Nurse Case Managers Improve Cardiac Risk Control in Diabetes

Nurse case managers can help more patients control hypertension, hyperglycemia, and hyperlipidemia

FRIDAY, Aug. 5 (HealthDay News) -- Nurse case managers can improve the percentage of patients with diabetes who achieve control of hypertension, hyperglycemia, and hyperlipidemia, according to a study published in the August issue of Diabetes Care.

Areef Ishani, M.D., from the Minneapolis Veterans Affairs Health Care System, and colleagues assessed whether nurse case management using therapeutic algorithm can effectively improve rates of control of hypertension, hyperglycemia, and hyperlipidemia compared with usual care among 556 veterans with diabetes. At baseline, patients had blood pressure (BP) >140/90 mmHg, hemoglobin A1c (HbA1c) >9.0 percent, or LDL >100 mg/dL. The percentage of patients achieving simultaneous control of all three parameters (BP <130/80 mm Hg, HbA1c <8.0 percent, and LDL <100 mg/dL) at one year was the primary outcome, while improvement within each individual component of the composite primary outcome was the secondary outcome.

The investigators found that having all three parameters under control was achieved in a significantly larger number of patients assigned to nurse case management compared with the usual-care group (21. 9 versus 10.1 percent). As compared to patients in the usual-care group, the treatment goals of HbA1c and BP were achieved by a larger number of patients assigned to the intervention group (73.7 versus 65.8 percent and 45.0 versus 25.4 percent, respectively), but there was no significant difference in the number of patients who achieved the treatment goals for LDL (57.6 versus 55.4 percent).

"In patients with diabetes, nurse case managers using a treatment algorithm can effectively improve the number of individuals with control of multiple cardiovascular risk factors at one year," the author writes.

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