General practice care of non-insulin-dependent diabetes with fasting blood glucose measurements.

Non-insulin-dependent diabetes can be treated using two criteria, the fasting blood glucose concentration and body weight. The feasibility of this means of control, aiming for a fasting blood glucose concentration of less than 6 mmol/liter (108 mg/dl) has been investigated in 10 general practices. Eight practices now use the method routinely. A one-year follow-up in six practices is reported. The number of patients with a fasting blood glucose concentration of less than 108 mg/dl increased from 39 (26 percent) to 65 (59 percent). The mean fasting blood glucose concentration of all 112 patients was significantly (p less than 0.01) decreased from a mean of 148 to 113 mg/dl at three months, and subsequently increased to a still reduced (p less than 0.01) level of 126 mg/dl after one year. The mean hemoglobin A1c level was decreased (p less than 0.01). Six practices preferred to have special clinics at which fasting blood glucose meaurements were taken. Two practices achieved good results with the administration and tests being undertaken by a practical nurse, with supervision from the general practitioner. Assessment of control by four fasting blood glucose determinations a year is less expensive than regular urine tests, and may improve blood glucose control.