BMJ 1994;309:275 (23 July)

Letters

Integrated care for diabetes

EDITOR, - The Diabetes Integrated Care Evaluation Team reports a comparison of integrated care versus conventional care for diabetes.1 In our opinion the results of this study cannot be generalised to all diabetic patients, even if the exclusion criteria are taken into account. The mean glycated haemoglobin concentration when the patients were recruited is impressive, being nearly normal (5.3% ISD 1.4%); normal <5.3%); it is evidence of good metabolic control before the trial. In the diabetes control and complications trial the mean glycated haemoglobin concentration at recruitment varied from 8.8% (1.6%) to 9.0% (1.5%) (normal value 1.05% (0.5%).2 After two years the value in the intensive therapy group had fallen to about 7%, thus remaining clearly above normal.

The degree of glycaemic control among non-insulin dependent patients who receive conventional care is not well known. The United Kingdom prospective diabetes study should answer this question next year. Nevertheless, in that . . . [Full text of this article]


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Relevant Article

Integrated care for diabetes: clinical, psychosocial, and economic evaluation
BMJ 1994 308: 1208-1212. [Abstract] [Full Text]

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