The development of community orientated recommendations for diabetes care in south Auckland. South Auckland Community Diabetes Planning Group.

Growing numbers and costs associated with diabetes and its tissue damage are of increasing concern. We describe the development of community orientated recommendations aimed at primary and secondary prevention of diabetes in an area with a high proportion of Maori and Pacific Islands people. Preliminary results from structured face-to-face interviews with patients (n = 555), general practitioners (n = 163) and other health professionals were discussed by a core group of elected or selected community and health professional representatives. Twelve meetings and one full day workshop were held over a 7 month period. Formal and informal consultation occurred among community and health groups between meetings. The 68 recommendations included the need to: empower communities and diabetic patients; improve coordination and standardisation of care and the importance of the general practitioner in this process; improve access to care by removing transport, cultural and language barriers to care; subsidize preventative treatment costs; improve foot and eye services; improve monitoring of those with past diabetes in pregnancy or impaired glucose tolerance; improve detection of diabetes by increased high risk screening linked to ongoing diabetes care programmes. Implementation requires quality information systems and a cooperative partnership approach between hospital, general practitioner and the community, particularly local Maori and Pacific Islands communities.