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University of Pittsburgh Schools of the Health Sciences

University of Pittsburgh Study Highlights Need for More Nurse Involvement in Diabetes Management

PITTSBURGH, January 29, 2007 The director of the University of Pittsburgh Diabetes Institute (UPDI), Linda Siminerio, Ph.D., R.N., CDE, has led the way in nationwide research demonstrating that physicians, nurses and their patients want nurses to be more involved in providing diabetes care. Dr. Siminerios finding is being reported in the February issue of the journal The Diabetes Educator.

Nationally, diabetes is the fifth leading cause of death, according to the American Diabetes Association. Many people first become aware of the disease when confronted with one of its life-threatening complications such as heart disease, blindness, high blood pressure, stroke, kidney disease or circulatory problems leading to amputation. Experts estimate that 1.5 million new cases of the disease are diagnosed each year in the United States and accounts for about $132 billion in total health care costs every year.

The nationwide Diabetes Attitudes, Wishes and Needs (DAWN) study examined the roles nurses and physicians play in caring for patients with diabetes. Previous studies have shown that a collaborative approach to diabetes management improves a variety of diabetes outcomes in patients, so understanding how nurses factor into the process is important, since they often are the health care provider who is in most contact with the patient, said Dr. Siminerio.

The DAWN study asked nurses and doctors to consider their role in administering diabetes care and rate their experiences. Nurses responded that they, more so than doctors, had a better rapport with patients and developed relationships with them enabling them to provide better diabetes self-management. The findings also showed that nurses reported a better appreciation for the psychological needs of the patient and the need for better communication with patients. Doctors, nurses and patients agreed that there was a need for nurses to be more involved in diabetes care.

According to the investigators, these results suggest that empowering nurses will enable improved diabetes care, better communication and promotion of self-management, ultimately resulting in better patient outcomes.

Nurses serve a critical role in diabetes care, they are at the front lines and are better able to provide the kind of information diabetes patients need to better manage their disease, said Dr. Siminerio.

This study supports the idea behind Governor Rendells Prescription for Pennsylvania plan by proposing that one of the best ways to care for diabetes, a chronic disease, is through the nurses who are skilled to provide information about disease self-management. Utilizing nurses expertise early on can enable patients to lead a healthier life and avoid the severe and costly complications that come with mismanagement of the disease later on, she added.

In addition to Dr. Siminerio, others involved in the study included Martha M. Funnell, M.S., R.N., CDE, University of Michigan; Mary Peyrot, Ph.D., Loyola College, Maryland; and Richard R. Rubin, Ph.D., CDE, John Hopkins University.

The mission of the UPDI, in partnership with the University of Pittsburgh Medical Center, is to provide and support diabetes prevention, detection, education, treatment and research. The UPDI unites experts in endocrinology, patient and physician education, epidemiology, clinical care, health economics, behavioral science and rural medicine. One of the countrys few programs focusing on the translation of diabetes research into practice, the UPDI is dedicated to delivering state-of-the-art treatments to everyone with diabetes, and to those at risk.

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