52 Implementation Of Clinical Guidelines For Type 2 Diabetes Care In General Practice Encouraging Individualised Goal-Setting

Author(s): 
HANSEN Lars J (1), OLIVARIUS Niels de Fine (1) and SIERSMA Volkert (2).
(1) Central Research Unit of General Practice
(2) Department of Statistics, Copenhagen University Panum Institute Denmark, Email: L.Hansen@gpract.ku.dk
Text: 
Aims: To describe the goals for the risk factors - haemoglobin A1c (HbA1c), blood pressure and lipids - chosen at diabetes diagnosis and the change of goals over the following 5 years. Furthermore, to examine whether the goals at diagnosis were met 5 years after diagnosis. Additionally, to explore the predictive value of the factors related to the general practitioner (GP) and the patient, with regard to the choice of goal at diabetes diagnosis, and the HbA1c-level achieved 5 years after diagnosis.
Methods and materials:
in 1989-92 244 GPs included all newly diagnosed diabetic patients (=729 patients) aged >40 years on their practice list. Immediately after diagnosis the GPs were encouraged to define a goal (good, acceptable or poor control) for the risk factors, primarily HbA1c, together with the patient. Regular reviews were recommended to determine progress in meeting goals and perhaps modify goals and/or treatment.
Results: At diabetes diagnosis good control (HbA1c 8.5%) in 53%. Data are currently further scrutinized
Conclusions:
Glycaemic control progressively deteriorated, and good control of HbA1c was difficult to achieve. The predictive value of goal setting will be demonstrated.
Literature: 
52 IMPLEMENTATION OF CLINICAL GUIDELINES FOR TYPE 2 DIABETES CARE IN GENERAL PRACTICE ENCOURAGING INDIVIDUALISED GOAL-SETTING