Case Study Nursing Diabetes Educator

The specialized role of nursing in the care and education of people with diabetes has been in existence for more than 30 years. Diabetes education carried out by nurses has moved beyond the hospital bedside into a variety of health care settings. Among the disciplines involved in diabetes education, nursing has played a pivotal role in the diabetes team management concept. This was well illustrated in the Diabetes Control and Complications Trial (DCCT) by the effectiveness of nurse managers in coordinating and delivering diabetes self-management education. These nurse managers not only performed administrative tasks crucial to the outcomes of the DCCT, but also participated directly in patient care.1

The emergence and subsequent growth of advanced practice in nursing during the past 20 years has expanded the direct care component, incorporating aspects of both nursing and medical care while maintaining the teaching and counseling roles. Both the clinical nurse specialist (CNS) and nurse practitioner (NP) models, when applied to chronic disease management, create enhanced patient-provider relationships in which self-care education and counseling is provided within the context of disease state management. Clement2 commented in a review of diabetes self-management education issues that unless ongoing management is part of an education program, knowledge may increase but most clinical outcomes only minimally improve. Advanced practice nurses by the very nature of their scope of practice effectively combine both education and management into their delivery of care.

Operating beyond the role of educator, advanced practice nurses holistically assess patients’ needs with the understanding of patients’ primary role in the improvement and maintenance of their own health and wellness. In conducting assessments, advanced practice nurses carefully explore patients’ medical history and perform focused physical exams. At the completion of assessments, advanced practice nurses, in conjunction with patients, identify management goals and determine appropriate plans of care. A review of patients’ self-care management skills and application/adaptation to lifestyle is incorporated in initial histories, physical exams, and plans of care.

Many advanced practice nurses (NPs, CNSs, nurse midwives, and nurse anesthetists) may prescribe and adjust medication through prescriptive authority granted to them by their state nursing regulatory body. Currently, all 50 states have some form of prescriptive authority for advanced practice nurses.3 The ability to prescribe and adjust medication is a valuable asset in caring for individuals with diabetes. It is a crucial component in the care of people with type 1 diabetes, and it becomes increasingly important in the care of patients with type 2 diabetes who have a constellation of comorbidities, all of which must be managed for successful disease outcomes.

Many studies have documented the effectiveness of advanced practice nurses in managing common primary care issues.4 NP care has been associated with a high level of satisfaction among health services consumers. In diabetes, the role of advanced practice nurses has significantly contributed to improved outcomes in the management of type 2 diabetes,5 in specialized diabetes foot care programs,6 in the management of diabetes in pregnancy,7 and in the care of pediatric type 1 diabetic patients and their parents.8,9 Furthermore, NPs have also been effective providers of diabetes care among disadvantaged urban African-American patients.10 Primary management of these patients by NPs led to improved metabolic control regardless of whether weight loss was achieved.

The following case study illustrates the clinical role of advanced practice nurses in the management of a patient with type 2 diabetes.

Case Presentation

A.B. is a retired 69-year-old man with a 5-year history of type 2 diabetes. Although he was diagnosed in 1997, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with large pasta meals and Italian pastries. At the time of initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken.

Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of mild agitation, in the late afternoon.

A.B. also takes atorvastatin (Lipitor), 10 mg daily, for hypercholesterolemia (elevated LDL cholesterol, low HDL cholesterol, and elevated triglycerides). He has tolerated this medication and adheres to the daily schedule. During the past 6 months, he has also taken chromium picolinate, gymnema sylvestre, and a “pancreas elixir” in an attempt to improve his diabetes control. He stopped these supplements when he did not see any positive results.

He does not test his blood glucose levels at home and expresses doubt that this procedure would help him improve his diabetes control. “What would knowing the numbers do for me?,” he asks. “The doctor already knows the sugars are high.”

A.B. states that he has “never been sick a day in my life.” He recently sold his business and has become very active in a variety of volunteer organizations. He lives with his wife of 48 years and has two married children. Although both his mother and father had type 2 diabetes, A.B. has limited knowledge regarding diabetes self-care management and states that he does not understand why he has diabetes since he never eats sugar. In the past, his wife has encouraged him to treat his diabetes with herbal remedies and weight-loss supplements, and she frequently scans the Internet for the latest diabetes remedies.

