Metabolic Control and Amputations among Diabetics in Primary Health Care - a Population-Based Intensified Programme Governed by Patient Education

Abstract

The clinical set-up in primary health care, with a specially trained nurse, a dietician, and a chiropodist under the supervision of general practitioners and giving patient education high priority, is evaluated after ten years in practice. Of the 391 patients cared for, 352 had non-insulin-dependent diabetes mellitus, treated as follows; diet 128, oral agents 132, insulin 91.

Forty patients had insulin-dependent diabetes mellitus. The metabolic control was good in the great majority of the patients. The mean HbA1C value for the whole diabetic population taken care of at the centre was 5.83% ± 1.16%, - reference range 3.2–6.0%. The metaboic control is presented according to the European NIDDM Policy Group. On comparing two five-year periods the number of amputations decreased from 18 to 4 (p < 0.01).

Key Words:

• diabetes
• amputation
• primary health care
• patient education