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 .
Implementation of Treatment Protocols in the Diabetes Control and Complications Trial
OBJECTIVE To describe the methods used to implement intensive and conventional therapies in the Diabetes Control and Complications Trial ( DCCT ) and the metabolic results that occurred with the different treatment regimens . RESEARCH DESIGN AND METHODS The DCCT was a controlled clinical trial that demonstrated the beneficial effect of intensive therapy on the long-term complications of insulin-dependent diabetes mellitus ( IDDM ) . A total of 1,441 volunteers with IDDM , aged 13–39 , from 29 centers in the U.S. and Canada , were r and omly assigned to conventional or intensive diabetes therapy . Intensive therapy , which used multiple daily injections ( MDI ) of insulin ( ≥3 injections/day ) or continuous subcutaneous insulin infusion ( CSI1 ) , was implemented by a team that included diabetes nurses , dietitians , behavioral experts , and diabetologists . Volunteers in the intensive treatment group could use MDI or CSII , based on patient and clinic preference , and could switch between therapies over the course of the study . The volunteers were followed for a mean of 6.5 years ( range 3–9 years ) . RESULTS A detailed analysis of implementation of the two treatments indicates that intensive and conventional treatment subjects adhered to their respective insulin injection regimens > 97 % of the time . Adherence to other elements of intensive treatment was similarly high and result ed in median HbAlc values between 6.7 and 7.2 , compared with 8.7–9.2 with conventional therapy , over the course of the study . Severe hypoglycemia occurred three times more often in intensively treated subjects . Although subjects on intensive treatment were not r and omly assigned to MDI or CSII , we compared those subjects who used either of these methods for > 90 % of the study time . CSIIy-treated patients maintained a mean HbAlc of 6.8 vs. 7.0 in MDI-treated subjects during the trial ( P < 0.05 ) . The frequency of hypoglycemia with coma and seizure and diabetic ketoacidosis was modestly higher with CSII than with MDI . CONCLUSIONS Intensive therapy was implemented successfully in the DCCT . The detailed description herein will serve to facilitate translation of the DCCT results to the clinical setting
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 .