During the past year, A.B. has gained 22 lb. Since retiring, he has been more physically active, playing golf once a week and gardening, but he has been unable to lose more than 2–3 lb. He has never seen a dietitian and has not been instructed in self-monitoring of blood glucose (SMBG).

A.B.’s diet history reveals excessive carbohydrate intake in the form of bread and pasta. His normal dinners consist of 2 cups of cooked pasta with homemade sauce and three to four slices of Italian bread. During the day, he often has “a slice or two” of bread with butter or olive oil. He also eats eight to ten pieces of fresh fruit per day at meals and as snacks. He prefers chicken and fish, but it is usually served with a tomato or cream sauce accompanied by pasta. His wife has offered to make him plain grilled meats, but he finds them “tasteless.” He drinks 8 oz. of red wine with dinner each evening. He stopped smoking more than 10 years ago, he reports, “when the cost of cigarettes topped a buck-fifty.”

The medical documents that A.B. brings to this appointment indicate that his hemoglobin A1c (A1C) has never been <8%. His blood pressure has been measured at 150/70, 148/92, and 166/88 mmHg on separate occasions during the past year at the local senior center screening clinic. Although he was told that his blood pressure was “up a little,” he was not aware of the need to keep his blood pressure ≤130/80 mmHg for both cardiovascular and renal health.11

A.B. has never had a foot exam as part of his primary care exams, nor has he been instructed in preventive foot care. However, his medical records also indicate that he has had no surgeries or hospitalizations, his immunizations are up to date, and, in general, he has been remarkably healthy for many years.

Physical Exam

A physical examination reveals the following:

  • Weight: 178 lb; height: 5′2″; body mass index (BMI): 32.6 kg/m2

  • Fasting capillary glucose: 166 mg/dl

  • Blood pressure: lying, right arm 154/96 mmHg; sitting, right arm 140/90 mmHg

  • Pulse: 88 bpm; respirations 20 per minute

  • Eyes: corrective lenses, pupils equal and reactive to light and accommodation, Fundi-clear, no arteriolovenous nicking, no retinopathy

  • Thyroid: nonpalpable

  • Lungs: clear to auscultation

  • Heart: Rate and rhythm regular, no murmurs or gallops

  • Vascular assessment: no carotid bruits; femoral, popliteal, and dorsalis pedis pulses 2+ bilaterally

  • Neurological assessment: diminished vibratory sense to the forefoot, absent ankle reflexes, monofilament (5.07 Semmes-Weinstein) felt only above the ankle

Lab Results

Results of laboratory tests (drawn 5 days before the office visit) are as follows:

  • Glucose (fasting): 178 mg/dl (normal range: 65–109 mg/dl)

  • Creatinine: 1.0 mg/dl (normal range: 0.5–1.4 mg/dl)

  • Blood urea nitrogen: 18 mg/dl (normal range: 7–30 mg/dl)

  • Sodium: 141 mg/dl (normal range: 135–146 mg/dl)

  • Potassium: 4.3 mg/dl (normal range: 3.5–5.3 mg/dl)

  • Lipid panel

        • Total cholesterol: 162 mg/dl (normal: <200 mg/dl)

        • HDL cholesterol: 43 mg/dl (normal: ≥40 mg/dl)

        • LDL cholesterol (calculated): 84 mg/dl (normal: <100 mg/dl)

        • Triglycerides: 177 mg/dl (normal: <150 mg/dl)

        • Cholesterol-to-HDL ratio: 3.8 (normal: <5.0)

  • AST: 14 IU/l (normal: 0–40 IU/l)

  • ALT: 19 IU/l (normal: 5–40 IU/l)

  • Alkaline phosphotase: 56 IU/l (normal: 35–125 IU/l)

  • A1C: 8.1% (normal: 4–6%)

  • Urine microalbumin: 45 mg (normal: <30 mg)


