Diabetic clinic defaulters — who are they and why do they default?

Abstract

To investigate the problem of diabetic clinic defaulting, we studied patients who had lapsed from follow‐up for at least 12 months and were referred back during one calendar year. Of the 37 investigated in detail, sex distribution, age, diabetes duration, treatment and BMI were not significantly different from a control group of regular clinic attenders. However, defaulters had a higher HbA1 (10.0 ± 2.5% v 8.5 ± 2.0%, p <0.01) and more micro‐and macrovascular complications (20 v 11, p < 0.05). Most complications had not been present at the time of default from clinic (mean period of lapse was 26 ± 14 months). Reasons given for default included: overcrowded clinic; prolonged waiting; seeing different doctors; and not seeing the consultant often enough. Defaulting is thus a common problem and is associated with poor glycaemic control and increased complication rates. Better education and more “user‐friendly” clinics may reduce the problem. Copyright © 1992 John Wiley & Sons, Ltd.