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To assess the impact of an insulin delivery system, the NovoPen®, on diabetes treatment for the homeless.Homeless patients (n=23) with diabetes and using insulin were identified from a registry of patients with diabetes maintained at the Homeless Outreach Medical Services clinical sites. Baseline evaluations included glycosylat-ed hemoglobin (HbAlc) measurements and a questionnaire about the patient's current treatment practices. Patients were instructed in the use of the NovoPen(r); HbAlc measurements and questionnaires were repeated after 3 and 6 months of participation.Reductions of HbAlc were observed at 3 and 6 months. The authors concluded that use of the pen improved patient compliance and thus glycemic control.Patients had improved quality of life after using the pen to administer insulin. Nurse practitioners should recognize quality of life issues when treating patients with chronic diseases. Nurse practitioners who care for homeless diabetes patients can promote better care for this population by educating homeless shelter staff about diabetes and its management.