SHARING THE CARE OF DIABETIC-PATIENTS BETWEEN HOSPITAL AND GENERAL-PRACTITIONERS - DOES IT WORK

A randomized controlled trial was conducted to compare three forms of diabetes follow-up: (1) general practitioner care, (2) a system of care shared between the general practitioner (GP) and clinic and (3) conventional clinic care. Two hundred and six diabetic patients without significant diabetes-related or other medical complications were randomized to one of these follow-up systems. Metabolic control and blood pressure improved significantly and equally in all three groups (p < 0.05). The shared care group performed as well as or better than either of the other two groups in all other outcome measures. In particular, final attendance rates were 72 % for shared care compared with only 35 % for GP care and 53 % for clinic care. Data collection rates for shared care were comparable with the clinic group for random blood glucose (88.9 % vs 95.1 %), weight (93.5 % vs 98.3 %), and blood pressure (94.8 % vs 92.7 %). Only in the case of glycosylated haemoglobin did shared care have poorer data collection (66.0 % vs 98.4 %). In all these parameters, except blood pressure, shared care out-performed the GP group. We conclude that with adequate support from and communication with hospital-based diabetes services, GPs are capable of providing care appropriate to the needs of uncomplicated diabetic patients.