The Role of a Nurse Practitioner in Diabetes Care

Christine Hoogasian, DNP, ACNP-BC, MSN, MS

• BS in Biology from Framingham State
• BS in Nursing from Fitchburg State
• Master’s in Animal Science from the University of New Hampshire
• Master’s in Nursing from the Tan Chingfen Graduate School of Nursing
• D.N.P. (Doctor of Nursing Practice) from UMass Amherst

• Currently (2022) working towards a Master’s degree in Public Health (MPH) from Rivier University.

Christine began working at UMass Memorial Health Care in 2008 as a staff nurse at Memorial Hospital. She enjoys helping people manage diabetes because it allows her to treat a multitude of health complications. Christine continues to educate herself by taking classes to broaden her knowledge of healthcare and health problems across the world. She's interested in the medical needs of people from various cultures.

Misconceptions about Nurse Practitioners in Diabetes Care

"Many patients don't understand the role and capabilities of a nurse practitioner when it comes to their diabetes care," said Christine. "NPs are taught two models of care, both the medical model and the nursing model. The role of a nurse practitioner varies from state to state." 

Massachusetts has one of the largest NP workforces in the country, according to the U.S. Bureau of Labor Statistics.  The state is one of 27 in the country that provides Full Practice Authority to an NP to diagnose and treat patients. That includes prescribing medication, insulin pumps and continuous glucose monitors. 

Nurse practitioners in Massachusetts provide health care services, including health promotion, disease prevention, health education, counseling, and making referrals to specialists as needed. They may also diagnose and manage chronic illness and disease. An NP fills multiple roles in diabetes care, as they diagnose, educate, counsel, and treat this growing patient population. 

Team Approach to Quality Care 

The UMass Memorial Diabetes Center of Excellence (DCOE) operates under the unique model of a team approach to diabetes care. Endocrinologists work together with nurse practitioners, certified diabetes care and education specialists (CDCES), registered dietitians (RD), licensed practical nurses (LPN), and primary care assistants (PCA). The DCOE also works closely with other specialty clinics, including diabetes eye specialists, behavioral health, kidney care, and weight management.  

Throughout the year, patients meet with each member of their care team, both in person and with the option of convenient telehealth appointments from the comfort of home.

The care team works closely with primary care physicians (PCP) to make sure all patients receive the best, most up-to-date, and consistent diabetes care possible. After each office visit, the physician or NP enters appointment notes not only to communicate with one another but also to send the notes to the patient’s PCP. Communication is essential for quality diabetes care. If a PCP finds an A1c to be high, they'll recommend an earlier appointment to the DCOE.     

Nurse practitioners at the UMass Memorial Diabetes Center of Excellence provide complete patient assessments. In addition to prescribing, changing, and/or regulating medication, they can also screen for and diagnose complications from diabetes and make the appropriate specialist referrals. They can diagnose neuropathy, high cholesterol, and hypertension, check for retinal changes, check kidney urine test results, and determine whether a blood glucose level is acceptable for surgery. 

Many patients see their endocrinologist once a year and their NP & CDCES for the other quarterly appointments. Diabetes care requires a trust-based relationship between the health care provider, patient, and the patient’s support system. It's important to establish a rapport with your health care provider.

In addition to working as a nurse practitioner (NP) at the UMass Memorial Diabetes Center of Excellence, Christine is an adjunct nursing professor at Massachusetts College of Pharmacy and Health Sciences (MCPHS) in Worcester, MA, and Rivier University in Nashua, NH. She also precepts students from MCPHS and UMass Chan Medical School.