Matthildur Birgisdóttir, a nurse at HSN in Blönduós, recently completed her master’s degree, during which she conducted a study on the effectiveness of nurse-led clinics within primary healthcare for individuals with type 2 diabetes. She pursued her studies alongside her work, with support from HSN as part of the institution’s continuing education program.

Nurse-led or health-promoting clinics focus on providing interdisciplinary and holistic care for individuals with chronic health conditions such as diabetes. These clinics are led by nurses in collaboration with other specialists and emphasize prevention and improved quality of life. The aim of the study was to evaluate the effectiveness of such follow-up care for diabetes patients, as well as to examine the services provided and analyze their medication use. The study was based on quantitative, retrospective data from HSN in Dalvík and Fjallabyggð over a two-year period, and the results were compared with international standards.

“I felt I didn’t have a clear enough picture of the situation myself and wanted my project to benefit both professionals and patients. I worked with data from medical records and had no direct contact with participants, but a total of 88 individuals were included in the study. They had undergone two long-term blood sugar tests at least six months apart during 2019–2020.”

Results Show Significant Benefits of Health-Promoting Clinics

When diagnosing diabetes, long-term blood sugar levels (HbA1c) are measured through a blood test that provides an overview of the past three months. A person must have certain values over a specific period for an accurate diagnosis. “At the beginning and annually thereafter, a comprehensive examination is conducted, measuring blood sugar, blood lipids, and kidney function; feet are examined, weight, blood pressure, and medication use are reviewed. Blood sugar is then monitored every six months to assess whether treatment is effective.”

Key findings showed that HbA1c levels significantly decreased in a large portion of participants during treatment. “At the second measurement, after six months, 72.7% of participants met the international standards we use for treating type 2 diabetes.” The study also revealed a notable increase in the use of medications related to weight management in treatments.

“Diabetes is often a hidden disease and is now increasingly believed to be more genetically linked, although other factors like overweight certainly play a role. In health-promoting clinics, we support patients in making lifestyle changes for better health, and weight management is part of that. We provide guidance on exercise, diet, and can refer patients to doctors or dietitians as needed. The study clearly shows that these clinics are working very well, following specific clinical guidelines and structures, and they are delivering results for those who participate. People want to take more control of their own health and appreciate the support they receive at the clinic. It’s a collaborative effort—people have to do the work, but they receive regular check-ins and encouragement. It becomes a lifestyle, and maintaining the results of treatment is a lifelong process. Follow-up keeps people on track and supports positive progress, potentially reducing medication use and improving quality of life.”

Sharp Increase in Diabetes Cases Calls for Expanded Services

About 10.5% of people aged 20–79 are diagnosed with diabetes globally. An Icelandic study shows that its prevalence in Iceland more than doubled between 2005 and 2018, and projections estimate that around 24,000 Icelanders will have the disease by 2040.

“This highlights the urgent need to strengthen prevention and follow-up care for patients, and there is increasing emphasis within primary healthcare to support these individuals. Primary care plays a key role here, and health-promoting clinics have proven to be powerful, as the study results show. These clinics will continue to evolve and develop. In Iceland, we have not yet implemented systematic screening for diabetes, as is done for some other diseases, but I believe this is something we could see developing within primary care in the future.”

Matthildur strongly encourages people to undergo regular health check-ups, whether offered at workplaces, health clinics, or during open health days. “You don’t always need to have something wrong to book an appointment with a doctor or nurse. People can simply come in to check their status. The increase in type 2 diabetes cases underscores the importance of early intervention so that appropriate treatment and support can begin.”

Read more about Matthildur’s research and findings in the Icelandic Nursing Journal.