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Family Practice Vol. 7, No. 4, 273-278
© Oxford University Press 1990

research-article

Feasibility and Effects of a Diabetes Type II Protocol with Blood Glucose Self-Monitoring in General Practice

G RUTTEN, J VAN EIJK*, E DE NOBEL**, M BEEK and H VAN DER VELDEN

Department of Family Medicine. University of Nijmegen Nijmegen, The Netherlands
*Department of General Practice and Nursing Home Mediane, Free University of Amsterdam Nijmegen, The Netherlands
**Department of Internal Medicine, University Hospital Nijmegen, The Netherlands

Correspondence to: G. Rutten, Haagstraat 19,6641 AH Beuningen, The Netherlands

A diabetes protocol characterized by self-monitoring of blood glucose was introduced in four general practices with the aim of making the frequency of consultations dependent on the metabolic regulation and emphasizing body weight reduction. The feasibility of the programme was investigated and the results after 1 year were compared with those of conventional care in four control practices.

In the experimental practices, 13 patients switched from a medical specialist's to a general practitioner's supervision, 20 remained under supervision of their GP and 33 started self-monitoring. The self-monitoring rate, the consultation frequency according to protocol, the low number of dropouts and inadequate referrals and adherence to the therapeutic scheme showed that the protocol was feasible for both the GPs and the patients.

At the initial assessment, the regulation of the diabetes was worse in patients of the experimental group, compared with those of the control group (mean HbA1 9.7% vs 8.9%; p<0.05). On average, patients in the experimental group (n=56) lost 0.4 kg of body weight, whereas those in the control group (n=73) gained 0.1 kg (n.s.). The mean change in HbA1, adjusted for the initial value, was –0.4% in the experimental and +0.5% in the control group (p<0.05).

The results of the protocol can be attributed to a combination of greater participation of the patient, the individualized consultation frequency and the prescription of oral hypoglycaemic agents according to body weight development.


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