Research Article
Volume 3 Issue 4 - 2021
Analysis of the Effect of Continuous Nursing Practice on Case Management of Intensive-Stage Diabetes Patients
Yiyi Deng1, Qingling Chen1, Xueyan Liu1*, Peiru Zhou1, Jiewei Huang1, Yan Liu1, Meili Tang1 and      Fengjiao Li2
1Department of Endocrinology, The First Affiliated Hospital of Jinan University, Guangzhou, China
2Departemt of nursing, Hulunbuir Institute of Vocational Technology, Hulunbuir, China
*Corresponding Author: Xueyan Liu, Department of Endocrinology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Received: February 22, 2021; Published: March 25, 2021


Objective: To identify the effects and related factors of extended nursing management for (1) newly diagnosed diabetes patients, (2) patients admitted with acute complications from diabetes mellitus, and (3) patients with glycated hemoglobin (HbA1c) levels of ≥9.0%, to suggest adjustments to the case continuation care plan.

Methods: This study adopted a cohort design. Convenience sampling was used to select diabetes patients hospitalized between October 2017 and March 2019 for the control group, and between April 2019 and September 2019 for the study group. Patients in the control group received routine nursing management, these in the study group were visited by a case manager within 48 hours of admission, the diabetes case management record data sheet was established, and a care plan was constructed according to the evaluation results. One telephone call or WeChat voice conversation (which can be carried out any time and any place) follow-up occurred 1, 4, and 12 weeks after discharge from the hospital (the number of follow-up visits was increased according to the needs of individuals), which included home self-care, diet, blood sugar control index, and outpatient review.

Results: The HbA1c level was significantly lower in the study group than in the control group (7.18±1.65% vs 8.46±2.02%, mean ± Standard deviation; p< 0.05), as was the cholesterol level (4.57±0.85mmol/L vs 5.24±1.95mmol/L, p< 0.05). The hypoglycemia incidence rates were 10.9% and 23.5% in the study and control groups, respectively, while the rates of HbA1c compliance were47.8% and 40.9%. There were no significant differences between the two groups in the total scores for triglycerides, low-density lipoprotein, uric acid, and pain.

Conclusion: Intensive case management can improve the blood glucose levels of diabetes patients, but is not ideal in reducing their pain and or the rate of reaching standard blood glucose levels. After the intensive phase, it is recommended that a case manager continues to manage patients in the life-long maintenance phase, with appropriate alterations to the intensity and frequency of interventions. The Internet should be used for flexible communications with patients, combining empowerment and education to help patients in a timely manner, increasing attention to reducing their distress, and improving blood glucose check-up compliance rates.

Keywords: Diabetes; Intensive-Stage; Case Management; Continuous Nursing Practice


