Room for Improvement

OBJECTIVE To further knowledge of diabetes management in family practice. DESIGN Retrospective, observational chart audit study. SETTING Southwestern Ontario. PARTICIPANTS A random sample of non-academic family physicians and a random selection of their patients with type 2 diabetes mellitus. MAIN OUTCOME MEASURES Glycemic control as measured by Hb A1C and adherence to recommendations in clinical practice guidelines (CPGs). RESULTS Eighty-four percent of patients had at least one Hb A1C test ordered in the previous year. Overall mean Hb A1C 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. CONCLUSION Management of glycemic control and screening for microvascular and macrovascular disease in family practice can be improved. RESUME