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 .
A Trial of Cognitive Analytic Therapy in Poorly Controlled Type I Patients
OBJECTIVE This study compared the effect of cognitive analytic therapy ( CAT ) , a focused time-limited psychotherapy , and diabetes specialist nurse education ( DSNE ) in a controlled trial of 26 chronically poorly controlled adult type I patients . RESEARCH DESIGN AND METHODS Patients were r and omized to either 16 sessions of CAT ( treatment )  or 14–18 sessions of DSNE ( control ) . Pre- and post-treatment blood glucose control ( HbA1 ) , interpersonal difficulties , and diabetes knowledge were measured before and up to 9 months after treatment was completed . RESULTS Although HbA1 levels improved in the DSNE group , at the end of treatment ( mean fall 1.2 % , P = 0.004 ) this was not maintained ; so by the 9-month follow-up , the overall net fall was limited to 0.9 % ( P = 0.03 vs. entry value ) . There were no significant improvements in interpersonal difficulties in DSNE subjects at any retest point ( P > 0.05 ) . In contrast , glycemic control and interpersonal difficulties both improved after CAT . In contrast to DSNE , this improvement continued so that at the 9-month follow-up visit , the changes were significant ( mean fall in HbA1 = 2 % , P = 0.002 and P = 0.03 for the Inventory of Interpersonal Problems [ IIP ] scores ) . CONCLUSIONS These results suggest that although there is no statistical difference between CAT and DSNE , the effects of CAT produce a more prolonged effect on glycemic control . If psychological difficulties underlying problems with self-care in a type I population are addressed , then improvements in diabetes control are likely to continue
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 .