Based on A.B.’s medical history, records, physical exam, and lab results, he is assessed as follows:

  • Uncontrolled type 2 diabetes (A1C >7%)

  • Obesity (BMI 32.4 kg/m2)

  • Hyperlipidemia (controlled with atorvastatin)

  • Peripheral neuropathy (distal and symmetrical by exam)

  • Hypertension (by previous chart data and exam)

  • Elevated urine microalbumin level

  • Self-care management/lifestyle deficits

        • Limited exercise

        • High carbohydrate intake

        • No SMBG program

  • Poor understanding of diabetes


A.B. presented with uncontrolled type 2 diabetes and a complex set of comorbidities, all of which needed treatment. The first task of the NP who provided his care was to select the most pressing health care issues and prioritize his medical care to address them. Although A.B. stated that his need to lose weight was his chief reason for seeking diabetes specialty care, his elevated glucose levels and his hypertension also needed to be addressed at the initial visit.

The patient and his wife agreed that a referral to a dietitian was their first priority. A.B. acknowledged that he had little dietary information to help him achieve weight loss and that his current weight was unhealthy and “embarrassing.” He recognized that his glucose control was affected by large portions of bread and pasta and agreed to start improving dietary control by reducing his portion size by one-third during the week before his dietary consultation. Weight loss would also be an important first step in reducing his blood pressure.

The NP contacted the registered dietitian (RD) by telephone and referred the patient for a medical nutrition therapy assessment with a focus on weight loss and improved diabetes control. A.B.’s appointment was scheduled for the following week. The RD requested that during the intervening week, the patient keep a food journal recording his food intake at meals and snacks. She asked that the patient also try to estimate portion sizes.

Although his physical activity had increased since his retirement, it was fairly sporadic and weather-dependent. After further discussion, he realized that a week or more would often pass without any significant form of exercise and that most of his exercise was seasonal. Whatever weight he had lost during the summer was regained in the winter, when he was again quite sedentary.

A.B.’s wife suggested that the two of them could walk each morning after breakfast. She also felt that a treadmill at home would be the best solution for getting sufficient exercise in inclement weather. After a short discussion about the positive effect exercise can have on glucose control, the patient and his wife agreed to walk 15–20 minutes each day between 9:00 and 10:00 a.m.

A first-line medication for this patient had to be targeted to improving glucose control without contributing to weight gain. Thiazolidinediones (i.e., rosiglitizone [Avandia] or pioglitizone [Actos]) effectively address insulin resistance but have been associated with weight gain.12 A sulfonylurea or meglitinide (i.e., repaglinide [Prandin]) can reduce postprandial elevations caused by increased carbohydrate intake, but they are also associated with some weight gain.12 When glyburide was previously prescribed, the patient exhibited signs and symptoms of hypoglycemia (unconfirmed by SMBG). α-Glucosidase inhibitors (i.e., acarbose [Precose]) can help with postprandial hyperglycemia rise by blunting the effect of the entry of carbohydrate-related glucose into the system. However, acarbose requires slow titration, has multiple gastrointestinal (GI) side effects, and reduces A1C by only 0.5–0.9%.13 Acarbose may be considered as a second-line therapy for A.B. but would not fully address his elevated A1C results. Metformin (Glucophage), which reduces hepatic glucose production and improves insulin resistance, is not associated with hypoglycemia and can lower A1C results by 1%. Although GI side effects can occur, they are usually self-limiting and can be further reduced by slow titration to dose efficacy.14

After reviewing these options and discussing the need for improved glycemic control, the NP prescribed metformin, 500 mg twice a day. Possible GI side effects and the need to avoid alcohol were of concern to A.B., but he agreed that medication was necessary and that metformin was his best option. The NP advised him to take the medication with food to reduce GI side effects.

The NP also discussed with the patient a titration schedule that increased the dosage to 1,000 mg twice a day over a 4-week period. She wrote out this plan, including a date and time for telephone contact and medication evaluation, and gave it to the patient.

