DoH diabetes czar Dr Sue Roberts said moving workload from secondary to primary care was one way of making access to diabetes services easier.
The number of people in England with diabetes is expected to increase from the current estimate of 2.35 million to 2.5 million by 2010.
But funding for any services must be decided by each PCT and paid for from existing funds, according to the latest of the DoH czars' reports on the clinical case for changes to services.
Commissioners should be using the diabetes commissioning tool kit to see what is needed in their areas, said Dr Roberts.
Patient education and the reorganisation of services are most important, she said.
'We're overwhelmed with good examples, so we know what can be done, but it's all piecemeal.
'If we're going to achieve this for everyone, it's got to be radical change we're looking for.'
Commissioners are ideally placed now to deliver radical change in diabetes, she said.
'It's up to local commissioners to use the money that they've got from the taxpayer to decide what the priorities are for their local population.'
But PBC allows GPs to push for change in their local area too, said Dr Roberts.
'PBC is really putting GPs in the driving seat of this process. Once they've done the planning, they are almost certain to be doing this as well.'
GPs could carry out annual assessments for diabetes if waiting lists are long at the local hospitals.
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