Diabetes matters in primary care
International Journal of Integrated Care, 1 April 2002 - ISSN 1568-4156
Book review
Diabetes matters in primary care
Ruth Chambers, Jonathan Stead, Gill Wakley
Abingdon: Radcliffe Medical Press, 2001, pp 158,
ISBN 1 85775 424 7
Rutten Guy, Professor of Diabetology in Primary Care, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Netherlands

The number of patients with diabetes is growing rapidly all over the world and in many countries the big majority of the patients are treated primarily in primary care. Treatment of diabetes became much more complex in the last decades because of growing evidence that systematic monitoring and appropriate treatment of risk factors may reduce the number of diabetes related complications to a large extent. Diabetes care should be systematic and patient-centred—that is beyond doubt. Unfortunately it isn't yet in many places, not only in the UK.

Against that background the National Service Framework in the UK set concrete goals for diabetes care to reduce undesired variations in the quality of the delivered care.

This book aims at offering an individual development plan for general practitioners, diabetes nurses and all other members of the primary care diabetes teams to bring their performance in accordance with the professional standards of care. In five chapters, out of 10, the reader can learn what every care provider should know about diabetes as a disease and about the evidence on patient-centredness in diabetes care. But gathering knowledge is just the beginning of a good performance…someone's personal attitude towards diabetes should fit into the development plan of the practice he or she works in. It is the attitude that matters. For that reason the first chapter about the components of clinical governance is of utmost importance and the interactive reflection exercises at the end of all chapters should oblige the reader to integrate the acquired knowledge into his/her development plan.

Chapter 7 relates to organising diabetes care in a general practice. The recommendations are largely in accordance with the English and international guidelines on diabetes type 2 as well. Although the organisation of diabetes care on a district level is more or less typical for the UK, the chapter also gives useful information for non-UK readers. The templates in the book and the worked example of a practice personal development plan make the book even more practically-oriented. For the latter reason the references are reviews and compendiums rather than original articles.

Becoming a dedicated and highly qualified diabetes care provider is quite a job. This book is (I quote M. Pringle in his Foreword) ‘an excellent, lucid and up-to-date guide’ for everyone who wants to manage that job.