During the visit, A.B. and his wife learned to use a glucose meter that features a simple two-step procedure. The patient agreed to use the meter twice a day, at breakfast and dinner, while the metformin dose was being titrated. He understood the need for glucose readings to guide the choice of medication and to evaluate the effects of his dietary changes, but he felt that it would not be “a forever thing.”

The NP reviewed glycemic goals with the patient and his wife and assisted them in deciding on initial short-term goals for weight loss, exercise, and medication. Glucose monitoring would serve as a guide and assist the patient in modifying his lifestyle.

A.B. drew the line at starting an antihypertensive medication—the angiotensin-converting enzyme (ACE) inhibitor enalapril (Vasotec), 5 mg daily. He stated that one new medication at a time was enough and that “too many medications would make a sick man out of me.” His perception of the state of his health as being represented by the number of medications prescribed for him gave the advanced practice nurse an important insight into the patient’s health belief system. The patient’s wife also believed that a “natural solution” was better than medication for treating blood pressure.

Although the use of an ACE inhibitor was indicated both by the level of hypertension and by the presence of microalbuminuria, the decision to wait until the next office visit to further evaluate the need for antihypertensive medication afforded the patient and his wife time to consider the importance of adding this pharmacotherapy. They were quite willing to read any materials that addressed the prevention of diabetes complications. However, both the patient and his wife voiced a strong desire to focus their energies on changes in food and physical activity. The NP expressed support for their decision. Because A.B. was obese, weight loss would be beneficial for many of his health issues.

Because he has a sedentary lifestyle, is >35 years old, has hypertension and peripheral neuropathy, and is being treated for hypercholestrolemia, the NP performed an electrocardiogram in the office and referred the patient for an exercise tolerance test.11 In doing this, the NP acknowledged and respected the mutually set goals, but also provided appropriate pre-exercise screening for the patient’s protection and safety.

In her role as diabetes educator, the NP taught A.B. and his wife the importance of foot care, demonstrating to the patient his inability to feel the light touch of the monofilament. She explained that the loss of protective sensation from peripheral neuropathy means that he will need to be more vigilant in checking his feet for any skin lesions caused by poorly fitting footwear worn during exercise.

At the conclusion of the visit, the NP assured A.B. that she would share the plan of care they had developed with his primary care physician, collaborating with him and discussing the findings of any diagnostic tests and procedures. She would also work in partnership with the RD to reinforce medical nutrition therapies and improve his glucose control. In this way, the NP would facilitate the continuity of care and keep vital pathways of communication open.


Advanced practice nurses are ideally suited to play an integral role in the education and medical management of people with diabetes.15 The combination of clinical skills and expertise in teaching and counseling enhances the delivery of care in a manner that is both cost-reducing and effective. Inherent in the role of advanced practice nurses is the understanding of shared responsibility for health care outcomes. This partnering of nurse with patient not only improves care but strengthens the patient’s role as self-manager.


  • Geralyn Spollett, MSN, C-ANP, CDE, is associate director and an adult nurse practitioner at the Yale Diabetes Center, Department of Endocrinology and Metabolism, at Yale University in New Haven, Conn. She is an associate editor of Diabetes Spectrum.

  • Note of disclosure: Ms. Spollett has received honoraria for speaking engagements from Novo Nordisk Pharmaceuticals, Inc., and Aventis and has been a paid consultant for Aventis. Both companies produce products and devices for the treatment of diabetes.

  • American Diabetes Association


Abu Hassan, H., Tohid, H., Mohd Amin, R., Long Bidin, M.B., Muthupalaniappen, L., & Omar, K. (2013). Factors influencing insulin acceptance among type 2 diabetes mellitus patients in a primary care clinic: a qualitative exploration. BMC Fam Pract. 2013 Oct 29;14:164. doi: 10.1186/1471-2296-14-164.

Ahmed, A, Jabbar, A., Zuberi, L., Islam, M., Shamim, K. (2012). Diabetes related knowledge among residents and nurses: a multicenter study in Karachi, Pakistan. BMC Endocr Disord. 2012 Sep 11;12:18. doi: 10.1186/1472-6823-12-18.

