Systematic review of the effectiveness of nurse‐led care in reducing glycated haemoglobin in adults with Type 1 or 2 diabetes

• Published in: International journal of nursing practice Vol. 29; no. 6; pp. e13135 - n/a
• Main Authors: Holloway, Danielle, James, Steven, Ekinci, Elif, Craft, Judy
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.12.2023
• Subjects: Adolescent; Adult; Algorithms; Chronic Disease; Chronic illnesses; Cultural sensitivity; Diabetes; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2 - therapy; English language; glycaemic control; glycated haemoglobin; Glycated Hemoglobin; Health promotion; Hemoglobin; Humans; literature review; Medical technology; nurse; Nurse led care; Nurse's Role; Nurses; primary care; Professional training; Subject headings; Systematic review; Type 1 diabetes mellitus; nurse; primary care; glycaemic control; literature review; diabetes; glycated haemoglobin
• ISSN: 1322-7114; 1440-172X; 1440-172X
• DOI: 10.1111/ijn.13135

Background Type 1 and 2 diabetes care, especially within primary health‐care settings, has traditionally involved doctor‐led clinics. However, with increasing chronic disease burden, there is scope for nurses to expand their role in assisting diabetes self‐management. Aims This study aimed to determine the effectiveness of nurse‐led care in reducing glycated haemoglobin in adults with Type 1 or 2 diabetes. Methods Methodology from the Joanna Briggs Institute Method for Systematic Review Research and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed, including identifying publications, assessing study quality, summarizing evidence and interpreting findings. The search strategy involved using the Medical Subject Headings and keyword variations when searching MEDLINE (Ovid), Scopus, PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Inclusion criteria were samples with Type 1 or 2 diabetes, mean age of ≥18 years, English language studies and publication date of January 2011–December 2021. Results Overall, 34 articles from 16 countries met inclusion criteria. Though not always clinically significant, results indicated that nurse‐led care had beneficial impacts on glycated haemoglobin values, with reductions from 0.03% to 2.0%. This was evident when nurses received formal training, used treatment algorithms, had limited medical support, utilized technology and offered defined culturally sensitive and appropriate diabetes care. Conclusions Findings support nurse‐led Type 1 and 2 diabetes care. Although further research is required, changes may necessitate increased recognition of nurse‐led care and funding. Nurse‐led care models should differ according to health‐care settings. Summary statement What is already known about this topic? Diabetes is the world's fastest growing chronic condition and is widely recognized as a leading global challenge to the health and well‐being of individuals, families and societies. What this paper adds? Findings highlight the effectiveness of nurse‐led care in reducing glycated haemoglobin values in patients with Type 1 or 2 diabetes. This was evident when nurses received formal training, used treatment algorithms, had limited medical support, utilized technology and offered defined culturally sensitive and appropriate diabetes care. The implications of this paper: There is scope for nurses to expand their role and assist diabetes self‐management.