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A Federally Qualified Health Center received ongoing external support for half-time salaries for two nurse practitioners to treat people with poorly controlled diabetes (A1C &amp;gt;9.0%) in the clinic’s diabetes program using approved detailed treatment protocols. Patients were treated for 1 year and graduated from this program if their A1C fell to &amp;lt;7.5%. Ninety-one percent graduated, and treatment was deemed to have failed in 9% who did not achieve an A1C &amp;lt;7.5% by the end of the year of treatment. The suggestion is made to assign a specially trained diabetes nurse or physician assistant to serve many primary care providers at important clinical junctures to improve diabetes outcomes throughout busy primary care practices.

Effect of Diabetes-Trained Nurse Practitioners on Glycemic Outcomes: Their Suggested Use in Busy Primary Care Practices