Ahmin, N., & Doupis, J. (2016). Diabetic foot disease: From the evaluation of the “foot at risk” to the novel diabetic ulcer treatments. World J Diabetes, 7(7), 153-164.

Ahola, A.J., & Groop, P.H. (2013). Barriers to self-management of diabetes. Diabet Med,(4),413-420.

American Diabetes Association. (2016).Standards of medical care in diabetes – 2016. Diab Care, 39 (Suppl 1), S1-S119.

Attridge, M., Creamer, J., Ramsden, M., Cannings-John, R., & Hawthorne, K. (2014). Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2014 Sep 4;9:CD006424. doi: 10.1002/14651858.CD006424.pub3.

Baig, A.A., Benitez, A., Quinn, M.T.,  & Burnet, D.L. (2015). Family interventions to improve diabetes outcomes for adults. Ann N Y Acad Sci. 2015 Sep;1353:89-112. doi: 10.1111/nyas.12844. Epub 2015 Aug 6.

Balk, E.M., Earley, A., Raman, G., Avendano, E.A., Pittas, A.G., & Remington, P.L. (2015). Combined diet and physical activity promotion programs to prevent type 2 diabetes among persons at increased risk: A systematic review for the community preventive services task force. Ann Intern Med,163(6),437-451.

Black, S., Maitland, C., Hilbers, J., Orinuela, K. (2016). Diabetes literacy and informal social support: A qualitative study of patients at a diabetes centre. J Clin Nurs. 2016 May 18. doi: 10.1111/jocn.13383. [Epub ahead of print]

Bonner, T., Foster M., & Spears-Lanoix, E. (2016). Type 2 diabetes-related foot care knowledge and foot self-care practice interventions in the United States: a systematic review of the literature. Diabet Foot Ankle. 2016 Feb 17;7:29758. doi: 10.3402/dfa.v7.29758. eCollection 2016.

Broadbent, E., Donkin, L., & Stroh, J.C. (2011). Illness and treatment perceptions are associated with adherence to medications, diet, and exercise in diabetic patients. Diabetes Care, 34(2), 38-40.

Brown, S.A., García, A.A., Brown, A., Backer, B.J., Conn, V.S., Ramírez, G.,…Cuevas, H.E. (2016). Biobehavioral determinants of glycemic control in type 2 diabetes: A systematic review and meta-analysis. Patient Educ Couns. 2016 Mar 19. pii: S0738-3991(16)30142-2. doi: 10.1016/j.pec.2016.03.020. [Epub ahead of print]

Centers for Disease Prevention and Control. (2014). National Diabetes Statistics Report. Accessed May 8, 2016 (Visit Source).

Centers for Disease Control and Prevention. (2014) Diabetes 2014 Report Card. Accessed may 8, 2016 (Visit Source).

Chang, S.A. (2012). Smoking and type 2 diabetes mellitus. Diabetes Metab J, 36(6), 399-403.

Colberg, S.R., Sigal, R.J., Fernhall, B. Regensteirner, J.G., Blissmer, B J., Rubin, R.R.,…Braun, B. (2010). Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care, 33(12), e147-e167.

Cryer, P.E. (2016). Management of hypoglycemia during treatment of diabetes mellitus. UpToDate, February 22, 2016. Accessed May 30, 2016 (Visit Source).

Dabelea, D., Mayer-Davis, E.J., & Saydah, S., (2014). Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA, 311(17),1778-1786.

Darbishire, P.L., Plake, K.S., Nash, C.L., & Shepler, B.M. (2009). Active-learning laboratory session to teach the four M's of diabetes care. Am J Pharm Educ, 73(2), Article 22, 1-9.

Davies, M.J., Gray, L.J., Troughton, J., Gray, A., Tuomilehto, J., Faroogi, A.,…Yates, T. (2016). A community based primary prevention programme for type 2 diabetes integrating identification and lifestyle intervention for prevention: the Let's Prevent Diabetes cluster randomised controlled trial. Prev Med, 84,48-56.

DeSisto, C.L., Kim, S.Y., & Sharma, A.J. (2014). Prevalence estimates of gestational diabetes mellitus in the United States, Pregnancy Risk Assessment Monitoring System (PRAMS), 2007-2010. Prev Chronic Dis. 2014 Jun 19;11:E104. doi: 10.5888/pcd11.130415.

