Complex treatment of a diabetic patient in a GP‘s surgery

In recent years, diabetes mellitus (DM) has been an increasing public health problem in both developed and developing countries. More

often than not, it feels like a cliché to me. The Czech Republic is way behind in the care of the diabetic patient. Beginning this year, GPs

(general practitioners) can treat uncomplicated type 2 diabetic patients in their practice. Up to now, they have not been paid for this work

and, what is more, it has not been considered by health insurance companies in terms of regulations. Paradoxically enough, sometimes GPs

were even penalized by higher costs for laboratories and drugs. In an overall effect, it was rather demotivating for general practitioners.

Since 1st January 2010, general practitioners have finally been provided with an opportunity to treat an uncomplicated diabetic patient.

In the European context, when the Euro Diabetes Consumer Index (EDCI) concerning the quality of diabetes care was assessed, the Czech

Republic ranked 23rd among 28 European countries. Is it really only a matter of glycaemia ? In addition to glycaemia, is it not necessary to

manage hypertension and dyslipidaemia ? How much can the subsequent risks in patients be reduced by a consistent treatment of these

risks ? How expensive will the reversal of damage be if they are not treated adequately ? Is treatment of hypertension not as important

as hypoglycaemic treatment ? The number of diabetics in the population is increasing but the number of diabetologist services is not.

Therefore, following a series of negotiations with the ministry of health, better availability and improved quality of care, particularly of

newly detected diabetics in GP surgeries have been advocated.

Keywords: diabetes mellitus, definition, diagnosis, complications, prevention