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Nurses less effective than GPs at patients' reviews

Rising levels of obesity could make it impossible for GPs to hit national targets for managing diabetes, research suggests.

Although monitoring and prescribing of oral anti-diabetic drugs has increased, glycaemic control has worsened since 1997, data from 74 general practices found.

The proportion of patients with type 2 diabetes whose HbA1c was below 6.5mmol/l fell from 28.7 per cent in 1997 to 22.5 per cent in 2001, according to the study, conducted at St George's Hospital Medical School and submitted for publication. The proportion with a BMI under 25 fell from 26.4 per cent in 1994 to 19.4 per cent in 2001.

Another new study, published in Diabetic Medicine (August), revealed mortality rates for diabetes have not improved in 20 years, despite huge changes in medication and management.

Dr Stephen DeWilde, lead-er of the St George's study and a GP in London, said: 'Unless the problem of weight management can be addressed it is unlikely that national management targets will be met.'

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