A snapshot of type two diabetes mellitus management in general practice prior to the introduction of diabetes Cycle of Care.

Abstract

Diabetes is associated with complications, including coronary heart disease, stroke, kidney failure, blindness and amputation, and ultimately is a major cause of disability and death worldwide. Adherence to best practice guidelines is limited in unstructured diabetes management in primary care settings. This study aims to establish what data was being collected in general practice prior to the introduction of the Cycle of Care, which is a proactive model of diabetes management introduced in Ireland. Medical students in general practices with the University of Limerick Graduate Entry Medical School and their supervisors used practice software to collect quantitative data from the clinical records of patients with T2DM. The sample included 2696 patients with T2DM who had visited their GP in the previous year. During the 12months studied, 18.5% of patients with T2DM attended an emergency department and 24% were admitted to hospital. The results of the documentation of three modifiable risk factors associated with T2DM were as follows: 49.5% had BMI documented, 51.7% had smoking status documented and 33.9% had alcohol consumption documented. Two hundred and fifty people were diagnosed with T2DM in the previous 12months. Of these, 19% had been referred to a chiropodist and 23% to a dietician. This study provides a comprehensive snapshot of care in Irish general practice for patients with T2DM prior to the introduction of the Cycle of Care. Future research must investigate the impact of Cycle of Care on patient care in general practice.