In recent decades, treatment of diabetes has moved from the hospital and specialist's office to mainstream medical care, with most patients treated by general or family practitioners. A new study has documented the success of a program that gave these doctors materials and guidance to help them treat their patients with diabetes.

The study was conducted in Denmark; general practitioners were divided into two groups: (1) the routine care group, 231 doctors, and (2) the intervention group, 243 doctors. Those in the intervention group were given leaflets for their patients, treatment guidelines, annual seminars and regular feedback. They were also prompted to review their patients' progress, to set realistic treatment goals and to revise them as needed. And they were exposed to a charismatic opinion leader.

Patients of these doctors received planned, quarterly consultations during which their treatment goals were evaluated, with emphasis on reducing cardiovascular risk factors. The comparison group received routine care from their doctor.

After six years, the patients of those doctors in the intervention group had reduced their risk factors to a level that has been shown to have a beneficial effect on complications of diabetes. Specifically, fasting plasma glucose concentration, glycated hemoglobin, systolic blood pressure and cholesterol levels were all lower in those patients. The researchers calculated these changes to correlate with risk reductions of 26% for heart attack and 12% for microvascular complications.

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