Efficacy of diabetes specialist nurse-led remote care in community clinics: a retrospective cohort study

Background: This study evaluates the impact of a diabetes specialist nurse intervention on clinical outcomes and healthcare utilization among patients with diabetes. Methods: A cohort of 452 patients was observed from 2019 to 2022. Clinical metrics such as HbA1C levels and BMI, as well as healthcare utilization patterns, were analyzed before and after the intervention. The intervention was conducted mostly during the COVID-19 pandemic. Results: There was a modest reduction in HbA1C levels, though this change was not statistically significant. Remote visits to primary care physicians increased significantly, reflecting a shift towards telemedicine. The intervention did not significantly alter BMI values, which remained stable despite the aging cohort and progression of the disease. However, In-person visits showed a slight decline, while Diabetes specialists and endocrinologist visits remained unchanged. Annual healthcare costs per patient increased post-intervention. Conclusions: The diabetes specialist nurse intervention positively impacted glycemic control and healthcare utilization, particularly through increased remote consultations. Despite higher healthcare costs, the intervention improved access to care and patient engagement. Further research is needed to assess the long-term sustainability and cost-effectiveness of such interventions.