General practice care of non-insulin-dependent diabetes with fasting blood glucose measurements

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      Non-insulin-dependent diabetes can be treated using two criteria, the fasting blood glucose concentration and body weight. The feasibility of this means of control, aiming for a fasting blood glucose concentration of less than 6 mmol/liter (108 mg/dl) has been investigated in 10 general practices. Eight practices now use the method routinely. A one-year follow-up in six practices is reported. The number of patients with a fasting blood glucose concentration of less than 108 mg/dl increased from 39 (26 percent) to 65 (59 percent). The mean fasting blood glucose concentration of all 112 patients was significantly (p < 0.01) decreased from a mean of 148 to 113 mg/dl at three months, and subsequently increased to a still reduced (p < 0.01) level of 126 mg/dl after one year. The mean hemoglobin A1c level was decreased (p < 0.01). Six practices preferred to have special clinics at which fasting blood glucose measurements were taken. Two practices achieved good results with the administration and tests being undertaken by a practical nurse, with supervision from the general practitioner. Assessment of control by four fasting blood glucose determinations a year is less expensive than regular urine tests, and may improve blood glucose control.
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