Which patients with type 2 diabetes attend secondary care clinics?

The aim of this study was to investigate the reasons for patients with type 2 diabetes continuing to attend a specialist clinic with an active discharge policy. Clinic letters of 526 patients with type 2 diabetes who attended annual review over one year were audited to identify the major reasons for them remaining in the clinic. The majority of patients (97.3%) fulfilled current specialist clinic criteria for remaining in the clinic. Poor glycaemic control, nephropathy, ongoing changes to management and diabetes foot problems were common reasons found. In 9% of cases, patient choice was identified as a factor. For 2.7% of patients no clear reason could be identified. It was concluded that while most patients fulfilled the criteria to continue attending the clinic at that time, some patients chose to remain even though they were fit for discharge. The reasons why patients choose to remain under secondary care need to be investigated as they could guide how primary and secondary care should work together.