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Br J Gen Pract. 1992 December; 42(365): 508–511.
PMCID: PMC1372142

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


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.

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Selected References

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  • Parving HH, Hommel E. Prognosis in diabetic nephropathy. BMJ. 1989 Jul 22;299(6693):230–233. [PMC free article] [PubMed]
  • Bild DE, Selby JV, Sinnock P, Browner WS, Braveman P, Showstack JA. Lower-extremity amputation in people with diabetes. Epidemiology and prevention. Diabetes Care. 1989 Jan;12(1):24–31. [PubMed]
  • Simmons D, Williams DR, Powell MJ. Prevalence of diabetes in a predominantly Asian community: preliminary findings of the Coventry diabetes study. BMJ. 1989 Jan 7;298(6665):18–21. [PMC free article] [PubMed]
  • Hill RD. Community care service for diabetics in the Poole area. Br Med J. 1976 May 8;1(6018):1137–1139. [PMC free article] [PubMed]
  • Singh BM, Holland MR, Thorn PA. 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. [PMC free article] [PubMed]
  • Kinmonth AL, 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]
  • Hayes TM, 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. [PMC free article] [PubMed]
  • Day JL, Humphreys H, Alban-Davies H. Problems of comprehensive shared diabetes care. Br Med J (Clin Res Ed) 1987 Jun 20;294(6587):1590–1592. [PMC free article] [PubMed]
  • 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]
  • Foulkes A, Kinmonth AL, 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]
  • Gatling W, Houston AC, Hill RD. The prevalence of diabetes mellitus in a typical English community. J R Coll Physicians Lond. 1985 Oct;19(4):248–250. [PubMed]
  • Gibbins RL, 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]
  • Rudenski AS, Hadden DR, Atkinson AB, Kennedy L, Matthews DR, Merrett JD, Pockaj B, Turner RC. 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. [PubMed]
  • Greenfield S, Kaplan SH, Ware JE, Jr, Yano EM, Frank HJ. 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. [PubMed]
  • 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]

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