Large variations in the quality of diabetes management exist between general practices in London with younger people worse off, according to a new study published in the Journal of the Royal Society of Medicine.

These are the findings of a survey of over 6000 patient records in 34 GP practices in south London. The study conducted by Christopher Millett and colleagues at Imperial College found that younger patients with diabetes had poorer recording of quality care and were more likely to suffer from higher cholesterol and poorer glycaemic control than older patients.

"We found considerable variation in the quality of diabetes care between GP practices in London, with younger patients aged 18 to 44 receiving poorer care," said Mr Millett.

"There is scope to improve the management of diabetes in most patients. However, our findings suggest that we need to raise awareness amongst GPs about the importance of closely monitoring diabetes control in younger patients.

"Failure to improve diabetes management amongst these patients may lead to an increase in major complications of the condition, such as heart disease, in future years," he said.

"Additional research is required to determine whether government initiatives to improve the quality of diabetes care, such as the National Service Framework and new GP contract, have been successful in reducing the variations in management identified in this study," Mr Millett said.

More than two million people in the UK are known to have diabetes with a further one million estimated to have the disease but not know it.

Diabetes has been identified as a national priority condition with considerable investment made in recent years to improve the quality of care received by patients. This includes the National Service Framework for Diabetes published in 2001 and the new General Practitioner contract in 2004.



'Association of age, sex and deprivation with quality indicators for diabetes: population-based cross sectional survey in primary care' by J Gray, C Millett, C O'Sullivan, RZ Omar & A Majeed is published in the November 2006 issue of the Journal of the Royal Society of Medicine.

JRSM is the flagship journal of the Royal Society of Medicine. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi.

The article is available free at rsm.ac

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Rania Wannous, The Royal Society of Medicine


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