Type 2 diabetes in family practice. Room for improvement.
OBJECTIVE
To further knowledge of diabetes management in family practice. DESIGN Retrospective, observational chart audit study.


METHODS
Southwestern Ontario.


METHODS
A random sample of non-academic family physicians and a random selection of their patients with type 2 diabetes mellitus.


METHODS
Glycemic control as measured by HbA1c and adherence to recommendations in clinical practice guidelines (CPGs).


RESULTS
Eighty-four percent of patients had at least one HbA1c test ordered in the previous year. Overall mean HbA1c was 0.079 and half-the patients had levels deemed acceptable by 1992 CPGs. Screening for microvascular complications was disappointing; only 28% were tested for microalbuminuria, and 15% were examined for diabetes-related foot conditions. Screening for macrovascular complications was more comprehensive; blood pressure was measured in 88%, and lipid profiles documented in 48%, of patient charts.


CONCLUSIONS
Management of glycemic control and screening for microvascular and macrovascular disease in family practice can be improved.
Harris
Stewart B
SB
Centre for Studies in Family Medicine, Department of Family Medicine, University of Western Ontario, London. sharris1@uwo.ca
Stewart
Moira
M
Brown
Judith Belle
JB
Wetmore
Stephen
S
Faulds
Catherine
C
Webster-Bogaert
Susan
S
Porter
Sheila
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000517:prevention & control; D019468:Disease Management; D005194:Family Practice / Q000592:standards*; D005260:Female; D006442:Glycated Hemoglobin / Q000031:analogs & derivatives* / Q000032:analysis; D019983:Guideline Adherence; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies
D006442:Glycated Hemoglobin; C025617:glucosylated hemoglobin A