Abstract
The efficacy and safety of replacing doctors with nurse specialists in the routine care of diabetics was assessed in peripatetic diabetes clinics on the Isle of Wight. During the weekly clinic sessions biochemical control was monitored, and patients were educated about the disease. If a physical examination was required the patients were referred to a consultant clinic. The results of biochemical tests were noted in the patients records and copies were passed onto the doctors and consultants in charge.
After one year questionnaires were sent to all general practitioners and patients involved in the study to assess their opinions of the nurse specialist clinics. Random blood sugar levels were similar when the clinics were run by both doctors and nurse specialists. However, glycosylated haemoglobin improved in the Type 1 diabetics controlled by the nurse specialists, and in both Type 1 and Type 2 diabetics the numbers of admissions to hospital from hyperβ or hypoglycaemia decreased.
The majority of GPs were in favour of the nurse run diabetes clinics; 68% felt that the nurse specialist clinics were beneficial for their patients. The patients were also in favour of the nurse specialist clincis, 97% said that they were confident in the nurse specialist system; and over half stated that they would prefer to have this kind of diabetes care in the future.