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Providing Diabetes Care in General Practice

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In diabetes primary care the first and one of the most important stages is identifying people with diabetes. According to the estimates, about 80 percent of those, who are diagnosed with diabetes, are able to be taught and to be managed within the limits of the primary care, though the potential patients with Diabetes Type 2 are really diagnosed, as they may live for years without any evident symptoms of the disease, that is why all specialists in all spheres of medicine must always be alert in relation to possible discovery of diabetes among their patients through other symptoms, which at first seem to have no connection with diabetes itself.

In order to increase the effectiveness of diabetes management in primary care it is necessary to undertake the following steps: It is necessary to check all pregnant women on the subject of diabetes; People, who have at least one possible symptom of diabetes, should be carefully investigated for the possible confirmation of diagnosis; Taking into account that the rates of diabetes among older people are higher than those among the younger, and that the rates of disease are higher among African, Caribbean and Asian races, with those who have hereditary cases in no relation to race or age, should be subjected to special control for discovering the correct diagnosis in time.

New criteria for diagnosis and definition of diabetes of both types have been recently announced by the World Health Organization. According to the new definitions and criteria, the indices of glucose have been lowered to 7.0 mmol/l, thus at present diabetes will be diagnosed at the bigger amount of patients, though this will allow more through management and control of diabetes in primary care.

These indices are used for the patients, who have no visual symptoms and the analysis should be repeated several times during several days. For the patients without any diabetes symptoms, the analysis and diagnosis are usually based on glucose determination only. (Standards of clinical care for people with diabetes, 1994)It is important to note the changes in the blood and plasma glucose levels, and in diabetes, primary care patients usually have their blood glucose measured with the help of glucose meter.

After the diagnosis has been confirmed and primary procedures and analyses have been performed, it is necessary to carry out the initial diagnostic assessment. It happens sometimes, that the patient under investigation may feel unwell and thus will need hospitalization, or insulin therapy.

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