An evaluation of a nurse case-managed program for children with diabetes.

This study evaluates an integrated model of care for children with diabetes that was developed at a health maintenance organization (HMO). This model program of 56 subjects included a nurse case manager, a multidisciplinary clinic team, and educational and counseling interventions to empower families to improve self-management of the children's diabetes. The purpose of the program was to improve diabetes self-management as measured by pre- and post-intervention glycosylated hemoglobin values, quality of life, and self-efficacy ratings. There were improvements in means of all measures of self-management and a statistically significant improvement in self-efficacy beliefs of the parents. The higher quality of life and self-efficacy ratings are related to adherence to a complex diabetic regimen that is critical to effective self-management. This model provides comprehensive, effective care to a service-intensive population.