Does case management improve diabetes outcomes?
Yes. Patients with type 2 diabetes benefit from case management, as evidenced by decreased glycated hemoglobin (HbA1c). The improvement in HbA1c appeared larger when case managers could make changes in medications independently and multidisciplinary teams were used (strength of recommendation [SOR]: C, 2 meta-analyses of randomized controlled trials [RCTs] with consistent disease-oriented fi ndings). Patients with type 1 diabetes who have case management and “intense control” experience fewer cardiovascular events and decreased retinopathy and clinical neuropathy (SOR: B, 1 large, good quality RCT).