Prevalence and characteristics of diabetic patients with no ongoing care in South Auckland

OBJECTIVE - To describe the prevalence of default from diabetes care and to reveal associated characteristics among patients with known diabetes in ur ban South Auckland, New Zealand. RESEARCH DESIGN AND METHODS - We developed a cross-sectional household stud y of patients with known diabetes and compared those patients with and with out ongoing care, Ongoing care was defined as having been clinically review ed at least once in the previous 10 months. RESULTS - Of the 1,488 European, Maori, and Pacific Islander subjects with known diabetes, 107 (6.3%) had not seen a general practitioner or a diabete s service in the previous 10 months. Subjects not attending a diabetes serv ice were more likely than subjects attending a diabetes service to have bee n diagnosed when screened asymptomatically (11.7 vs. 5.2%, P = 0.008) and a fter gestational diabetes (39.7 vs. 11.7%, P < 0.001). Maori were most like ly to have no ongoing care (10.8 vs. 5.8% European and 6.6% of Pacific Isla nder subjects, P = 0.01). Nonattenders were younger, were diagnosed at a yo unger age, knew less about diabetes, were less satisfied with past care, an d were less likely to require medication. CONCLUSIONS - The elevated number of diabetic individuals not attending ong oing care is a significant problem in this population, and it may reflect a decisional balance as seen in problem behaviors. Diagnosis when asymptomat ic may contribute to default from ongoing care; in this case, caution is re quired if population-based screening programs are being considered.