Diabetes nurse case management: Improving glucose control: 10 years of quality improvement follow-up data

The purpose of this retrospective case-control review is to determine the effectiveness of a registered nurse case managers (RNCMs) certified diabetes educator (CDE) quality improvement case management program. RNCMs have a long tradition of providing chronic care intervention, particularly for the high-risk diabetes population with glycosylated hemoglobin (A1C) of 9% or more. However, limited data are available with regard to evaluation of such programs in a Veterans Health Administration population. Results: A large population (N = 3956) of high-risk veterans with a baseline A1C of 9% or more (mean = 10.6%) was seen by the RNCM's. Paired T-tests of A1C after the last RNCM visit showed a statistically significant A1C reduction (p < 0.001) (mean = 8.5%), after 14-26 months of intervention. Conclusions: RNCMs clinical intervention demonstrated significant A1C reduction (~ 2%). This is an important finding for health care policy makers for planning interventions with respect to long-term management of diabetes mellitus.