0001 ) and mean knowledge scores increased ( P = 0.0001 ) in the intervention group but not in control subjects . However , this improvement in HbA1c and increase in knowledge was not maintained in the intervention group at 12- and 18-month follow-up assessment s. Parents ' knowledge scores also improved significantly from baseline levels in the intervention group at 6 and 12 months ( P = 0.001 , P = 0.005 , respectively ) . CONCLUSIONS An ambulatory program improves metabolic control and knowledge in adolescents with poorly controlled type 1 diabetes ; however , it is effective only while the intervention is maintained
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 .