Ghorob, A., Vivas, M.M., De Vore, D., Ngo, V., Bodenheimer, T., Chen, E., & Thom, D. (2011). The effectiveness of peer health coaching in improving glycemic control among low-income patients with diabetes: protocol for a randomized controlled trial. BMC Public Health, 11, 208-213.

Fitzgerald, J.T., Funnell, M.M., Anderson, R.M., Nwankwo, R., Stansfield, R.B., & Piatt, G.A. (2016). Validation of the revised brief diabetes knowledge test (DKT2). Diabetes Educ. 2016 Apr;42(2):178-87. doi: 10.1177/0145721715624968. Epub 2016 Jan 14.

Haas, L., Maryniuk,  M., Beck. J., Cox, C.E., Duker, P., Edwards, L.,…Youssef, G. (2014) National standards for diabetes self-management education and support. Diab Care, 37(Suppl. 1), S144 - S153

Han, J., Kim, S., Kim, G., Kim, E., & Lee, S.Y. (2016). Factors affecting a screening for diabetic complication in community: A multi-level analysis. Epidemiol Health. 2016 May 3. doi: 10.4178/epih.e2016017. [Epub ahead of print]

Hempler, N.F., Joensen, L.E., & Willaing, I. (2016). Relationship between social network, social support and health behaviour in people with type 1 and type 2 diabetes: cross-sectional studies. BMC Public Health. 2016 Feb 29;16(1):198. doi: 10.1186/s12889-016-2819-1.

Horigan, G., Davies, M., Findlay-White, F., Chaney, D., & Coates, V. (2016). Reasons why patients referred to diabetes education programmes choose not to attend: a systematic review. Diabet Med. 2016 Mar 21. doi: 10.1111/dme.13120. [Epub ahead of print]

Hussain, R., Rajesh, B., Giridhar, A., Gopalakrishnan, M., Sadasivan, S., James, J.,…John, N. (2016). Knowledge and awareness about diabetes mellitus and diabetic retinopathy in suburban population of a South Indian state and its practice among the patients with diabetes mellitus: A population-based study. Indian J Ophthalmol, 64, (4),272-276.

Kim, M.T., Han, H.R., Song, H.J., Lee, J.E., Kim, J., Ryu, J.P., & Kim, K.B. (2009). A community-based, culturally tailored behavioral intervention for Korean Americans with type 2 diabetes. Diabetes Education, 35(6), 986-994.

Knowler, W.C., Barrett-Connor, E., Fowler, S.E., Hamman, R.F., Lachin, J.M., Walker, E.A., & Nathan, D.M.; Diabetes Prevention Program Research Group. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med, 346(6), 393-403.

Krishnan, V., & Thirunavukkarasu, J. (2016). Assessment of knowledge of self blood glucose monitoring and extent of self titration of anti-diabetic drugs among diabetes mellitus patients - A cross sectional, community based study. J Clin Diagn Res. 2016 Mar;10(3):FC09-11. doi: 10.7860/JCDR/2016/18387.7396. Epub 2016 Mar 1.

Kueh, Y.C., Morris, T., Borkoles, E., Shee, H. (2015). Modelling of diabetes knowledge, attitudes, self-management, and quality of life: a cross-sectional study with an Australian sample. Health Qual Life Outcomes. 2015 Aug 19;13:129. doi: 10.1186/s12955-015-0303-8.

Kueh, Y.C., Morris, T., Ismail, A.A.(2016). The effect of diabetes knowledge and attitudes on self-management and quality of life among people with type 2 diabetes. Psychol Health Med. 2016 Feb 5:1-7. [Epub ahead of print]

Mahon, A.M., Moore, G.D., Gazes, M.I., Chusid, E., & MacGilchrist, C. (2016). An investigation of diabetes knowledge levels between newly diagnosed type 2 diabetes patients in Galway, Ireland and New York, USA: A cross-sectional study. Int J Low Extrem Wounds. 2016 Mar 23. pii: 1534734616638775. [Epub ahead of print]

Mainous, A.G. III, Tanner, R.J., Baker, R. (2016). Prediabetes diagnosis and treatment in primary care. J Am Board Fam Med, 29(2):283-285

May, M., & Schindler, C. (2016). Clinically and pharmacologically relevant interactions of antidiabetic drugs. Ther Adv Endocrinol Metab. 2016,7(2),69-83.

