Trends in diabetes management practices of patients from an Australian insulin-treated diabetes register

Aims: To compare diabetes management practices in 2001 among individuals from Tasmania, Australia, with a previous management survey conducted in 1995-7. Methods: Subjects were ascertained through the Tasmanian Insulin-Treated Diabetes Register. General demographic data were collected by telephone interview, and participants mailed a questionnaire on their diabetes management practices. Results: The response rate in 2001 was 80.8% (n = 1336). There was a trend to more frequent blood glucose self-monitoring, notably in those less than 25 years (P < 0.001 for monitoring > 2 times/day), together with continued uptake of the pen system of insulin administration. More intensive shared management by general practitioner and diabetes specialist was noted, including a greater proportion visiting their doctor more than five times per year (P = 0.006 for those < 50 years). Most patients continue to be appropriately screened for hypertension and retinopathy. Dietitian visits declined overall (P = 0.03 for at least annual visits), and there appeared to be an inadequate level of foot examination by patients and doctors. Conclusions: The survey indicated that most patients were taking greater responsibility for their metabolic control, and intensive management practices and more convenient methods of administration may be contributors. Two areas of possible concern are access to dietitian services, and patient and health provider education on appropriate foot care.