A SINGLE VISIT DIABETES COMPLICATION ASSESSMENT SERVICE - A COMPLEMENT TO DIABETES MANAGEMENT AT THE PRIMARY-CARE LEVEL

Modern diabetes management emphasizes the early detection and prompt t reatment of diabetic complications. However it is difficult to organiz e comprehensive screening at the primary care level. To address this p roblem we established a complication assessment service whereby all th e major diabetes-specific complications were assessed in a single 3 h visit. A report with results and recommendations was sent to the gener al practitioner (GP). Being philosophically a complication-specific se rvice, no attempt was made to intervene with metabolic management. Thi s paper describes our experience with the first 743 patients of whom 9 2 % had been referred from GPs. Of the diabetes-specific complications , 22 % of patients had one, 5 % had two, and 1 % had three major compl ications. Many of the patients were unaware of the presence of these c omplications. One hundred and three people had attended the service on more than one occasion with an average time between visits of 1.7 yea rs. The results demonstrated that GPs were very good at following a re commendation to refer a patient for ophthalmic assessment (85 % of cas es) and improving hypertension but were less successful in treating hy perlipidaemia. This service has proven to be an excellent forum for th e collection of data and the teaching of health professionals. It is a move away from the traditional format of hospital-based clinics provi ding comprehensive diabetes management.