RESUMO
OBJECTIVE: To audit outcome and process of care at the diabetic and medical clinics. DESIGN: Prospective interventional study with each patient acting as a retrospective control. SETTING: The Sri Jayawardenepura General Hospital (SJGH) diabetic clinic. PATIENTS: 250 consecutive patients with NIDDM transferred to the diabetic clinic from the general medical clinic. INTERVENTION: Participation in a structured scheme of health care delivery which included patient education dietary advice and screening for complications. MEASUREMENTS: Fasting blood glucose, patients' knowledge score, patient satisfaction, frequency of screening. RESULTS: A Significant improvement was seen after attendance at the diabetic clinic in fasting blood glucose (8.7 SD 1.3 vs 12.5 SD 3.2 mmol/l, p < 0.05), body mass index (26.8 SD 0.6 vs 27.4 SD 0.4 kg/m2, p < 0.05), admission rates (10% vs 21%, p < 0.05), patients knowledge score (76 SD 12 vs 42 SD 16%, p < 0.05) rates of screening for retinopathy (88% vs 6%, p < 0.05) and patient satisfaction in clinical care (87% vs 13%, p < 0.05). There was no significant improvement in cholesterol levels (5.7 SD 0.1 vs 5.8 SD 0.9 mmol/l). CONCLUSIONS: The diabetes clinic is a more efficient system and a more appropriate setting to care for patients with NIDDM.