Type 2 diabetes in family practice. Room for improvement

Stewart B Harris, Moira Stewart, Judith Belle Brown, Stephen Wetmore, Catherine Faulds, Susan Webster-Bogaert, Sheila Porter, Stewart B Harris, Moira Stewart, Judith Belle Brown, Stephen Wetmore, Catherine Faulds, Susan Webster-Bogaert, Sheila Porter

Abstract

Objective: To further knowledge of diabetes management in family practice. DESIGN Retrospective, observational chart audit study.

Setting: Southwestern Ontario.

Participant: A random sample of non-academic family physicians and a random selection of their patients with type 2 diabetes mellitus.

Main outcome measures: Glycemic control as measured by HbA1c and adherence to recommendations in clinical practice guidelines (CPGs).

Results: Eighty-four percent of patients had at least one HbA1c test ordered in the previous year. Overall mean HbA1c was 0.079 and half-the patients had levels deemed acceptable by 1992 CPGs. Screening for microvascular complications was disappointing; only 28% were tested for microalbuminuria, and 15% were examined for diabetes-related foot conditions. Screening for macrovascular complications was more comprehensive; blood pressure was measured in 88%, and lipid profiles documented in 48%, of patient charts.

Conclusion: Management of glycemic control and screening for microvascular and macrovascular disease in family practice can be improved.

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