According to a study published today in the of The the BMJ , a new model of health care that focuses on increasing the role of nurses in primary health care, is associated with a wider intake of insulin in patients with type 2 diabetes.
According to forecasts by 2030 Type 2 diabetes is diagnosed at 600 million people, so innovation in the provision of effective clinical care for patients with diabetes is an urgent priority.
Leadership of the UK, US and Europe recommend early use of insulin for better long-term results. However, insulin therapy is often delayed due to barriers in clinical practice, especially in the field of primary health care.
A group of researchers led by John Furlerom from the University of Melbourne in Australia assessed the results of the implementation model, Stepping Up, which focuses on eliminating some of the barriers observed in clinical practice, enabling nurses to manage patients with insulin treatment as part of routine care. Increasing the role of nurses who are trained skilled employees, this model uses existing resources to improve results.
The study compared patients receiving nurse consultations within the model Stepping Up, with a control group where patients received usual medical care. 266 patients participated in the study.
After 12 months, patients had significantly higher levels of HbA1 c (an important indicator of blood glucose), which is associated with the best long-term results such as reduction in the incidence of kidney disease and eye. The authors note that the study results are not suitable for all people with diabetes.
According to scientists, the results show that, with appropriate support and restructuring practice therapy with insulin may be part of the standard diabetes treatment in primary health care by eliminating the need to refer to specialist services with geographical, cost and available barriers. The study has important implications for policy makers, funders, and practitioners who are looking for innovative ways to provide the best care for people with type 2 diabetes in primary health care.