DIABETIC-PATIENTS IN PRIMARY HEALTH-CARE - QUALITY OF CARE 3 YEARS APART

Objective - To compare registering of diabetic complications and metab olic control in diabetic subjects in primary health care in 1992 and 1 995. Design - Cross-sectional surveys of medical records. Setting - Th ree community health centres in Stockholm County. Subjects - Diabetic patients aged 18-84 years in 1992 (n = 177) and in 1995 (n = 413). Mai n outcome measures - Rate of noted diabetic complications and metaboli c values. Results - Retinopathy examination nas noted in 64% in 1992 v ersus 65% in 1995, neuropathy examination in 44 versus 49%, and urine examination in 88% versus 73% (p < 0.001). HbAlc was examined in 52% I n 1992 versus 65% (p < 0.001) In 1995, fasting blood glucose in 89 ver sus 90%, and cholesterol in 34 versus 42%. Acceptable HbAlc values wer e noted in 51% in 1992 versus 46% in 1995. Smoking habits were availab le in 26% in 1992 versus 53% in 1995 (p < 0.001) and BMI in 5 versus 3 9% (p < 0.001). Diabetic blindness was present In 2.2% in 1995, uraemi a in 0.3%, and amputation due to gangrene in 1.2%. Conclusion - Docume nted examination rates of diabetic patients are unacceptably low, and the metabolic level unsatisfactory in most cases. Severe complications are, however, rare.