A review of diabetes care initiatives in primary care settings.

This paper describes a variety of initiatives by general practitioners who assumed varying degrees of responsibility for diabetic patients. The initiatives differ in size, the way they were launched, the support given to general practitioners and the groups of people with diabetes. Evaluation of two projects demonstrate that general practitioners in selected practices, when compared to hospital colleagues, achieve as good or even better outcomes in terms of metabolic control and thoroughness of review. The outcomes of other initiatives are less encouraging, although the evidence is exteremely sparse and somewhat dated. A full quality assessment of all kinds of initiatives is urgently required.