Housebound diabetic patients can also be forgotten

Editor—Benbow et al described the care of elderly diabetic patients in institutions, highlighting the inadequate provision of diabetic care.1 I believe that many of their comments could also be applied to housebound diabetic patients in the community.

In 1995 I surveyed the provision of diabetic care in my practice in Frinton on Sea, Essex. The practice had 6721 patients, of whom 19 diabetic patients were identified as being housebound—that is, unable to attend a diabetic clinic at the surgery. Of these, nine lived in their own home and 10 in institutions. Only three (16%) of the housebound diabetic group had had a documented diabetic review in the past year (two at home and one in a residential home). By comparison, 62% of a random 100 diabetic patients who could attend the surgery had had an annual review.

Elderly housebound or institutionalised diabetic patients are a high risk group and would benefit from being specifically targeted by the primary health care team.

British Geriatrics Society has produced document on diabetes care

Editor—Throughout Britain, information on the incidence of, provision of care for, and outcome of diabetes among elderly people living in residential and nursing homes has been generally scant and unfocused. Benbow et al's survey 1 complements our own research, in which we undertook objective assessments of cognitive and physical disability.2 In addition we ascertained the level of basic knowledge of diabetes among both staff and diabetic residents.2

Like Benbow et al, …