PATTERNS OF CARE OF AN ITALIAN DIABETIC POPULATION

We set out to describe patterns of care of an Italian diabetic populat ion, with reference to the recommendations of the St Vincent Declarati on. We investigated different aspects of care received by 2707 patient s, of whom 2196 in the charge of 35 Diabetes Outpatient Clinics (DOCs) and 511 tared for by 49 General Practitioners (GPs). Data were collec ted by interviewing the patients, their physicians and by reviewing me dical records. Our data show that diabetes care in Italy differs in ma ny aspects from the recommendations of the St Vincent Declaration. Gly cated haemoglobin measurement was racking in 50% of the patients in th e charge of GPs and in 15% of those attending DOCs. While the control of cardiovascular risk factors was satisfactory, information on albumi n excretion was not available in one third of the patients. Overall, 7 9% of the patients had had an eye examination in the previous 12 month s. More than one-third of the patients had not received adequate infor mation on different aspects of care, with wide variations according to the setting of care. Forty-two per cent of the patients attending DOC s and 14% of those cared for by GPs practised blood glucose self-monit oring; similarly, insulin therapy self-management was performed by 50% and 19% of the patients attending DOCs and CPS respectively. Our data call for vigorous efforts aimed at improving the awareness of the pot ential for reducing major diabetic complications. Therefore, it is ess ential to promote the incorporation of clearly defined clinical practi ce guidelines at each level of care.