title: Structuring diabetes care in general practices: many improvements, remaining challenges.
abstract: BACKGROUND
  For people with type 2 diabetes to enjoy improved longevity and quality of life, care needs to be organised in a systematic way.
  
  
  OBJECTIVE
  To test if processes and intermediate outcomes for patients with type 2 diabetes changed with the move to structured care in general practice shared with secondary care.
  
  
  METHODS
  An audit of process and intermediate outcomes for patients with type 2 diabetes before and after the change to structured care in 10 Dublin general practices shared with secondary care four years on.
  
  
  RESULTS
  Structured diabetes care in general practice has led to more dedicated clinics improved processes of care and increased access to multidisciplinary expertise. Improvement in blood pressure control, the use of aspirin and the use of lipid lowering agents indicate a significant decrease in absolute risk of vascular events for this population.
  
  
  CONCLUSIONS
  Structured care in general practice improves intermediate outcomes for people with type 2 diabetes. Further improvements need to be made to reach international targets.
authors.affiliation: Dept of Public Health Medicine, Health Service Executive, Dr Steevens Hospital, Dublin. siobhan.jennings@mailf.hse.ie
authors.forename: S
authors.initials: S
authors.lastname: Jennings
authors.forename: D L
authors.initials: DL
authors.lastname: Whitford
authors.forename: D
authors.initials: D
authors.lastname: Carey
authors.forename: S M
authors.initials: SM
authors.lastname: Smith
mesh_terms: D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000628:therapy*; D005194:Family Practice; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D007494:Ireland; D008297:Male; D008485:Medical Audit; D010043:Outcome and Process Assessment, Health Care; D011320:Primary Health Care; D016540:Smoking Cessation
chemical_list: D006442:Glycated Hemoglobin