A Nurse Practitioner (NP) positioned in an endocrinology practice is well suited to initiate, monitor and facilitate time dependant therapies, namely insulin and Glucagon like peptide-1 analogue (GLP-1 analogue).  This service ensures time dependant communication with patients, Medical Specialists, General Practitioners. The services also seek to decrease the potential risk of hypoglycaemic episodes, and patient non adherence and misunderstanding of therapeutics plans. This presentation will; 1. Through a clinical audit, highlight biomedical outcomes (weight (kg)) and Haemoglobin A1c (HbA1c) %) for patients “trialling” a GLP-1 analogue. 2. Identify and discuss how the NP’s role, scope and practice lead to improving patient outcomes.

A retrospective descriptive analysis was conducted to review clinical outcomes for 30 patients who were identified as good candidates to start a GLP-1 analogue.

For patients who could tolerate the GLP-1 analogue, a 3 month weight reduction of >5kg and HbA1c % of 1% reduction was experienced by 70% of the insulin naïve group as compared to 19% of the insulin requiring group. Weight reduction (>5kg/3months)  but nil reduction in HbA1c % was recorded in the 15% insulin naïve group as compared to 44% of the insulin requiring group.

The result of this clinical audit informed endocrinologist and the NP for future practice initiatives utilising the GLP-1 analogue. This included an extensive advocacy focus for the group of patients who were titrated off insulin (per Pharmaceutical Benefits Scheme authorisation requirement) in lieu of starting the GLP-I analogue. This group achieved favourable weight reduction goals but nil HbA1C% goals. Advocacy initative included a department wide application process to the Statewide Drugs Therapeutic Committee for dual combination insulin and GLP-1 Therapy.