Involve GPs more in child diabetes

Specialist services need to recognise the vital role GPs play in the care of young patients with diabetes, says an NHS report.

GPs should have access to medical records for children and adolescents with type-1 or -2 diabetes, says the report.

Round-the-clock support for GPs from specialist teams also needs to be made available.

The prevalence of diabetes in young people is increasing in the UK, with around 25,000 people under 25 diagnosed with type-1 diabetes and 1,400 with type-2 diabetes.

However current standards of care are proving inadequate for reducing the risk of complications.

More than 25 per cent of young diabetics may need laser treatment for retinopathy and up to 40 per cent will develop microalbuminuria.

‘From the GP point of view, we require much better communication with the teams who are looking after these children,’ said Dr Mary Pierce, London GP and member of the report’s working party.

‘People in hospitals need to remember that primary care is an important part of the team.’

All young people with diabetes need a personalised care plan under the NHS report.

It is hoped it will improve self-management of diabetes and improve the transition from child to adult services. But GPs must also have access to this information, said Dr Pierce.

‘GPs don’t often know what is going on,’ she explained. ‘We then have to start from scratch and try to contact people to try to find what the story is.

‘What we would need would be IT links to understand the plan.’

Primary care could be the key to keeping in touch with patients who fail to attend specialist clinics and encouraging them to receive help.

Dr Eugene Hughes, a member of the Primary Care Diabetes Society, said: ‘We know that quite often, particularly in adolescence, young people with diabetes can go off the rails a bit.

‘The existing structure isn’t successful because it’s seen as paternalistic.’

This problem would be best addressed by psychologists who specialise in diabetes, but there are only two or three posts in the country, said Dr Hughes.

‘The problem is getting in tune with young people instead of forcing them down the road of medical management,’ he said.

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