  1. Zheng Y., et al. “Global aetiology and epidemiology of type 2 diabetes mellitus and its complications”. Nature Reviews Endocrinology 2 (2018): 88.
  2. Saeedi P., et al. “Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas”. Diabetes Research and Clinical Practice 157 (2019): 107843.
  3. International Diabetes Federation. IDF DIABETS ATLAS 9th edition (2019).
  4. Xu Y., et al. “Prevalence and control of diabetesin Chinese adults”. The Journal of the American Medical Association 310 (2013): 948-959.
  5. Lukersmith S., et al. “What is Case Management? A Scoping and Mapping Review”. International Journal of Integrated Care4 (2016): 2-13.
  6. You E C., et al. “What is the role of a case manager in community aged care? A qualitative study in Australia”. Health and Social Care in the Community4 (2016): 495-506.
  7. Jones Shelley L. “Diabetes Case Management in Primary Care: The New Brunswick Experience and Expanding the Practice of the Certified Diabetes Educator Nurse into Primary Care”. Canadian Journal of Diabetes4 (2015): 322-324.
  8. Xiaodan Y., et al. “Effect of case management on glycemic control and behavioral outcomes for Chinese people with type 2 diabetes: A 2-year study”. Patient Education and Counseling8 (2016): 1382-1388.
  9. Hsu CC and Tai TY. “Long-term glycemic control by a diabetes case-management program and the challenges of diabetes care in Taiwan”. Diabetes Research and Clinical Practice 106 (2014): S328-S332.
  10. Hung S., et al. “A qualitative study on why did the poorly-educated Chinese elderly fail to attend nurse-led case manager clinic and how to facilitate their attendance”. International Journal for Equity in Health1 (2015): 10.
  11. Andjela Drincic Elisabeth., et al. “The effect of diabetes case management and Diabetes Resource Nurse program on readmissions of patients with diabetes mellitus”. Journal of Clinical and Translational Endocrinology 8 (2017): 29-34.
  12. Fisher L., et al. “Development of aBrief Diabetes Distress Screening Instrument”. Annals of Family Medicine 3 (2008): 246-252.
  13. Polonsky W H., et al. “Assessing Psychosocial Distress in Diabetes: Development of the DiabetesDistress Scale”. Diabetes Care3 (2005): 626-631.
  14. Diabetes society of Chinese medical association. Guidelines on prevention and treatment of type 2 diabetes in China (2017 edition)”. Chinese Journal of Practical Internal Medicine04 (2017): 292-344.
  15. Donabedian A. “The Quality of Care: How Can It Be Assessed?”. JAMA the Journal of the American Medical Association8 (1988): 1151-1152.
  16. Julie A., et al. “An interdisciplinary approach using case management and clinical pharmacy improves results for people with diabetes”. Research in Social and Administrative Pharmacy10 (2020): 1387-1391.
  17. Howe CJ., et al. “Education and Telephone Case Management for Children With Type 1 Diabetes: A Randomized Controlled Trial”. Journal of Pediatric Nursing2 (2005): 83-95.
  18. Li D., et al. “Diabetes Nurse Case Management in a Canadian Tertiary Care Setting: Results of a Randomized Controlled Trial”. Canadian Journal of Diabetes 41 (2017): 297-304.
  19. Gabbay R A., et al. “Nurse case management improves blood pressure, emotional distress and diabetes complication screening”. Diabetes Research and Clinical Practice 1 (2006): 28-35.
  20. American Diabetes Association. Standards of Medical Care in Diabetes-2018”. Diabetes Care1 (2018): S1-S159.
  21. Colhoun HM., et al. “Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentrerandomised placebo-controlled trial”. Lancet 9435 (2004): 685-696.
  22. Elnaem MH., et al. “Statin therapy prescribing for patients withtype 2 diabetes mellitus: A review of current evidence and challenges”. Journal of Pharmacy and Bioallied Sciences 9 (2017): 80-87.
  23. Lipid Metabolism Group, Chinese Society of Endocrinology, Chinese Medical Association. Expert Consensus on prevention and treatment of Type 2 diabetes complicated with dyslipidemia (2017 revision)”. Chinese Journal of Endocrinology and Metabolism 11 (2017): 925-936.
  24. Lau TW., et al. “Regional evidence and international recommendations to guide lipid management in Asian patients with type 2 diabetes with special reference to renal dysfunction”. Journal of Diabetes 10 (2017): 200-222.
  25. Grundy SM., et al. “2018 AHA/ACC/nAACVPR/AAPA/ ABC/ACPM/ADA/ AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary”. Journal of the American College of Cardiology24 (2019): 3168-3209.
  26. Fisher L., et al. “When Is Diabetes Distress Clinically Meaningful?” Diabetes Care2 (2012): 259-264.
  27. Ibrahim IA., et al. “Measuring outcomes of type 2 diabetes disease management program in an HMO setting”. Southern Medical Journal1 (2002): 78.
  28. Biruk ShalmenoTusa., et al. “Heath related quality of life and associated factors among adults with and without diabetes in Adama city East Shewa, Ethiopia 2019; using generalized structural equation modeling”. Health and Quality of Life Outcomes83 (2020): 1-13.
  29. Bui LP., et al. “Does an all-condition case management program for high-risk patients reduce health care utilization in medicaid and medicare beneficiaries with diabetes?” Journal of Diabetes and its Complications 6 (2019): 445-450.
Citation: Xueyan Liu., et al. “Analysis of the Effect of Continuous Nursing Practice on Case Management of Intensive-Stage Diabetes Patients”. EC Nursing and Healthcare 3.4 (2021): 79-85.

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