Introduction: According to guidelines, to predict early signs of micro-vascular complications in patients with diabetes, regular foot examination and perform regular investigations which include HbA1c, urea and electrolytes (U+Es), albumin-creatinine ratio (ACR) and lipid profile.
Methods: During February 2017, consecutive patient medical notes were collected from a weekly general diabetic clinic. Using the patient notes and clinical portal blood test results, it was noted whether patients had had an albumin-creatinine ratio, lipid profile or urea and electrolytes checked within the last year, a HbA1c result within the last 6 months and if a neurovascular foot examination had been recorded in the clinic notes (either examined in clinic or recorded as being done by their GP in the last year).
Results: The notes of 156 patients were analyzed. The number of females to males was 68:88, the age range 16 to 88 years of age and the mean age 50 years. An up-to-date HbA1c result was available for 97.3% of patients, with an average result of 73 mmol/mol. Within the last year, 82.1% of patients had a U+E result available, with 50.6% an ACR and 52.6% a lipid profile result checked. A foot examination was recorded as having been done within the last year in 41.7% of clinic entries.
Conclusion: The audit clearly highlighted the issues in our practice as compared with NICE guideline recommendations, especially with the feet examination and the ACR requesting. Therefore, cooperation between the primary and secondary care is essential in the annual diabetic assessment. And electronic record may be a future solution.