Mayberry, L.S., & Osborn, C.Y. (2014). Family involvement is helpful and harmful to patients' self-care and glycemic control. Patient Educ Couns, 97, (3),418-425.

Mehravar, F., Mansournia, M.A., Holakouie-Naieni, K., Nasli-Esfahani, E,, Mansournia, N., & Almasi-Hashiani, A. (2016). Associations between diabetes self-management and microvascular complications in patients with type 2 diabetes. Epidemiol Health. 2016 Jan 25;38:e2016004. doi: 10.4178/epih/e2016004. eCollection 2016.

Mendes, G.F., Nogueira, J.A., Reis, C.E., DE Meiners, M.M., & Dullius, J. (2016). Diabetes education program with emphasis on physical exercise promotes significant reduction in blood glucose, HbA1c and triglycerides in subjects with type 2 diabetes: a community-based quasi-experimental study. J Sports Med Phys Fitness. 2016 May 24. [Epub ahead of print]

Modesti, P.A., Galanti, G., Cala', P., & Calabrese, M. (2016). Lifestyle interventions in preventing new type 2 diabetes in Asian populations. Intern Emerg Med, 11(3), 375-384.

Osborn, C.Y., & Gonzalez, J.S. (2016). Measuring insulin adherence among adults with type 2 diabetes. J Behav Med. 2016 Apr 9. [Epub ahead of print]

Patiño-Fernandez, A.M., Eidson, M., Sanchez, J., & Delamater, A.M. (2010). What do youth with type 1 diabetes know about the HbA1c test? Child Health Care. 38(2), 157-167.

Powers, M.A., Bardsley, J., Cypress, M., Duker, P., Funnell, M.M., Fischl, A.H.,…Vivian, E. (2015). Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Diabetes Educ,41(4),417-430.

Prabhu, M., Kakhandaki, A., Chandra, K.R., & Dinesh, M.B. (2016). A hospital based study regarding awareness of association between glycosylated haemoglobin and severity of diabetic retinopathy in type 2 diabetic individuals. J Clin Diagn Res. 2016 Jan;10(1):NC01-4. doi: 10.7860/JCDR/2016/15834.7014. Epub 2016 Jan 1.

Prasad, S., & Cucullo, L. (2015). Impact of tobacco smoking and type-2 diabetes mellitus on public health: A cerebrovascular persepective. J Pharmacovigil. 2015 Nov;Suppl 2. pii: e003. Epub 2015 Nov 12.

Pronk, N.P., & Remington. P.L.; Community Preventive Services Task Force. (2015). Combined diet and physical activity promotion programs for prevention of diabetes: Community preventive services task force recommendation statement. Ann Intern Med,163(6):465-468.

Rashed, O.A., Sabbah,H.A., Younis, M.Z., Kisa, A., & Parkash, J. (2016). Diabetes education program for people with type 2 diabetes: An international perspective. Eval Program Plann. 2016, 56:64-68.

Sakane N., Sato J., Tsushita K., Tsujii, S., Kotani, K., Tominaga, M.,…Kuzuya, H; Japan Diabetes Prevention Program Research Group. (2011). Prevention of type 2 diabetes in a primary health care setting: three- year results of lifestyle intervention in Japanese subjects with impaired glucose tolerance. BMC Public Health, 11(1), 40-49.

