A SURVEY AND AUDIT OF DIABETIC CARE IN A LARGE FAMILY-PRACTICE IN RIYADH

Objectives: To audit the current practice of diabetic care provided by family physicians in a large family practice in Riyadh one year after the previous audit. To also assess the outcome measures, including gl ycemic control and other diabetic complications. Design and subjects: A total of 390 diabetic patient files were reviewed out of 2,234 patie nts who consulted their general practitioners during the period 1 Apri l 1995 to 30 June 1995. The following parameters were reviewed: blood pressure, weight and height, urine dipsticks, microalbuminurea, fundos copy, visual acuity, foot inspection, blood sugar, fractosamine or hem oglobin A(1)C, urea and creatinine, lipids. The patients' characters, complications and glycemic control outcome were also reviewed. Setting : Riyadh Armed Forces Hospital, Family and Community Medicine Departme nt. Results: Fifty percent of the sample were female, 92% were 40 year s of age or over. Just over a third of the patients had been diagnosed for 10 years or more. One third of the recorded patients had a positi ve family history of diabetes mellitus. Blood sugar and blood pressure were recorded in 100% of the cases, but microalbuminurea was recorded in only 12% of the cases. The other parameters recorded were moderate . Glycemic control was acceptable or good in 54% of patients. Choleste rol was elevated in 13% and triglyceride was elevated in 10% of cases. Both were elevated in a further 9% of patients. Retinopathy was prese nt in 18%, neuropathy in 5%, nephropathy in 13%, diabetic foot in 0.8% and ischemic heart disease in 6.6% of cases. Conclusions: There has b een some improvement since the last audit one year ago. However, there is still room for more improvement. Further measures will need to be taken to improve the diabetic care including a reminder sheet and flow chart in the patients file, patient guidelines for management of diab etes and home blood glucose monitoring.