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Since the introduction of the GMS contract in 2004, the quality and outcomes framework has supported significant improvements for diabetes care in the UK. Dr Jonathan Graffy—Senior Clinical Research Fellow at the University of Cambridge and GP—discusses the diabetes indicators; he explains the changes introduced in the 2009/10 indicators, including why new HbA_1c targets have been set at 7%, 8%, and 9% (previously 7.5% and 10%). He also notes the importance of patient involvement and suggests that potential new indicators should focus on engaging and educating patients and agreeing personalised care plans. Their inclusion should encourage GPs to help patients tackle their own, often complex, problems.

Healthcare professionals should also be alert to the possibility of depression in their patients with diabetes. According to Diabetes UK, people with diabetes are twice as likely to have depression compared with the general population, and many experience a significant loss in their quality of life as a result.¹ Diabetes UK has therefore welcomed the publication of guidance from NICE on the identification, treatment, and management of depression in adults who have a chronic health problem such as diabetes, heart disease, or cancer.² In this guideline various treatments are recommended, including individual or group-based cognitive behavioural therapy. Further details are available in the news section, and a member of the Guideline Development Group will review the recommendations in the January 2010 issue of Guidelines in Practice.

Julia Morris, Editor
julia.morris@mgp.ltd.uk G

References

1. Diabetes UK. www.diabetes.org.uk/About_us/News_Landing_Page/New-guidance-on-diabetes-and-depression/ (accessed 4 November 2009).
2. National Institute for Health and Clinical Excellence. Depression in adults with a chronic physical health problem: treatment and management. Clinical Guideline 91. London: NICE, 2009.