Management of insulin-treated diabetes in Tasmania

Objective: To evaluate patterns of self-management, healthcare utilisation and screening for major complications among Tasmanians with insulin-treated diabetes. Main outcome measures: Frequency of self-monitoring of blood glucose, healt h care utilisation and screening for diabetic complications. Design and setting: A questionnaire survey of 1517 people listed on the Tas manian Diabetes Register in 1995-1997. Results: Response rate was 79.5%. Self-monitoring of blood glucose was repo rted by 98% of respondents, daily self-monitoring by 74%. About 41% of resp ondents were being managed jointly by GPs and diabetes specialists, 29% sol ely by GPs and 25% solely by diabetes specialists. Over 96% visited the doc tor treating their diabetes more than once a year, but 21% reported they ha d never visited a diabetes educator and 43% reported they had never visited a dietitian. Most respondents aged greater than or equal to 25 years (90%) reported having an eye examination within the past two years, almost all b y an eye specialist. Blood pressure was commonly assessed, but most adults indicated that the doctor treating their diabetes did not routinely examine their feet. Nearly 19% of respondents smoked cigarettes. Conclusions: Some aspects of diabetes self-care and medical care have impro ved in Tasmania since the 1984 survey (eg, frequency of self-monitoring of blood glucose rose from 50% to 98%). However, our findings suggest that fur ther improvements are needed to increase daily self-monitoring of blood glu cose, attendance at diabetes educator and dietitian services, and foot exam inations by doctors. Additional efforts are also needed to lower the preval ence of smoking.