Prevalence and characteristics of diabetic patients with no ongoing care in South Auckland

OBJECTIVE - To describe the prevalence of default from diabetes care and to reveal associated characteristics among patients with known diabetes in urban South Auckland, New Zealand. RESEARCH DESIGN AND METHODS - We developed a cross-sectional household study of patients with known diabetes and compared those patients with and without ongoing care. Ongoing care was defined as having been clinically reviewed at least once in the previous 10 months. RESULTS - Of the 1,488 European, Maori, and Pacific Islander subjects with known diabetes, 107 (6.3%) had not seen a general practitioner or a diabetes service in the previous 10 months. Subjects not attending a diabetes service were more likely than subjects attending a diabetes service to have been diagnosed when screened asymptomatically (11.7 vs. 5.2%, P = 0.008) and after gestational diabetes (39.7 vs. 11.7%, P < 0.001). Maori were most likely to have no ongoing care (10.8 vs. 5.8% European and 6.6% of Pacific Islander subjects, P = 0.01). Nonattenders were younger, were diagnosed at a younger age, knew less about diabetes, were less satisfied with past care, and were less likely to require medication. CONCLUSIONS - The elevated number of diabetic individuals not attending ongoing care is a significant problem in this population, and it may reflect a decisional balance as seen in problem behaviors. Diagnosis when asymptomatic may contribute to default from ongoing care; in this case, caution is required if population-based screening programs are being considered.