Samson, W.K., Stein, L.M., Elrick, M., Salvatori, A., Kolar, G., Corbett, J.A., & Yosten, G.L.C. (2016). Hypoglycemia unawareness prevention: Targeting glucagon production. Physiol Behav. 2016 Apr 11. pii: S0031-9384(16)30147-0. doi: 10.1016/j.physbeh.2016.04.012. [Epub ahead of print]

Sapkota, S., Brien, J.A., Greenfield, J.,& Aslani, P. (2015). A systematic review of interventions addressing adherence to anti-diabetic medications in patients with type 2 diabetes--impact on adherence. PLoS One. 2015 Feb 24;10(2):e0118296. doi: 10.1371/journal.pone.0118296. eCollection 2015.

Saundankar, V., Peng, X., Fu, H., Ascher-Svanum, H., Rodriguez, A., Ali, A.,…Louder, A.(2016). Predictors of change in adherence status from 1 Year to the next among patients with type 2 diabetes mellitus on oral antidiabetes drugs. J Manag Care Spec Pharm, 22 (5),467-482.

Schreiner, B., & Ponder, S. (2015). Self-management education for the child with diabetes mellitus. (2015. UpToDate, September 16, 2015. Accessed May 28, 2016 (Visit Source).

Schwartz, S.S., Epstein, S., Corkey, B.E., Grant, S.F.A., Gavin III, J.R., & Aguilar, R.B. (2016). Rationale and implications of the beta-cell-centric classification schema. Diab Care, 39(2), 179-186.

Shivashankar, R., Bhalla, S., Kondal, D., Ali, M.K., Prabhakaran, D., Narayan, K,M., & Tandon, N. (2016).Adherence to diabetes care processes at general practices in the National Capital Region-Delhi, India. Indian J Endocrinol Metab, 20,(3),329-336.

Tol, A., Alhani, F., Shojaeazadeh, D., Sharifirad, G., & Moazam, N. (2015). An empowering approach to promote the quality of life and self-management among type 2 diabetic patients. J Educ Health Promot. 2015 Mar 26;4:13. doi: 10.4103/2277-9531.154022. eCollection 2015.

Trep, R., Wille, T., Wieland, T., & Reinhart, W.H. (2010). Diabetes-related knowledge among medical and nursing house staff. Swiss Medical Weekly, 140(25-26), 370-375.

Utz, S.W., Williams, I.C., Jones, R., Hinton, I., Alexander, G., Yan, G.,…Oliver, M.N. (2008). Culturally tailored intervention for rural African Americans with type 2 diabetes. Diabetes Education, 3(5), 854-865.

Vorderstrasse, A., Lewinski, A., Melkus, G.D., & Johnson, C. (2016). Social Support for Diabetes Self-Management via eHealth Interventions. Curr Diab Rep. 2016 Jul;16(7):56. doi: 10.1007/s11892-016-0756-0.

Weinstock, R.S., DuBose, S.N., Bergenstal, R.M., Chaytor, N.S., Peterson, C., Olson, B.A.,…Hirsch, I.B. (2016). Risk factors associated with severe hypoglycemia in older adults with type 1 diabetes. Diabetes Care, 39(4), 603-610.

Winkley, K., Evwierhoma, C., Amiel, S.A., Lempp, H.K., Ismail, K., & Forbes, A. (2015). Patient explanations for non-attendance at structured diabetes education sessions for newly diagnosed Type 2 diabetes: a qualitative study. Diabet Med, 2(1),120-128.

Wong, C.K., Wong, W.C., Wan, E.Y., Chan, A.K., Chan, F.W., & Lam, C.L. (2016). Macrovascular and microvascular disease in obese patients with type 2 diabetes attending structured diabetes education program: a population-based propensity-matched cohort analysis of Patient Empowerment Programme (PEP). Endocrine. 2016 Jan 19. [Epub ahead of print]

World Health Organization. (2016). Global report on Diabetes. Accessed May 8, 2016 from (Visit Source).

Yeom, H., Lee, J.H., Kim, H.C., & Suh. I. (2016). The association between smoking tobacco after a diagnosis of diabetes and the prevalence of diabetic nephropathy in the Korean male population. J Prev Med Public Health, 49(2), 108-117. 

Categories: 1

0 Replies to “Case Study Nursing Diabetes Educator”

Leave a comment

L'indirizzo email non verrà pubblicato. I campi obbligatori sono contrassegnati *