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Role of a Nurse Practitioner in Diabetes Care

Staff Spotlight: Christine Hoogasian, DNP, ACNP-BC, ADM-BC, MSN, MS


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

Christine began working at UMass Memorial Health Care in 2008, starting 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 healthcare needs of people from various cultures.

In addition to working as a nurse practitioner at the UMass 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, and also precepts students from MCPHS and UMass Medical School.

- Christine is married and they have 3 cats and a dog
- Favorite TV Show: Game of Thrones
- Enjoys watching hockey (Worcester Railers) and baseball (Red Sox)
- Sings in her church choir
- Favorite Local Spot: Moore State Park

Misconceptions about Nurse Practitioners in Diabetes Care

Many patients do not understand the role and capabilities of a nurse practitioner (NP) when it comes to their diabetes care. 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. Some states have restrictive laws as to the scope of practice that an NP may perform. Massachusetts has one of the largest NP workforces in the country, according to the U.S. Bureau of Labor Statistics. To work as an NP in Massachusetts, one must enter into a collaborative agreement with a physician which allows them to diagnose and treat patients. That includes prescribing medication, insulin pumps and continuous glucose monitors. NPs do not require a physician to co-sign medication prescriptions. 

Nurse practitioners in Massachusetts provide health care services including health promotion, disease prevention, health education, counseling and making referrals to other members of the health care team. They may also diagnosis and manage chronic illness and disease. A nurse practitioner fills multiple roles in diabetes care, as they diagnose, educate, counsel, and treat this growing patient population. 

A Team Approach to Quality Care at the UMass Diabetes Center of Excellence 

The UMass 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, kidney care and the UMass Memorial Weight Management Center.  

Throughout the year, patients will meet with various members of their care team, both in-person as well as convenient telehealth appointments from the comfort of home!

The DCOE care team works closely with primary care physicians (PCP) to ensure that 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 the notes are also sent to the patient’s PCP.  Such communication is essential for quality diabetes care. If a PCP finds a patient’s A1c to be high, they'll recommend an earlier appointment to the DCOE.     

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

Many of our patients see an MD/physician in clinic once a year and work with their nurse practitioner and/or CDESE for the other three quarterly appointments. Diabetes care requires a trust-based relationship between a health care provider, the patient and the patient’s support system. People may choose to see a specific provider (MD or NP) based on their specific needs, and with whom they have established rapport.

More UMass Diabetes Center of Excellence Staff Spotlights

Rachael Armenti - Pediatric Nurse Educator

Cheryl Barry - Adult Diabetes Educator

Fernanda Costa - Adult Diabetes Educator

Elizabeth Dickinson, Inpatient Diabetes Nurse Practitioner

Stella Lopez - Health Psychologist

Nicole Sauve - Child Life Specialist

Nancy Sidhom - Nurse Practitioner

Jessin Varghese, Inpatient Diabetes Nurse Practitioner

Alicia Warnock - Endocrinologist