Skip to main content
NCBI home page
The British Journal of General Practice logoLink to The British Journal of General Practice
. 1992 Dec;42(365):508–511.

How effective is systematic care of diabetic patients? A study in one general practice.

M Koperski 1
PMCID: PMC1372142  PMID: 1297371

Abstract

A method of systematic diabetic care compatible with personal lists, the 'diabetic day', was introduced into a seven partner inner city general practice. The effect on glycosylated haemoglobin levels and the recording of six process measures (fundoscopy, visual acuity, weight, blood glucose levels, glycosylated haemoglobin levels and blood pressure) was assessed. Of the 111 known registered diabetic patients, 64 entered the diabetic day and fulfilled the eligibility criteria. General practice records were analysed retrospectively over a period of four years--the two years before entry into the diabetic day were compared with the subsequent two years. Mean glycosylated haemoglobin levels fell from 10.52% in the year before entry to the diabetic day to 9.71% in the second year after entry (P < 0.01, 95% confidence intervals 0.19 to 1.39). There was a significant increase in all process measures recorded in the general practice notes after entry into the diabetic day. The introduction of systematic care for diabetic patients led to an improvement in recorded process measures and a reduction in patients' glycosylated haemoglobin levels in a general practice which had made previous efforts to improve diabetic care and was already well staffed, organized and motivated.

Full text

PDF
508

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bild D. E., Selby J. V., Sinnock P., Browner W. S., Braveman P., Showstack J. A. Lower-extremity amputation in people with diabetes. Epidemiology and prevention. Diabetes Care. 1989 Jan;12(1):24–31. doi: 10.2337/diacare.12.1.24. [DOI] [PubMed] [Google Scholar]
  2. Day J. L., Humphreys H., Alban-Davies H. Problems of comprehensive shared diabetes care. Br Med J (Clin Res Ed) 1987 Jun 20;294(6587):1590–1592. doi: 10.1136/bmj.294.6587.1590. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Foulkes A., Kinmonth A. L., Frost S., MacDonald D. Organized personal care--an effective choice for managing diabetes in general practice. J R Coll Gen Pract. 1989 Nov;39(328):444–447. [PMC free article] [PubMed] [Google Scholar]
  4. Gatling W., Houston A. C., Hill R. D. The prevalence of diabetes mellitus in a typical English community. J R Coll Physicians Lond. 1985 Oct;19(4):248–250. [PMC free article] [PubMed] [Google Scholar]
  5. Gibbins R. L., Saunders J. Characteristics and pattern of care of a diabetic population in mid-Wales. J R Coll Gen Pract. 1989 May;39(322):206–208. [PMC free article] [PubMed] [Google Scholar]
  6. Greenfield S., Kaplan S. H., Ware J. E., Jr, Yano E. M., Frank H. J. Patients' participation in medical care: effects on blood sugar control and quality of life in diabetes. J Gen Intern Med. 1988 Sep-Oct;3(5):448–457. doi: 10.1007/BF02595921. [DOI] [PubMed] [Google Scholar]
  7. Hayes T. M., Harries J. Randomised controlled trial of routine hospital clinic care versus routine general practice care for type II diabetics. Br Med J (Clin Res Ed) 1984 Sep 22;289(6447):728–730. doi: 10.1136/bmj.289.6447.728. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hill R. D. Community care service for diabetics in the Poole area. Br Med J. 1976 May 8;1(6018):1137–1139. doi: 10.1136/bmj.1.6018.1137. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kinmonth A. L., Murphy E., Marteau T. Diabetes and its care--what do patients expect? J R Coll Gen Pract. 1989 Aug;39(325):324–327. [PMC free article] [PubMed] [Google Scholar]
  10. Koperski M. Systematic care of diabetic patients in one general practice: how much does it cost? Br J Gen Pract. 1992 Sep;42(362):370–372. [PMC free article] [PubMed] [Google Scholar]
  11. Koperski M. The diabetic day. A model for the management of chronic illness in general practice. Practitioner. 1987 Nov 23;231(1439):1537–1539. [PubMed] [Google Scholar]
  12. Parving H. H., Hommel E. Prognosis in diabetic nephropathy. BMJ. 1989 Jul 22;299(6693):230–233. doi: 10.1136/bmj.299.6693.230. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Rudenski A. S., Hadden D. R., Atkinson A. B., Kennedy L., Matthews D. R., Merrett J. D., Pockaj B., Turner R. C. Natural history of pancreatic islet B-cell function in type 2 diabetes mellitus studied over six years by homeostasis model assessment. Diabet Med. 1988 Jan;5(1):36–41. doi: 10.1111/j.1464-5491.1988.tb00938.x. [DOI] [PubMed] [Google Scholar]
  14. Simmons D., Williams D. R., Powell M. J. Prevalence of diabetes in a predominantly Asian community: preliminary findings of the Coventry diabetes study. BMJ. 1989 Jan 7;298(6665):18–21. doi: 10.1136/bmj.298.6665.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Singh B. M., Holland M. R., Thorn P. A. Metabolic control of diabetes in general practice clinics: comparison with a hospital clinic. Br Med J (Clin Res Ed) 1984 Sep 22;289(6447):726–728. doi: 10.1136/bmj.289.6447.726. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners

RESOURCES