Evidence-based early stage type 2 diabetes follow-up in Belgian primary care practices: Impact of multi-professional teams and care protocols.

AIM: The aim of this research is to explore the current early-stage diabetes mellitus type 2 care in Belgian general practices. This, to find out if the care is provided according to the proposed evidence-based national diabetes care guideline. Additionally, this research aims to detect which person and practice characteristics can be associated with a more evidence-based care provision. METHODS: People were included in the study if they were recently diagnosed with type 2 diabetes by the participating practice. Practice and person characteristics, and clinical parameter monitoring and lifestyle monitoring data were collected by using a questionnaire and a topic list. RESULTS: A total of 27 general practices participated and a total of 249 people were included through their patient records. People monitored in a practice according to a self-developed protocol were 5.5 times more likely to have a better clinical parameter follow-up. Larger practices (>2000 patients), follow-up by general practitioners and practice nurses together and according to self-developed protocols were associated with a significantly better lifestyle follow-up. CONCLUSION: Practices providing multidisciplinary diabetes care, in collaboration with practice nurses, and with diabetes care based on self-developed protocols achieved a more comprehensive follow-up.

Fainting and hemolysis during blood sampling in youngsters: prevalence study.

OBJECTIVE: To assess the incidence of fainting and hemolysis in taking blood samples from adolescents in a school setting. DESIGN: A cross-sectional school-based survey. All blood samples and data were collected during September and October 2005. SUBJECTS: A community sample of 869 youngsters attending third grade secondary education in 14 secondary schools in the Flemish province of Antwerp, Belgium (mean age: 17.3 years, +/-1.2 years). MEASUREMENTS: Fasting blood samples were obtained on-site for measurement of levels of glucose, high density lipoprotein cholesterol and triglycerides. The incidence of fainting and hemolysis was assessed. RESULTS: In 60% of the total sample a blood sample was taken, 15% refused. In the remaining 25%, taking a blood sample was not possible due to problems in drawing blood from the vein (4%) or not fasting (21%). The incidence of fainting was 2.5%. Hemolysis occurred in 2.4% of the blood samples. CONCLUSION: When taking blood samples in this age group, there seems to be a great willingness to participate. Precaution should be taken though when taking blood samples in youngsters. In this study, about 1 in 40 students fainted. When blood samples are taken on-site and transported to a laboratory, an incidence of hemolysis of 2.4% should be taken into account.