Can primary care team-based transition to insulin improve outcomes in adults with type 2 diabetes: the stepping up to insulin cluster randomized controlled trial protocol
journal contributionposted on 14.02.2014, 00:00 authored by J S Furler, D Young, J Best, E Patterson, D O'Neal, D Liew, Jane SpeightJane Speight, L Segal, C May, J A Manski-Nankervis, Elizabeth Holmes-TruscottElizabeth Holmes-Truscott, L Ginnivan, I D Blackberry
Type 2 diabetes (T2D) brings significant human and healthcare costs. Its progressive nature means achieving normoglycaemia is increasingly difficult, yet critical to avoiding long term vascular complications. Nearly one-half of people with T2D have glycaemic levels out of target. Insulin is effective in achieving glycaemic targets, yet initiation of insulin is often delayed, particularly in primary care. Given limited access to specialist resources and the size of the diabetes epidemic, primary care is where insulin initiation must become part of routine practice. This would also support integrated holistic care for people with diabetes. Our Stepping Up Program is based on a general practitioner (GP) and practice nurse (PN) model of care supported appropriately by endocrinologists and credentialed diabetes educator-registered nurses. Pilot work suggests the model facilitates integration of the technical work of insulin initiation within ongoing generalist care.
Pagination1 - 8
Publication classificationC Journal article; C1 Refereed article in a scholarly journal
Copyright notice2014, Biomed Central
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AdolescentAdultAgedAged, 80 and overBlood GlucoseDiabetes Mellitus, Type 2FemaleHemoglobin A, GlycosylatedHumansHypoglycemic AgentsMaleMiddle AgedPatient Care TeamPrimary Health CareResearch DesignTranslational Medical ResearchScience & TechnologyLife Sciences & BiomedicineHealth Care Sciences & ServicesHealth Policy & ServicesType 2 diabetesPrimary careNursingRandomized trialInsulinImplementationAustraliaHealth services researchGLYCEMIC CONTROLCLINICAL INERTIATHERAPYINITIATIONMANAGEMENTRESISTANCEHYPERGLYCEMIASTATEMENTCOMMUNITYMETFORMIN