Challenges in diabetes management

Abstract

Background: Type 2 diabetes and its macro- and micro-vascular complications are increasingly common in general practice.

Objective: This article outlines the early detection and management of type 2 diabetes in general practice.

Discussion: The use of new risk questionnaires and screening tests will provide opportunities for prevention and allow earlier diagnosis of diabetes, before the development of complications. Achieving optimal metabolic control (including control of glucose, blood pressure, lipids and weight) remains a challenge for up to half of patients. Improved diet and physical activity; targeted use of medications to achieve glycaemic, blood pressure and lipid control; and the use of aspirin are key interventions. Achievement of these goals needs to be underpinned by organisational changes both within general practice and between it and other services, to provide self management education, create effective teamwork, and improve decision support and information systems.