Should diabetes be commissioned through multidisciplinary networks, rather than practice-based commissioning?

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Rachael Addicott, David Simmons, Patrick English, Peter Robins, Andrew Craig

The impact of diabetes is increasing rapidly with the growing obesity epidemic.

Publication:  Primary Care Diabetes
Reference:  Volume 5, Issue 1, Pages 39-44 (April 2011)

Modern interventions are very effective at reducing the incidence of diabetes complications including hospitalisation, premature death, cardiovascular, renal, eye and foot disease. However, the rapid rise in diabetes prevalence is overwhelming the benefits of effective diabetes management.

There is one other 'elephant in the room' around why the impact of diabetes is not diminishing at the rate expected from trials: the multiple barriers to the delivery of care and self care. These include psychological, psychosocial and knowledge barriers and diabetes and non-diabetes related co-morbidities.

A further barrier revolves around how 'the system' benefits or obstructs care. It has become clear that with a condition as complex and multifaceted as diabetes, systems which integrate primary, community and secondary care around the needs of the patient are most likely to optimise outcomes. This includes integrating information management.

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#40154 Jennifer Scott

As a type II diabetic on multiple meds ,and with NICE no longer supporting home glucose monitoring, how can I possibly be in control of my condition and in a position to optimise my outcome?

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