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Diabetes Outcomes in Patients by PCPs, NPs, or PAs

Ann Intern Med; ePub 2018 Nov 20; Jackson, et al

In a large cohort of adult patients with diabetes, no clinically significant variation was found among those managed by physicians, nurse practitioners (NPs), or physician assistants (PAs) regarding diabetes outcomes. 368,481 adult patients from 568 VA primary care facilities and treated pharmaceutically were included and potential differences in intermediate diabetes outcomes were measured among the 3 primary care providers (PCP) types. Among the findings:

  • The PCPs were physicians (n=3,487), NPs (n=1,445), and PAs (n=443) for 74.9%, 18.2%, and 6.9% of patients, respectively.
  • The difference in HbA1c values compared with physicians was ‒0.05% for NPs and 0.01% for PAs.
  • For systolic blood pressure (SBP), the difference was ‒0.08 mm Hg for NPs and 0.02 mm Hg for PAs.
  • For low-density lipoprotein cholesterol (LDL-C), the difference was 0.01 mmol/L for NPs and 0.03 mmol/L for PAs.


Jackson GL, Smith VA, Edelman D, et al. Intermediate diabetes outcomes in patients managed by physicians, nurse practitioners, or physician assistants: A cohort study. [Published online ahead of print November 20, 2018]. Ann Intern Med. doi:10.7326/M17-1987.