New plans could see up to 50 per cent of patients with type 1 diabetes in Dorset under the care of their GPs for their diabetes management.
The plans would see a significant number of patients with type 1 diabetes changing from seeing a specialist diabetologist to seeing a GP instead.
If the plans go through, it will place additional workload and responsibility upon GPs in Dorset. Pulse Today, a medical news provider for GPs, has reported that the General Practitioners Committee (GPC) is “flabbergasted” by the decision that does not detail how GPs will be funded or supported.
The effects the move will have on patients are less clear. Under the plans, patients should still have access to specialists, such as diabetologists, diabetes specialist nurses and dietitians, when required.
It is possible that, with GPs under significant time pressures already, the change could result in shorter, less in-depth appointments for people with type 1 diabetes. In a worst case scenario, the move could demotivate patients or lead to them disengaging with their self-care.
However, a similar scheme has been running successfully in North East Essex. In terms of patient care, the change has resulted in a significant improvement in the number of people with diabetes receiving the eight essential diabetes care processes, which includes HbA1c, blood pressure, cholesterol and foot checks. 95 per cent of patients in the scheme were offered the chance to go on a structured diabetes education course.
The number of people achieving an HbA1c below 64 mmol/mol (8%) decreased slightly, however. The statistics did not differentiate between people with type 1 and type 2 diabetes. It is unknown how much the HbA1c levels of people with type 1 diabetes were affected therefore.
If the plans in Dorset go ahead, it will be important to ensure that blood glucose control data across patients with diabetes are monitored and reported in order to effectively judge the level of success. Additional assessments could reveal whether any other difficulties need to be addressed.

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