Ambulatory Medical Care for Elderly Diabetics: The Fredericia Survey of Diabetic and Fasting Hyperglycaemic Subjects aged 60-74 years

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Abstract
The use of services from the primary health care system and hospital outpatient clinics was studied in persons aged 60-74 years. We studied 228 persons with known diabetes (KD) (52 insulin treated, 101 OHA, 66 diet, 9 untreated) and 87 with fasting hyperglycaemia (FH) and compared with sex and age matched controls (223 CKD, 82 CFH). Information on all services provided by the primary health care system during the 12 months before ascertainment was obtained from local and national registers. FH did not receive more primary care services and did not visit outpatient clinics more than controls. Two to three times more KD than controls received all kinds of services from general practice or visited outpatient clinics. No difference was seen for specialists, except for dentists and otologists who provided fewer services to KD than to CKD. Of insulin treated KD 56% had greater than or equal to 10 contacts with physicians during the year, independent of residual beta-cell function. The corresponding proportions for OHA-treated and diet treated KD were 27% and 29%. Outpatient clinics were visited by 79% of insulin treated KD (88% with high and 65% with low C-peptide secretion), 26% of OHA-treated KD and 33% of diet-treated KD. The prevalence of ischaemic heart disease, hypertension, and microalbuminuria was not increased in the KD using most primary care services.