CARE OF PATIENTS WITH TYPE-II DIABETES - A STUDY OF FAMILY PHYSICIANSCOMPLIANCE WITH CLINICAL-PRACTICE GUIDELINES

BACKGROUND. Most patients with type II diabetes mellitus receive care by family physicians, The goals of this study were to determine the le vel of diabetes care provided by family physicians; to assess family p hysicians' compliance with the Canadian Diabetes Association (CDA) gui delines; and to examine relationships between various aspects of diabe tes care and glycemic control. METHODS. A retrospective medical chart review was conducted of 118 patients with type II diabetes mellitus in 10 family practice clinics in Newfoundland. The study population cons isted of 55 male and 63 female patients with a mean age of 64 (range 2 9 to 88) years. Using standardized forms based on the CDA guidelines, information about plasma glucose and lipid levels, presence of diabete s complications, and physician management practices were extracted fro m patient charts. The main outcome measure was glycosylated hemoglobin (HbA(1c)) levels. RESULTS. Only 53% patients had HbA(1c) measurements done in the previous year; these persons had a significantly longer d uration of diabetes that those who did not have their HbA(1c) measured . Eighty-seven percent of patients had optimal or good plasma glucose levels. Compliance with CDA guidelines by physicians was poor; physici ans were doing about half the recommended checks and procedures. CONCL USIONS. Data from the present study seem to suggest that family physic ians are doing a good job of providing care for their patients with ty pe II diabetes. The results, however, should be interepreted with caut ion until further research is done to replicate our findings because o f the limitations of this small retrospective study.