With the impending diabetes tsunami coming and some saying already here, what can we all do?

In a recent study conducted at a Melbourne hospital’s emergency department, the diabetes status of 725 random people were checked, finding 19% knew they had diabetes (2 x expected) and were receiving treatment. Of the rest, who were apparently diabetes free, 36% had a random blood glucose labelled as ‘suspicious’. These people were asked to come back for a further test of which only an astoundingly low 25% showed. From this small percentage a further 13% were diagnosed with diabetes and an additional 18% had levels consistent with pre diabetes.

The biggest thing about this study was the large percentage of people who were told they may have diabetes who did not come back to find out.  As one of the investigators remarked, “They simply wouldn’t come back despite the risk they had diabetes – we rang them many, many times and sent them letters”, and “it’s a real concern that people are underestimating the seriousness of this disease, and are not bothering to come back and be tested for it”.

From this study, it would seem that people have a lack of understanding of diabetes and its implications or are just apathetic about it. Lucky they have their friendly GP to look after them, right?

Maybe…
A GP Audit of the Division of General Practice of Perth by the Alfred Workforce Development Team in 2005 found that nearly one third of patients with pre-diabetes had not had a blood glucose test within the past 12 months. They found from focus groups with the GPs that:

• there was a reluctance to proactively screen for diabetes
• that GPs don’t involve other health professionals in management of pre-diabetes
• that most follow up was opportunistic
• that no recall systems were used and
• that patient characteristics such as a lack of understanding and motivation were seen as the biggest barriers to managing pre diabetes.

Ideally people would be much more pro-active when it comes to their health and looking after themselves - it would certainly make the GPs and other health professional’s job a lot easier. We all know people who are like this, but I bet most of us know many, many more people who are less inclined to look after themselves.  We also know that GPs can make a big difference in people’s perception of health issues and behaviour changes.

Not everyone, but a lot of people listen to their GP and take it seriously and indeed, in the Prevent Diabetes – Live Life Well program we have a lot of people who are very happy that their risk of developing diabetes was picked up and are taking the opportunity to do something about it – and this is all because their GP or practice decided to screen them. We have had reports of some of our participants even giving their GP gifts as a thank you!

GPs are in a great position to encourage change leading to better health outcomes. Some GPs do already routinely screen people for diabetes and monitor and actively treat those with pre-diabetes. If you don’t do this, consider how you can introduce it into your practice, your patients will be extremely grateful.