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I am writing in response to the Bottom Line article ‘What will the 2020s hold for diabetes care?’ 1.
I was flabbergasted, not to mention acutely disappointed, that there was no mention of the role of Primary Care in the transformation of the management of diabetes in the past 10 years. Dr Kar focussed on the technological advances made in Insulin monitoring and delivery while failing to mention anything about the explosion of type 2 diabetes and the fact that this group are now almost exclusively managed in Primary Care resulting in convenience and continuity of care. His call to arms about ensuring deprived populations receive good care is something that Primary Care has been tackling for years and continues to do so.
The real challenge is how to best deliver care to the ever-growing population of Type 2 diabetics which is completely swamping Primary Care. Secondary Care has almost washed their hands of the clinical management of this group but it is incumbent on diabetic specialists to shape Public Policy to reduce the obesity epidemic and ensure that clinical services are able to cope with the ever-burgeoning demand whether it be in Primary or Secondary Care. These should be Dr Kar’s stated principal challenges.