Objective: The purpose of this study was to identify problems encountered by primary care physicians in the care of patients with diabetes in order to develop appropriate education programs for physicians.
Methods: A random, stratified telephone survey of 832 physicians in Pennsylvania who listed their specialty as internal medicine, family practice, or general practice was conducted. The response rate was 73%.
Results: Following diet and weight control were by far the most common problems reported by physicians for patients with insulin-dependent and non-insulin-dependent diabetes mellitus. Although physicians reported that education regarding diet is discussed during office visits, fewer than 25% of the physicians routinely refer patients to a dietician or health educator. Maintaining glucose control and dealing with the complications of diabetes were the next most common problems for patients with insulin-dependent diabetes mellitus, while compliance issues were common problems for patients with non-insulin-dependent diabetes mellitus.
Conclusions: Efforts to improve the care of patients with diabetes need to recognize and address the problems identified by primary care physicians. Education programs for physicians should deal with attitudes as well as knowledge and should focus on problems such as diet, compliance, referrals to eye doctors, and methods to improve glucose control, such as the use of multiple injections.